November 05, 2018
How startup-driven innovation could be optimised in the NHS
By: Niamh McKenna

Barely a day goes by without someone saying that “innovation” is the solution to deliver healthcare to an increasingly demanding population. Startups have the benefit of microscope-like, uncompromising focus on a single problem, unimpeded by other challenges except insofar as they interface with the primary challenge. Indeed, Accenture is living this ethos, through a new partnership with PUBLIC. Our goal with the partnership is simple: to collaborate with an aim to bring to market new startup technologies that will enable the Government to deliver smarter, more-efficient public services.

But startups need an environment in which to flourish. Sadly, I think their passion and energy is not being harnessed optimally at all. One problem that causes big issues is burn rate (the rate at which expenses like salaries etc pile up in a small, cash-strapped business). However, startups tell us that to sell a product into the NHS typically takes 12-18 months, partly due to the fact that the health service is so complex that they can end up having conversations with a myriad of people who can’t actually buy anything from them. It’s a real risk when you’re a small company with a few people—not understanding who holds the purse strings.

It’s a shame, because startups can bring a passion and drive and a laser-sharp focus to solving a problem. And they are not being pulled by the millions of other responsibilities that can often face executives in our National Health System. Startups will often think in ways and apply solutions that aren’t shackled by established ways of doing things. So, our startup founder has the room to think laterally and, under the right conditions, can be set loose on a problem like a top-rated scientist wielding an electron microscope.

This unfettered thinking should be a massive boon to the UK health ecosystem. But how often do things stick at a pilot stage? As one startup founder said when asked for advice on how to break into the UK health system: “The NHS stamp of approval opens doors all over the world, but it’s very difficult and time-consuming. The ‘valley of death’ [the period of time companies suffer after initial capital has run out, but revenues have yet to flow] is well before the NHS can approve new services or technologies so many of these companies will never make it to seriously pitch.” Frankly it’s not easy to be a startup working with the NHS. The NHS is not short of incubators and bursaries—but these need to be more structured to help startups to do more than help it get off the ground. They need to build traction, especially through the move from pilot to scaling up, which will give them the cash lifeblood they need.

Startups need to engage with the appropriate NHS leaders, or they can end up spending a lot of time “selling” to people who aren’t empowered to make buying decisions. They need support from senior NHS champions as well as patients and clinicians.

The NHS also needs to be clear about what can be fixed locally vs. centrally. It can help startups get access to the data and services they need to be successful—so providing open APIs and then allowing the market to solve the problem (i.e. patient power!).

Startups have the ability to deliver transformational solutions if properly nurtured and protected from some of the red tape that is endemic to the NHS. Their potential to act with microscope-like focus and efficiency and plug into open platforms for broad-based benefit should be leveraged.

In short, startups need access to the right NHS buyers, leaders and clinicians. They need engagement with patients, and access to critical data systems that allow them to problem solve effectively. Most critical of all, they need quick engagement and decision making from those NHS leaders to see them through the valley of death.

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