9 July 2026

CASE STUDY: £75m Healthcare Group Where The Board Hired Interim, Then Realised Why

An interim CFO is the right first move when a board is unsure what the role actually needs. In this case, the interim's real value was not steadying the ship. It was telling the board what kind of permanent CFO to hire, and why the one they thought they wanted would have failed.

This is an anonymised account of a £75m revenue healthcare group, private equity backed, roughly two years into a buy and build. Details have been changed to protect the parties. The pattern is common.

What was the situation the board faced?

The group had grown by acquiring four smaller clinical services businesses. Revenue had tripled in three years. The founder era finance director, competent and loyal, had run finance since the first turnover was under £20m.

He resigned. The timing was awkward. A refinancing was six months out, and the integration of the most recent acquisition was only half done.

The instinct in the boardroom was to replace like for like, fast. Find a permanent CFO, get them in, keep the refinancing on track. The chair, sensibly, paused that instinct.

The group did not actually know what it needed. It knew it had a hole. Those are different things.

Why did the board hire an interim instead?

The operating partner made the call to bring in an interim CFO for six months rather than rush a permanent search.

The reasoning was disciplined. A permanent hire made under time pressure, before a refinancing, into a business the board did not fully understand financially, is a high risk hire. If it goes wrong, you are unwinding it twelve months later, at cost, with the refinancing already behind you.

An interim carried far less downside. The engagement could run for the period that mattered, deliver the refinancing, and buy the board time to define the permanent brief properly.

The interim they placed had done three healthcare transactions and two refinancings. He started within a fortnight.

What did the interim actually find?

Within six weeks the interim had told the board three things they did not want to hear.

First, the numbers were not as clean as the board believed. Each acquired business still ran on its own chart of accounts. Group consolidation was a manual spreadsheet exercise done by one person. The monthly board pack was accurate only because that person worked late.

Second, working capital was the real story, not EBITDA. In healthcare, the timing of NHS and insurer receipts against clinical staff payroll drives cash. The old FD had managed this by feel. Nobody else understood it.

Third, and most important, the role the board had been about to recruit was the wrong role.

Why was the board about to hire the wrong CFO?

The board had drafted a brief for a transaction focused CFO. Deal experience, City polish, someone to lead the next phase of buy and build.

The interim's assessment was blunt. The group did not need a dealmaker next. It needed someone who could build finance infrastructure inside a growing clinical business. Systems, consolidation, a proper FP&A function, a controller layer that did not depend on one heroic individual.

A pure transaction CFO would have found the operational grind beneath them and left within eighteen months. The board would have paid twice.

This is the quiet value of an interim. They have no stake in the permanent role, so they tell the truth about it. A candidate interviewing for the permanent job would never say the brief was wrong.

What did the board do next?

The board rewrote the brief. They defined a CFO with genuine operational and systems experience in a regulated, multi site business, who also understood transactions but did not live for them.

We ran that search. The successful candidate was a former group financial controller who had grown into a CFO in a healthcare services business of similar shape. Less deal glamour, far more relevant scar tissue.

The interim stayed on for a two month handover, then left cleanly. The refinancing completed on time. The consolidation project he had scoped was already running when the permanent CFO walked in, which is the smoothest possible start.

If you are weighing interim against permanent, or defining a brief you are not certain about, this is exactly the conversation we have with boards at Harper May.

What is the lesson for boards and PE operating partners?

The lesson is not that interim is better than permanent. It is that interim and permanent solve different problems, and confusing them is expensive.

Use an interim when the brief is genuinely uncertain, when there is a defined event to deliver, or when a fast permanent hire would carry real downside if it went wrong.

Use the interim period to learn what the permanent role actually is. A good interim leaves you with a clearer brief than the one you started with. That clarity is worth as much as the work they deliver.

And write the permanent brief around the next twenty four months of the business, not the last CFO's job description. The finance leader who fits your current reality is often not the one your instinct reaches for. You can see the kind of leaders we place on our current mandates.

Common questions

How long should an interim CFO engagement run? Long enough to deliver the defined event and to hand over cleanly, typically three to nine months. If it drifts past a year with no permanent search underway, the board has usually avoided a decision rather than made one.

Should the interim be considered for the permanent role? Occasionally, but be careful. A brilliant interim is not automatically the right permanent CFO, and their independence, the thing that made them useful, weakens the moment they want the job.

When is a permanent CFO the right first move? When the brief is clear, the business is stable, and you know precisely what the next phase demands. In that case, going straight to permanent search saves time and money.

Hiring for a role like this?

We place CFOs, FDs, FCs and Heads of FP&A across London and the UK. Send us the brief and we will come back the same working day.

Tell us about your vacancy

Read next

Work with Harper May

Three ways to put this to use.

Hiring a finance leader?

Send us the brief. We reply the same working day with a view on the market and how we would run the search.

Tell us about your vacancy

Want the fortnightly brief?

Market reads, pay data and live roles, for the people who hire finance leaders. No fluff.

Subscribe free →

Scoping a finance role?

Use our finance leader scorecard to pin down the remit, the must-haves and the pay range before you start.

Build your scorecard →