What Lenders Actually Look At Maintainable EBITDA, Not Headline Turnover
Lenders assess normalised earnings that strip out one-off items and non-recurring costs. A practice with a £900,000 turnover might have a maintainable EBITDA of £180,000 or £280,000, depending on associate structure and how the accounts are presented. That difference determines whether the loan works.
NHS Contract and UDA Delivery
Consistent delivery at or above the UDA target across two to three years is the baseline lenders want. Below-target delivery or a history of clawback needs a clear context. The UDA rate matters too — 4,000 UDAs at £32 is a materially different income picture from the same volume at £22.
Associate Dependency
Practices heavily reliant on the selling principal or a single associate without a clear retention plan carry transition risk. Lenders look at how many associates are in post, what their agreements look like, and what the clinical continuity plan is.
Structure the Funding Well
Separating acquisition funding from post-acquisition investment usually produces cleaner outcomes. Acquiring cleanly, establishing trading under new ownership, then funding refurbishment 3–6 months later — rather than trying to do everything at once — is usually the right sequence.
