Operose Health

Fast Facts

  • icon £118m turnover
  • icon 70 locations across UK
  • icon Employ 1,500+ health care professionals
  • icon 97% of services rated as good or outstanding by the CQC

Operose Health is the UK’s largest provider of primary care services, operating practices with more than 640,000 patients. It is Operose Health’s purpose to deliver great primary care by improving access, outcomes and patient experience.

Their people, operating models, growth ambition and values led culture means that they can offer a unique level of support to each practice and service that we run.

Operose Health are committed to being lifelong partners to their patients and the NHS. It is their ambition to be the first primary care provider to support one million patients.

Twenty20 Capital Support

With primary care such a crucial part of the NHS, we recognised Operose Health’s model was one which could increase access for communities while providing safe services and affordability for the taxpayer and the NHS.

On acquisition, the business had key challenges recruiting permanent clinical staff, ensuring consistent models of care were operating across the entire business and developing one united culture.

We supported the management team and broader workforce to develop and implement a plan which has improved staffing within practices, reduced agency spend allowing investment in permanent staff, and consequently improved patient access.

We also supported a wider business review, empowering the business to focus on its core product: providing primary care services.

The changes are already having an impact: the business now operates within a more commercially sound framework, while communities and commissioners are benefiting from continually improving services.

Medacs Global Group


Medacs Global Group is a leading global healthcare workforce solutions provider providing a range of services, including staffing, managed services, staff bank, occupational health, workforce consulting, social care and homecare through their specialist brands; Medacs Healthcare, Global Medics and Litmus Workforce Solutions.

With an enviable reputation for providing high-quality locum, temporary and permanent doctors, nurses, allied health professionals, clinical assessors and care workers, they are the largest provider of locum doctors to the NHS, and the largest supplier of specialist healthcare managed services outside of the United States.

With operations across the United Kingdom, Ireland, the Middle East, India, Australia and New Zealand, the Medacs Global Group ensure the delivery of outstanding care wherever clients are in the world.

Medacs Group is formed of Medacs Healthcare, Litmus and Global Medics.


Twenty20 Capital Support

As the world of work keeps changing, we recognised the exciting opportunities Medacs Group presented. With shared ambitions for the future, we resonated with a team that prioritised partnership, innovation and service excellence.

The acquisition represented a significant milestone. Joining forces allows space for growth and to build on the heritage of some of the most well-known and well-respected healthcare brands in the staffing and workforce solutions sector.


As a specialist healthcare agency, with vast expertise across a range of medical professions, CRG supports public and private organisations. In 2021, CRG merged with HCL Workforce Solutions, with its clinical services arm being acquired by Polaris Medical.

Sugarman Group

Fast Facts

  • icon £20M+ Annual Turnover
  • icon 174 Employees

Sugarman Group is a London-based recruitment agency specialising in sourcing outstanding staff for outstanding organisations. With over 23 years of experience within the sector, the Sugarman team are on a mission to fill every role with passionate and purpose-driven people.

As specialists in the healthcare recruitment sector, Twenty20 Capital saw the Sugarman Group as a complementary fit for the HCRG family of brands. With shared values and a healthy market stake, the acquisition bolsters Twenty20’s position in the ​​health and social care service sector.

In 2021 the Education division of Sugarman Group was hived across to a fellow subsidiary of HCRG; Affinity Workforce Solutions.

We are delighted to have joined an established, successful and respected group of industry-leading brands which have been made successful by the expertise and dedicated support of Twenty20 Capital. Our combined strength, knowledge, sector presence and technological prowess will provide us with the opportunity to drive our business forward.
Luke Harper, Sugarman Business Director

Allied Healthcare

Allied Healthcare began life in 1972 as a one-branch home nursing service in Staffordshire. Allied provided basic personal care, through to more intensive support, for individuals with learning disabilities, autism and issues around mental health.


Twenty20 Capital Support

We acquired Allied Healthcare in 2018 when it was on the brink of financial collapse. Following a swift turnaround, considerable investment in people, and a programme of order-book protection we stabilised Allied’s ability to service clients.

We later merged Allied with an existing homecare brand; increasing its CQC rating and quality, whilst growing the overall group profitability. As a result, the two brands grew to become one of the top five home care businesses in the UK with revenues of £75m.

The business was later sold to Ceracare.


Investment Focus
  • Financial stability
  • Management team nurturing
  • Organisational restructuring
  • Operational consolidation
  • Corporate governance
  • Cash control support
"After acquiring Allied Healthcare, we worked closely with the management team and were quickly able to return the business to breakeven trading. We successfully raised the CQC rating, assisted the leadership team in full operational transformation and revived what is now a truly thriving business".
Ian Munro, founder at HCRG

HCRG Workforce Solutions

Fast Facts

  • icon 72% organic increase in turnover over the last 3 years
  • icon Over 3x organic increase in EBITDA over last 3 years

HCRG Workforce Solutions is an amalgamation of a number of well-known brands, including but not limited to HCL, Sugarman and CRG.

They provide a range of services, from fully outsourced staffing solutions and staff bank management services to outsourced healthcare, including but not limited to complex care, mental health services and occupational health.

As experts in large-scale workforce deployment both at domestic and overseas, HCRG has an impressive track record of managing far-reaching international campaigns across various sectors, offering bespoke solutions to distinct needs and challenges whilst improving spending efficiency without compromising patient care.


Twenty20 Capital Support

As part of our investment strategy, we supported the management team through a transformational journey, challenging strategic and operational decisions to create a highly attractive, scaled and profitable brand.

Multiple complementary mergers created radical movement in the business’s turnover and allowed us to build one of the UK’s biggest and most recognised health and social care solutions providers.

“Through the support of Twenty20 Capital, and their undoubted passion for the healthcare sector, we have been able to stabilise these businesses, drive significant growth across all arms, increased profitability and market share whilst delivering sustainable solutions aligned to our clients’ needs and objectives. This deal allowed us to proudly continue supporting the UK health service and local community and a vast number of service users”.
Gary Taylor, CEO , HCRG Workforce Solutions

Medicare First

Medicare First is an established specialist locum social work recruiter; partnering with local authorities, private organisations and charities throughout the UK. Set up in response to a growing shortage of skilled professionals, they now maintain an enviable reputation for high standards, professional partnership and a personalised approach to recruitment.

Engaged in a wide variety of specialist areas they offer immediate employment opportunities across the country; constantly meeting expectations and delivering unsurpassed, tailored solutions for clients and candidates.


Team24 is a nationwide healthcare agency providing flexible temporary and permanent staff in medical environments. From doctors and nurse practitioners to nurses and carers, their dedicated team work closely with both NHS and private clients, working hard to match the best candidates with the right jobs.

As part of our commitment to offering leading services to the health and social care community, we merged Team24 with HCL Workforce Solutions in 2021.

HCRG Care Group

Fast Facts

  • icon £280M turnover
  • icon Serve 500 locations across England
  • icon Employ 5,000+ health and social care professionals
  • icon 2% of their workforce are apprentices

HCRG Care Group is one of the UK’s leading independent providers of community health and care services, supporting communities of many millions across England. Their innovative approach ensures they lead the way when it comes to transforming care.

With a focus on experience, efficiency and improved outcomes HCRG Care Group works with commissioners and communities to deliver and transform adult and children community health, public health and well-being services, including sexual health and 0-19 services, offender care and police custody services, primary care, urgent care, dermatology, MSK and social care.

Twenty20 Capital Support

We were excited by the prospect of supporting this recognised care brand, continuing its strong legacy and market position whilst providing outstanding service to customers. Complimenting our already established portfolio of healthcare brands, it further enhanced the value we could contribute to health and care commissioners.

On acquisition, the business had key challenges in achieving target staff numbers within critical health and care services, exacerbated by external market forces. Our expertise allowed us to renew the focus on employee value proposition, recruitment and retention and provide a more commercially sound structure and framework, in turn supporting the recovery and improvement of front-line services.

We supported the management team, and broader workforce, by streamlining the support teams and reinvesting in essential services with a ‘healthcare first’ approach. Since collaborating and strengthening operations, the business has more than doubled its profitability.

As part of our commitment to further transform the brand, in 2022, we acquired a medical services business, which specialises in providing staff to prison custody clients and compliments HCRG Care Group’s exceptional offering.

“Twenty20 Capital has presented us with the opportunity to continue changing lives by transforming health and care. They are aligned to our ethics and values and fully support us in delivering high-quality, purposeful services.”
Patrick Birchall, Managing Director of HCRG Care Group