Private Equity in the UK Animal Companion Veterinary Sector

My first article in this two-part series provided a high-level summary of Private Equity (PE) and Venture Capital (VC). This article looks at their involvement in the UK veterinary sector.

The UK veterinary sector was a rich tapestry of independently owned practices deeply rooted in their local communities for a long time. Today, 60% of the market belongs to just six companies, known as “The Big Six”: IVC, CVS, Medivet, Pets at Home, Linnaeus, and VetPartners.?

What is the history of PE and VC involvement in the UK veterinary sector?

How have key regulatory changes and the rise of corporate groups shaped the current market?

What are the pros and cons, and what do we need to know about the ongoing Competition and Markets Authority (CMA) investigation?

Let’s look.

Why 1999 changed the veterinary sector

In the UK, the Royal College of Veterinary Surgeons (RCVS) regulates the veterinary profession per?The Veterinary Surgeons Act 1966?(legislation requiring much-needed modernisation!).

Until 1999, this legislation required veterinary practices to be owned by qualified and licensed veterinary surgeons. The purpose of this was to protect clinical autonomy – i.e. the right of a vet to make independent decisions based on their expertise, knowledge, and judgement, free from external pressures – as well as the ethics of the veterinary profession.

The doors opened to a seismic shift when the UK government introduced the Competition Act 1998, legislation that was seen as a harmonisation with European competition policy.

While the Competition Act 1998 doesn’t directly mention the veterinary sector, it prohibits anti-competitive or restrictive actions that might stop people from entering any market.

This came as many independent veterinary practices faced financial and operational challenges, especially due to the growing demand for advanced treatments and technologies.

In 1999, the RCVS allowed non-vets to own practices. One perspective is that they hoped to foster competition, attract investment, and encourage innovation, especially in larger, multi-branch practices. [Update 20.01.25, via Barry Johnson] Others argue that the decision was imposed on the RCVS by the Department of Trade due to the aforementioned Competition Act 1998.

Many believed increased competition would lead to better services and potentially lower costs for pet carers.

Reactions within the veterinary community

Reactions within the veterinary community to this rule change appear to have been mixed and evolved over time.

Initially, many veterinary professionals welcomed the potential for investment and modernisation. There was optimism about the benefits of corporate ownership, such as improved employee benefits, training opportunities, further education, and access to new graduate schemes. These advantages continue to be seen today.

Some believed that better treatments, technological advances, and the sharing of experience and resources would improve their patients' overall quality of care.

Others were concerned about the risks of prioritising profit over animal welfare and human wellbeing, rising fees, and the erosion of the vet's clinical independence and the pet carer's clinical choice.

These concerns persist today, as evidenced by numerous articles discussing the impact of corporate takeovers on veterinary practices.?For instance, articles like “Rising vet fees leave pet owners facing tough choices” or “Uncovering the Impact of Corporate Takeovers on Veterinary Practices: A Closer Look at Rising Fees and Animal Welfare” highlight issues such as reduced clinical autonomy and increased pressure to upsell services.

Corporate ownership may have brought efficiencies and advancements while concurrently reducing clinical independence and the prioritisation of animal welfare over profits.

The rise of corporate-owned veterinary practices (1999 to today)

Since 1999, PE firms have been drawn to the UK veterinary sector for several reasons.

More and more of us share our lives with animal companions and are prepared to spend money on their care (stats suggest that spending on domestic animal companions has increased by 76% over the past five years alone).

This means that veterinary practices tend to be financially resilient, even in times of economic downturn, such as the COVID pandemic.

People are willing to pay – often out-of-pocket rather than through insurance – for their furry or feathered family members to receive veterinary care.

The rise of corporate-owned veterinary practices gained momentum in the early 2000s, with companies like Companion Care and Vets4Pets leading the charge through franchise models.

By the mid-2010s, corporate consolidation had accelerated as PE and VC firms recognised the sector's profitability and began acquiring practices at a staggering pace.

As mentioned above, the UK veterinary sector is today dominated by several large corporate groups, primarily “The Big Six.”

In March 2024, these six groups reportedly collectively owned 2,869 of Britain’s 4,920 veterinary practices.

This consolidation has prompted the Competition and Markets Authority (CMA) to launch a major investigation into the sector. The CMA cites multiple concerns about market concentration and competition (more below).

So, who are the big six?

1. IVC Evidensia

Founded in 2011, this group – now the biggest of the big six – began life as Independent Vet Care. It quickly became Europe’s fastest-growing veterinary group and launched offshoots such as a Graduate Academy and the My Family Vets website.

In 2017, IVC merged with Evidensia, a successful veterinary group operating in Norway, Finland, Denmark, Germany, the Netherlands, and Switzerland. Two years later, the company formally launched its new IVC Evidensia brand and acquired the UK Vets Now group.

In 2023, IVC Evidensia built its first purpose-built, multi-disciplinary referral hospital in Longbridge, Birmingham.

On its website, the group says that its name and branding will sometimes be visible in its veterinary practices, but other times, a local brand will be more visible.

IVC Evidensia is owned by EQT Partners (a Swedish private equity firm) and Silver Lake (a global investment firm). The group now has a network of clinics, hospitals, and out-of-hour centres in 20 different countries and employs approximately 41,000 staff. In 2022, it is reported as generating ￡1.2 billion in revenue.

EQT’s portfolio includes companies in the healthcare, real estate, social, energy, technology, and insurance sectors (for example, it also owns ManyPets, one of the UK’s leading pet insurance providers).

2.CVS Group Plc

Founded in 1999 and incorporated in 2007,?CVS Group Plc?has become one of the largest integrated veterinary service providers in the UK and Europe. The company operates a range of veterinary practices, referral hospitals, laboratories, and pet crematoria, and its services extend to small animal, equine, and farmed animal practices.

CVS now has over 500 practices (many offering multiple services) across the UK and Australia where it continues to focus on growth. CVS used to own practices in Ireland and The Netherlands but has since sold them to focus on growth in Australia (thanks to Nis Peter Lorentzen for flagging this after I published this article.)

In addition to its veterinary services, CVS Group has diversified its portfolio by launching complementary businesses. These include Animed Direct, an online pharmacy offering prescription medicines, supplements, and pet care products, and MiPet Cover, its own pet insurance brand.

The company employs more than 8,800 people, including over 1,600 veterinary surgeons.

As a UK-based publicly listed company, the CVS Group’s shares are listed on the Stock Exchange. In 2022, CVS reported revenues of ￡554 million.

Most of CVS's practices operate under local branding but tap into integrated systems and resources to ensure consistency across its network.

3. Medivet

Medivet began as a single independent veterinary practice in Hendon, London, in 1987. Over the years, the company has expanded its network through acquisitions and partnerships to become one of the UK’s largest veterinary groups. It now operates over 500 practices across the UK, Spain, Germany, and France and is supported by twenty-seven 24-hour veterinary centres.

The Medivet model?was and continues to be one of partnership. Practice partners co-own their clinics alongside Medivet. This arrangement ostensibly aims to help vets retain their local and clinical autonomy while giving them centralised support.

Medivet has been through significant growth and changes since a private equity firm, CVC Capital Partners, acquired a majority interest in the company in 2021 – a deal reportedly worth more than ￡1 billion. CVC Capital Partners has a global investment portfolio featuring over 130 companies in various sectors, including the farmed animal industry.

Currently, Medivet employs over 5,000 staff, including 1,500 veterinary professionals. Its offerings span veterinary care, advanced diagnostics, surgery, and specialist treatments. The group also operates a 24-hour emergency care network.

4. Pets at Home

Pets at Home Plc was founded in 1991 by Anthony Preston as a pet supplies retail store in Chester. Since then, it has expanded to become a leading UK retailer specialising in pet supplies, services, and veterinary care.

When the RCVS rule change allowed non-vets to enter the veterinary sector in 1999, Pets at Home diversified into veterinary services by establishing Companion Care in-store veterinary clinics.

In 2013, Pets at Home acquired?Vets4Pets, a standalone veterinary group, further expanding its veterinary portfolio. The combined Companion Care and Vets4Pets network now operates approximately?440 veterinary practices, many of which are located within Pets at Home shops.

Like Medivet, the group offers a joint venture model, enabling veterinary professionals to co-own and run their practices with the support of Pets at Home’s extensive infrastructure and resources.

Pets at Home emphasises a holistic approach to caring for domestic animal companions. The group offers services such as grooming, nutrition advice, and veterinary care under one roof. It has also launched its own brands of pet food and products, including Wainwright's and AVA.

In 2014, Pets at Home became a publicly listed company on the London Stock Exchange. As of 2023, the company employs over 16,000 people.

Pets at Home reported revenues of over ￡1.4 billion in its most recent financial year, demonstrating the success of its integrated pet care model.

5. Linnaeus Group

Founded in 2014, Linnaeus Group focuses more on advanced referral services. The group operates over 180 practices in the UK and Ireland and 17 multi-disciplinary referral centres.

In 2018, Linnaeus Group was acquired from Sovereign Capital by Mars Veterinary Health, a division of Mars, Inc., which also owns international veterinary brands such as Banfield Pet Hospital and VCA in the United States. This acquisition has provided Linnaeus with significant resources and opportunities for collaboration within a global network of veterinary professionals.

Notably, Mars, Inc’s global brands include PEDIGREE?, WHISKAS?, ROYAL CANIN?, and WISDOM PANEL?.

Currently, Linnaeus employs more than 6,750 associates, 2,107 nursing staff, and 1,457 veterinary surgeons.

Although Linnaeus Group operates under its central name, its practices often retain their original branding while benefiting from the support and resources of the wider group.

6. VetPartners

VetPartners was founded in October 2015 by Jo Malone, a qualified veterinarian from Glasgow University. The company began with three practices, including Minster Vets in York, where Malone was a partner. Under her leadership, VetPartners experienced rapid growth, expanding to over 350 small animal, equine, and farmed animal practices by 2018.

In November 2018, BC Partners, through its fund BCEC X, acquired a majority stake in VetPartners, valuing the company at approximately ￡720 million.

Despite this acquisition, Jo Malone continued as CEO. VetPartners expanded its operations within the UK and internationally. It now operates nearly 500 sites, including veterinary nursing schools, laboratories, pet crematoria, and veterinary practices across the UK and EU.

VetPartners employs more than 10,000 people and, in 2022, was ranked the UK’s number one company for senior leadership (it was the only healthcare/veterinary provider to make the list).

Since its inception, BC Partners has made 124 investments in 18 countries, with a total enterprise value of over €161 billion. Its portfolio includes companies in the food, services and industrials, healthcare, technology, media, and telecommunications (TMT) sectors.

The role of Private Equity and Venture Capital in the veterinary sector today

With such rapid growth and wealth to invest, it’s little surprise that PE and VC firms have played a pivotal role in reshaping the veterinary sector as they have done in many other sectors (see my last article for more on this).

Key strategies employed by these firms include:

• Consolidation: Acquiring multiple practices to benefit from economies of scale.
• Standardisation: Implementing procedures, services, and consistent pricing models across multiple clinics.
• Operational efficiency: Streamlining administrative functions, reducing overheads, providing ongoing training, and sharing best practices.
• Investment: Developing innovative technologies and equipment.
• Diversification: Investing in related facilities such as diagnostic laboratories, referral centres, out-of-hours suppliers, crematoriums, pharmacies, locum agencies, and veterinary nursing schools to provide a “one-stop-shop” service.

By employing these strategies, corporate veterinary groups can provide a wide range of general and specialist services and treatments, ostensibly giving pet carers more choices.

While these changes have introduced efficiencies, they’re also increasingly sparking criticism. Concerns include:

• Rising costs: Many pet carers report higher fees at corporate-owned practices. With just six companies dominating the UK’s veterinary market, there are increasing concerns about prices being driven up without competition, lack of choice, pressures to upsell, and the disparity between prices in the UK compared to Europe.
• Lack of choice: For some pet carers (often location dependent), there is a lack of choice about seeing an independent vet or sourcing a second opinion.
• Reduced autonomy: Veterinary professionals may feel constrained by profit-driven policies and having to meet key performance indicators. Decision-making often needs to follow set protocols, and there may be preferred drugs or treatments within the group.
• Staff turnover: High workloads and limited decision-making power contribute to burnout among vets. There has been some public condemnation of low wages paid to support and administrative staff.
• Lack of transparency: Pet carers may not realise that they’re being upsold products owned by the same group as the veterinary practice. Can they trust food or insurance recommendations, for example, if the corporate owners stand to profit from the recommendation?

Similarly, there may be a lack of transparency about whether a practice is part of a large multi-national group or independent.

In December 2023, Which? reported its concerns about a lack of transparency around veterinary fees – 36% of pet carers report only learning the price of an agreed treatment after their appointment.

The CMA Investigation: Addressing Industry Concerns

In 2023, the UK’s Competition and Markets Authority (CMA) launched an investigation into the veterinary sector. The current timeline for the investigation suggests that the final report will be published in November 2025.

In September 2024, the CMA announced the appointment of its veterinary?advisory panel.?The panel consists of two veterinary nurses and four veterinary surgeons. It is intended to provide the Inquiry Group with clinical and practical insight and analysis on an ad hoc basis throughout the investigation.

Key concerns driving this investigation include:

• Market concentration: The dominance of a few large groups raises questions about competition and consumer choice.
• Price transparency: Pet carers often struggle to understand or compare costs for veterinary services. Also, some vet practices make up to a quarter of their income selling medicines – so there may be little incentive to inform pet carers of alternatives.
• Impact on independents: The growing power of corporate groups threatens the survival of independent practices and may be causing the anti-competitive market that opening the sector was meant to prevent. That said, anecdotal evidence suggests that there has been a significant uptick in the opening of new primary care and referral veterinary practices in recent times, with many more on the way. When well-executed, these practices seem to ‘hit the ground running’, being busy from very early on, capitalising on a backdrop of anti-corporate sentiment and the CMA investigation.
• Concerns about regulation:?Nobody in the UK is currently responsible for regulating veterinary practices. The RCVS continues to regulate veterinary surgeons, but this organisation has no meaningful authority over the practices in which they work. The RCVS wishes to address this situation, but legislation must change.

We await the CMA’s findings' impact on the future regulatory landscape of the UK veterinary sector.

Conclusion

The rapid transformation of the UK veterinary sector over the past twenty-five years highlights the profound impact of private equity and venture capital. While corporate ownership has introduced efficiencies and investment, it has also raised valid concerns about cost, competition, animal wellbeing, preserving veterinary ethics, and human care.

Currently, animal rescue centres throughout the UK are full, with increased abandonment of animal companions, including some of the many adopted during the COVID-19 lockdown, rising vet bills and the cost-of-living crisis. While veterinary practices need to make a profit to operate, there are concerns that corporate-owned practices are enjoying “profits in excess of those expected in a competitive market”.?

As the CMA investigation unfolds, the sector faces a critical juncture. Policymakers, professionals, and investors must work together to balance business needs, animal welfare, and human wellbeing.

This could include increased regulation, pricing transparency and clinical autonomy guidelines, more significant support for independent practices (such as grants, training programmes, and partnerships), and ongoing research and monitoring of the impact of corporate ownership on the veterinary sector.

The sector must evolve in a way that benefits animals, their human carers, veterinary teams and business owners in a balanced way.

What About Outside of the UK?

This article focuses on the UK and predominantly the animal companion sector. However, it is worth noting that corporate involvement in the North American veterinary sector predated that in the UK. Groups like Banfield Pet Hospital (owned by Mars Inc.) and National Veterinary Associates (backed by JAB Investors) dominate the market.

As described above, many of the UK’s “Big Six” also have interests across Europe and elsewhere. Australia, Singapore, Hong Kong, China and India are other areas of interest.

Notably, corporate-owned veterinary groups emerged in the USA and UK in mature, well-established veterinary sectors. More recently, corporate groups have entered markets where veterinary services are often at an earlier stage of development and where there is considerable variation regarding the cultural/societal role of ‘domesticated’ fellow animals, pet carer affluence, pet insurance availability and affordability, and more.