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The three elements of post-merger integration

If I asked you what makes workforce integrations challenging, how many different answers would I get? Well, to make it easier, I have identified three key elements that all HR teams should consider before, during and after a large integration.   


It all starts with philosophy and within that the commitment you make to the consumer. As a healthcare provider, our commitment is to deliver outstanding care. Circle Health and BMI Healthcare spent considerable time and resources developing their own distinct approach to this.  

We brought together the best from each and relaunched our philosophy. Eight principles were chosen and used as the guide for how our people work.  

Let’s pause and consider why this is important. Integrations are fiendishly difficult. If you align the values of the workforce around mutually agreed upon principles, it makes bridging that gap faster and more successful.  

But how does two become one? Well, we spoke to staff and doctors about what mattered to them. Organisations tend to embark without remembering something important. Objectives are not met unless staff feel ownership over their philosophy.  

So, we moved forward knowing what had worked, what our people brought to us, and, critically, what mattered to them. 

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Culture is the behaviours and beliefs of every employee. It’s organic and, since our integration, we’ve found that the culture has evolved to be progressively stronger and embedded. 

In this context, the challenge becomes making theoretically constructed values correspond to actions, approaches and behaviours.   

Additionally, BMI and Circle had effective cultures, sharing commitment to quality and patient safety. However, one prioritised speed and delivery, while the other focused on efficiency at scale. Creating a culture from this was a tough nut to crack and disastrous should it go wrong.  

The solution was simple and itself a lesson to organisations facing this challenge. We built the principles of “selflessness” and “compassion” into everything. From administration to operating theatres, staff were equipped with a set of values for each other and patients.  

To embed this, board members visited hospitals across the group. The UK-wide roadshow prioritised spending hours talking and guiding teams through the philosophy and culture.  

I am a believer in visible and approachable leadership. When establishing a culture, leaders need to be accessible to ensure the principles and approaches are successfully established. 


Ways of working

The proof is in the pudding; there’s only value if there are results. 

Success means longevity. The work must remain relevant in changing markets. Our integration story is an example of this. The staff and consultant survey has now become annual. Thousands of staff filled out the survey this year and in hundreds of teams the results were meticulously discussed.  

Each outcome became part of a business target. Culturally, our 'stop the line' operating system has empowered staff to voice concerns and own success. This approach must be at the heart of any business looking to succeed today.  

The work is hard, but the results speak for themselves: significantly outperforming on recruitment and retention at a time of global staffing challenges, increased engagement rates in our annual staff survey, and ranked as a top employer in the country post integration in national awards.  Most importantly, a dramatic increase in the quality of patient care - a 30% increase in hospital ratings. 

Integrations are a challenge, but the art is understanding what makes you and your people unique. It’s then about making people integral in decision making. It sustains through building belief and ownership. It’s successful when you build an organisation that pushes the boundaries of possibility.  


David Cooper is chief people officer at Circle Health Group