Custodial Healthcare - M&A and Private Equity in the UK

Market Overview

The UK custodial healthcare market, covering healthcare delivery in police custody suites, prisons and other secure environments, has developed rapidly in recent years. Increasing outsourcing by police forces and the NHS has driven demand for independent providers capable of delivering high-quality, compliant care in complex and tightly regulated settings.

Scale & Commissioning Landscape

Across England and Wales, police forces spend around £21 million annually commissioning healthcare for detainees in custody suites, although recent contract awards indicate this figure is now rising. NHS England separately funds healthcare for over 80,000 prisoners across 118 prisons, covering primary care, mental health, and substance misuse services. Modern contracts increasingly favour nurse and paramedic-led models, supported by forensic medical examiners (FMEs) on an on-call basis - a structure that improves responsiveness and strengthens clinical governance.

Custodial Healthcare Private Equity and M&A Activity

Private equity has been an important driver of consolidation. Literacy Capital’s investment in RCI Group (Mountain Healthcare) in 2018 created a leading forensic and custodial healthcare platform, expanded through acquisitions such as Prometheus Safe & Secure, adding secure patient transport and observation services. Ethos Partners’ investment in PHL Group has enabled the business to scale its police custody healthcare operations alongside its urgent and elective care services.

The market has also seen repositioning among established operators. HCRG Care Group, which previously acquired CRG Medical Services, has since disposed of the business and its custodial healthcare operations to 4Merit, a new entrant led by an experienced management team from major outsourcing firms. The transaction marked a notable shift, with 4Merit emerging as a credible, clinically focused platform positioned for further growth.

Key Market Participants

Practice Plus Group remains the UK’s largest independent provider focused purely on healthcare delivery within prisons and detention settings, supporting around 41,000 patients across more than 45 sites. Mitie Care & Custody is also a major player, combining large-scale justice and immigration contracts with a healthcare component through its forensic medical services arm.

Outlook for Investors

With specialist operators gaining scale and outsourcing set to continue, custodial healthcare remains a niche but expanding segment of the UK healthcare services market.