Accessing the NHS for health tech SMEs

By Zoe Bedford

There’s no money.  The market is prone to political interference.  There are sudden and often unclear changes in the balance of power.  The customer frequently doesn’t know what they want or why, and the sector is subject to intense scrutiny by media and a powerful anti-privacy lobby.

This is a hard market.

On the other hand, the sustainability of not just the NHS but most of the developed world’s health economies lies, in part, on health tech.  And that is quite some burning platform.  All of us with new ideas, new businesses, new ways of doing old things have an important role to play here. Without these, we are not going to disrupt patterns and models of care that have remained unchanged in over 60 years.

Speaking at the Digital Health Festival last week, this was my plea to the room of entrepreneurs and start-ups: your contribution is essential to the sustainability of the greatest healthcare system in the world.  Keep this firmly in mind at all times, because this is a hard gig. For those intrepid enough to enter this market, there are four points to bear in mind when trying to get that all important first contract.

1. Take time to understand your market and identify the right customer

This sounds crass and patronising, but this is overwhelmingly the most common mistake we see: people wasting their time on the central bodies.

The NHS isn’t a single entity with a single procurement function.  It has many heads and many hands and it is labyrinthine in its complexity.

It would be unusual if NHS England purchased your product on behalf of hospitals or clinical commission groups – this is not their responsibility.   Their job is to create and stimulate the market by putting in the levers, standards and incentives to encourage local health organisations to look at what the market has to offer.

There are grants, funds, frameworks and initiatives a-plenty, including Tech Fund, The Prime Minister’s Challenge and Test Beds.  There is no shortage of opportunity, but the trick is working out which one is your best bet, which is why we recommend getting yourself an NHS navigator. Someone who knows what’s what, what the policy landscape is like, where the next shift or opportunity is likely to be, and what’s really going on when NHS England is seemingly at odds with its own policy and issuing conflicting guidance.

2. Focus on the right relationships

There is no wholesale route to market, so you will need to start at the front line and work your way through the system.  Find the individuals who really understand you and your product.

Chemistry, trust and a shared goal will overcome most procurement hurdles. Focus on building one or two really strong relationships, not 20.

Develop those relationships so that they are at all levels within an organisation and you become part of their team. Be wary of those who don’t get it, and don’t be lured into thinking that they will if you just spend a bit more time with them.

We have a rule that if after the third meeting you’ve not seen much change in either the scope of the discussion or the people attending those meetings, then bow out gracefully as it’s unlikely to go anywhere.

3. Get an advisory board, a clinical champion and/or a patient advocate 

Advisory boards are all too often mishandled and misused, but that’s another story for another time.  When assembled correctly and then used appropriately, an advisory board can give you credibility that is often hard to find in a company or product’s early development.  A member can be one of your biggest advocates at important forums and conferences.

A clinical champion is also an essential. A shared experience with your customer base means you can understand their pain points that you are seeking to cure, and be able to communicate that back to your customers as well as to your own team and developers.

4. Look at others not as competition, but as co-conspirators.

At a dinner last week, a wisened medical director mooted that digital health will never be the answer until the underlying care models are changed. Some of these models have been in place for decades, and it’s going to take more than a lone voice to change that, and so we must always remind ourselves that we, as a group, will always be a greater force than I.

Go find successful companies and ask them what they did.  Learn from them and their mistakes. They need you as much as the NHS does because the more of us who are out there talking to GPs, patients, consultants, nurse practitioners, carers, managers the sooner we can normalise technology’s role in the delivery and management of care.  Most business leaders in this space are in it for the right reasons and will therefore welcome other healthcare and tech enthusiasts.  I never cease to be surprised by how generous people are in their time and the candour with which they share their experience.

Don’t fool yourself that there is an easy route to market.  However it’s not all doom and gloom and at ZPB we have many examples of small companies who have been able to successfully introduce their health tech innovations to the NHS.  Following these principles: understanding the market, building relationships, convening an advisory board and collaborating with others is the right place to start.

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