TFS Healthcare: the pursuit of excellence
Ambition, determination and unwavering self-belief are just some of the traits that TFS Healthcare founder and CEO Ben Cambage has demonstrated leading up to his recent management buyout of the business. We explore what the future holds with Cambage as the sole leader of this growth-oriented business.
Founded in 2010, TFS Healthcare is one of the largest healthcare recruitment agencies in the UK. It specialises in making temporary and permanent placements of nurses and other healthcare professionals into the NHS and the private healthcare market.
Until 2021, the group consisted of five operating businesses: TFS Healthcare, Aspect Healthcare, Soleus People, CareBridge and Complete Life. Spring 2021 heralded a new era in its history as the group split into two operating groups. Aspect, Soleus and TFS Healthcare remained operating as a recruitment group. The second group, Innovate Care Group, was launched with existing businesses Carebridge and Complete Life and combined with a new business, Innovate Complex Care. With the group split into two distinctive disciplines, as a whole it will be able to lead two markets.
How do you shape a market-leading company?
Ben Cambage, one of the four founders of TFS, started his career in IT recruitment at a young age and enjoyed success, but he left that market just after the 2008 Global Financial Crisis:
“I used to recruit IT staff into the finance sector amongst others, including investment banking clients. I decided to leave that market in 2008 after the banking crash. I had the idea of setting up my own business quite early on in my career and after working in the financial sector I was determined to make this a reality,” said Cambage.
Cambage was successful in his own right as a recruiter and had gained career experience after weathering the financial crisis. It certainly helped his decision making when it came to setting up a business:
“Healthcare stood out to me. After my experience of the banking crash and recession that followed I looked for a sector where the demand for staff would remain high regardless of what was going on in the world. Healthcare was and continues to be an incredibly resilient and rewarding sector.”
Ben approached Andrew Yetzes and his two business partners with a vision to create a recruitment business to serve the healthcare industry to the extent it deserves.
“Healthcare stood out to me. After my experience in the banking crash and recession that followed I looked for a sector where the demand for staff would remain high regardless of what was going on in the world. Healthcare was and continues to be an incredibly resilient and rewarding sector.”
For the first few years of the business, Cambage drove the strategy of the company. The team focused on permanent placements in the private sector. “We were focusing on private rather than public healthcare and became the market leader in placing nurses permanently into the private hospital sector. We were building our reputation and brand to allow us to get on the NHS framework. This was our main goal as a newly found business.”
This was crucial for TFS’ success in its early years, as being on the NHS frameworks and providing temporary and flexible staffing solutions to the NHS to cover its staff shortages is essential in building a healthcare recruitment business.
Thanks to Cambage's meticulous planning and measured approach to hiring, TFS continued to grow organically:
“I was 22 at the time of setting up TFS and I was determined to hire young and hungry recruiters who were also right at the start of their careers. I wanted to focus heavily on training and development and bring the IT recruitment style to the healthcare sector. It was important that those I hired didn’t carry too many preconceptions or habits when working at TFS.
I was 22 at the time of setting up TFS and I was determined to hire young and hungry recruiters who were also right at the start of their careers. I wanted to focus heavily on training and development and bring the IT recruitment style to the healthcare sector.
The desire to grow, succeed and achieve
Due to his success as a recruiter, Cambage could have taken the slightly easier route of working for a larger recruitment business. With this came stability, a good salary and a clear future. However, Cambage wanted to stay true to his decision of creating his own business rather than working for someone else:
“When I looked at it, to me, it didn’t feel right that I was working for someone else. I made the decision to start my own business within the first year of my recruitment career and I wanted to stay true to myself. When it got to the stage where I was about to embark with TFS, I had multiple offers on the table which were far more financially beneficial than starting my own business. It wasn’t an easy decision from that perspective, but it was something I knew I wanted to do.”
Cambage epitomised the mentality of many entrepreneurs and was cognizant of the sacrifices he would need to make to ensure his business succeeded:
“For the first two or three years, I remember vividly paying myself a lot less than the staff members I was employing. But, those that have been in the business long enough - some of which are now running other businesses within the group - managed to see first-hand what it takes to grow a successful business and hopefully they have taken that with them on their careers too.”
The businesses that Cambage refers to are those in the wider TFS group, like Soleus People and Aspect Healthcare. The managing directors are all former employees, but Cambage made sure that each business holds its own identity, yet still maintaining that culture and values seen across the group.
How has culture enabled growth?
Cambage has an infectious and driven personality that promotes excellence throughout his business. TFS is a market leader for a reason and this could be down to Cambage’s approach and culture:
“It’s very much a business that is centred on its staff. Huge amounts of training and development go into the staff and that's something that we've always put a lot of emphasis on. When it has come to development, we tend to train internally. So the majority of our directors and managers have been promoted from within.”
Cambage believes that a solid culture is particularly important in the recruitment sector:
“The vast majority of recruiters will be on a percentage commission structure. Most will think the business takes the remaining commission and are less mindful of the costs to run a business. Ultimately this means that you have to be a person and a business that your employees want to work for. It’s also important to instil a mentality that encourages employees to work for themselves and the wider business. The moment you stop being that person and stop being that business that people want to work for, then I think you lose that culture. When you lose that culture, I think it's very hard to get back.”
Indeed, Cambage is also one to lead from the front to drive the business forward:
“I would never expect anyone to do something I haven’t done myself.”
This mentality is pivotal to the accomplishments of TFS. Cambage believes that the whole company is accountable for the application and practice of this culture:
“I can recall many businesses who have had similar growth projections as us but didn’t sustain it because they lost sight of their core values that got them there in the first place. That’s something I try not to lose track of myself. I make sure it’s instilled right the way down through to the directors and management.”
I can recall many businesses who have had similar growth projections as us but didn’t sustain it because they lost sight of their core values that got them there in the first place. That’s something I try not to lose track of myself. I make sure it’s instilled right the way down through to the directors and management.
A parting of ways: a new beginning
In 2017, Cambage and Andrew Yetzes performed a management buyout with the two other owners of TFS. After this, Cambage was in the position to approach a financial partner to support the next buyout.
Cambage and co-owner Yetzes had an excellent first decade, but in 2020 the partnership was heading to a natural juncture:
“Andy and I were at different stages of our career. We have an excellent relationship, but it was at a point where I was looking to kick on into the next 10 years of the business with new ambitious plans. Andy had reached a natural conclusion with the business and was open to stepping away. I was ready to acquire 100% of the business to drive it forward. I wasn’t just buying the other half of the TFS business, but I was also buying 100% of all the future businesses that I’d be setting up.”
“We went out and approached eight different banks. Investec included. The conversation with Gregg and Lyle from the Investec team was very different. It was a refreshing approach, as they covered off the term loan and set out how they would work with me, the future relationship and what came with that. I very much felt that Investec’s approach was the best match for my growth plans and ambitions. Investec demonstrated that they were keen to back me personally as a business owner as well. So we see each other as partners and both parties can now get excited about the investments and acquisitions we potentially have in the pipeline.”
Investec provided a private capital facility to enable the management buyout. To further support the business’ cash flow requirements, Investec provided an invoice financing facility as well.
"It feels like we’re in a strong position now and we’re very happy to be a constant provider of staff for the NHS. We’re also beginning to identify the gaps in our offering and looking at the opportunities to plug those. Eventually, we should be able to go to an NHS trust and cover absolutely any need they may have."
Cambage certainly isn’t the type of business owner to let a good opportunity pass by. With clarity over the ownership established, Cambage strode into the future with well-set plans in place.
“There are huge opportunities within this market. For me, I’m looking forward to trying something new - acquisitions. So bringing established businesses into the group and seeing what value we can add. It feels like we’re in a strong position now and we’re very happy to be a constant provider of staff for the NHS. We’re also beginning to identify the gaps in our offering and looking at the opportunities to plug those. Eventually, we should be able to go to an NHS trust and cover absolutely any need they may have.”
It’s true Cambage’s objective to create a national care group is ambitious, but certainly achievable with his approach. In January 2021, he brought in Andrea Kinkade as group CEO of the recently launched Innovate Care Group. Kinkade’s track record in the sector is well established and together they have ambitious plans for this group through organic growth and acquisitions. By dividing the group into two separate entities with one side focusing on recruitment and the other side focusing on care, they are very well placed for an exciting future.
The acquisition growth plan was one of the main motivators for Cambage to partner with Investec. He is looking forward to partnering with them on an ongoing basis to help establish his businesses as market leaders in recruitment as well as care.
It's abundantly clear that Cambage is not just a successful business owner but also an enabler for staff to develop and grow. He has a track record of building businesses and that mentality has rubbed off on the rest of his team. With Cambage in pole position, we can certainly expect another era of prosperity for TFS Healthcare and its associated businesses.
The view from Investec
Investec's Gregg Pietersen gives his take on the partnership: "We are of course absolutely delighted to be partnering with Ben as he builds out his vision. We took the view that we were backing a strong in-sector entrepreneur and saw not only his vision of what he hopes to create but also that if we provided the right structure we could enable it. Together we worked well with Ben and his team to design and implement the right structure enabling us to not only to be aligned but we are firmly committed to working with Ben and his executive team to enable his vision.”
Investec's Lyle Ammon added: "Establishing strong partnerships is fundamental to what we do at Investec. We focus on dynamic business builders and Ben is exactly that. Our combination of term funding and invoice discounting allows Ben to achieve his strategic goals not only now but in the future. We needed to deliver a structure that was right for Ben's business plans, because we wanted the facility to evolve with every acquisition made, giving Ben the confidence and freedom to evolve and fund expansion."