Shareholders of Altrincham-based healthcare real estate investment trust Assura have voted to accept a roughly £1.8 billion cash and shares takeover offer from UK-listed rival Primary Health Properties (PHP), defeating an all-cash offer from private equity firms KKR and Stonepeak Partners.

Nonetheless, the UK’s Competition and Markets Authority (CMA) has already issued an initial enforcement order on a PHP-Assura transaction while it examines the potential deal.

Primary Health Properties declared its revised offer for Assura as unconditional, effectively taking “significant” control of the major NHS landlord.

On Tuesday afternoon, PHP had received valid acceptances for its offer amounting to 2.05 billion Assura shares, representing 62.9% of the issued share capital of Assura.

The CMA has said it is considering whether “it is or may be the case that this transaction, if carried into effect, will result in the creation of a relevant merger situation under the merger provisions of the Enterprise Act 2002 and, if so, whether the creation of that situation may be expected to result in a substantial lessening of competition within any market or markets in the United Kingdom for goods or services.”