Recognising that their work with the NHS would help to create the foundation of their work globally, Israeli company Healthy.io, employed a UK leader to run their global commercial operations. That UK leader was NIA Fellow, Katherine Ward. Here, Katherine shares her experiences and describes some of the challenges for international SMEs looking to engage with the NHS.

“I have described my job in selling to the NHS as feeling as if I am pushing several large rocks up a hill, and running between them to make sure that none of them slide gently down behind me. When people have responded, ‘oh, you mean like spinning plates?’, I have disagreed – spinning plates requires a gentle nudge to keep a momentum; this is solid work.“However, thanks to the NHS Innovation Accelerator (NIA), three of my rocks are now at the top of the hill, and on the cusp of moving rapidly. Two NHS and one private sector client signed up in the first quarter of 2018, and I expect two more NHS customers by June.

“It helps to have a credible product, and Healthy.io is the first company in the world to be CE accredited for using the smartphone camera as a clinical grade diagnostic device. We have a kit together with a chatbot on a smartphone app, which enable people to undertake a urine test at home with clinical grade accuracy.

“This enables self-management, reduction in face-to-face contacts, potential avoidance of admissions, promotion of prevention, and improvement in quality. All potentially compelling outcomes for the NHS, although interestingly one of our first deals – working with Salford Royal Foundation Trust – is also motivated by reducing pressure on car parking, improving estates utilisation, reducing pressure on workforce, and impacting waiting lists.

Filling the gaps: securing commercial expertise and knowledge of the UK’s healthcare system

“As an Israeli company, Healthy.io made an early decision to hire a UK leader experienced in healthcare to run their global commercial operations. This stemmed from a recognition that whilst they had incredible product management capabilities, highly patented computer vision engineers, cutting-edge technologists, and a founder with a vision for improving global healthcare through using the smartphone camera; they lacked commercial experience and deep domain healthcare knowledge, and had awareness of these gaps. They also understood that Israel was not a large enough market for them to scale from, nor geographically well positioned for global expansion.

“I was lucky enough to be that UK healthcare leader – having straddled the NHS itself (15 years from NHS management trainee to Director of a Primary Care Trust) and the private sector (11 years with Optum, part of UnitedHealth Group), I have a comprehensive understanding of NHS culture and process, in addition to global commercial experience from a Fortune 6 company.

A network of friends and colleagues to share the journey

“I realised early on that the NIA would not only give us a branding and recognition within the NHS which would open doors and make us easier for the NHS to do business with us, but that it would also provide me, as the first employee outside Tel Aviv, with a network of friends and colleagues with whom I could share the journey. The NIA also opened the doors of the Academic Health Science Networks (AHSNs) to us, who have been critical friends – helping with marketing materials, introductions and funding evaluations.

Challenges for international companies looking to engage with the NHS

“The three main challenges for international companies looking to engage with the NHS are, in my view:

  • Identifying the buyer: Companies believe the NHS to be a single government payer and that there will be a single decision-maker to enable adoption at scale. Unfortunately, this is almost never the case, and choosing to navigate between c200 CCGs, c350 NHS providers or c8,000 GPs is more likely to be the task in hand
  • Navigating the funding streams to make a compelling return on investment (ROI) case: So often the existing budget and the beneficiary of any savings that are made do not reflect the buyer of the product. Disentangling the financial incentives, despite a logical case for the benefit of the whole system, is incredibly tough
  • Implementation and delivery: Even when the deal is done, there is still risk that the product won’t fulfil its full potential unless there is rigorous project implementation – being prepared to invest in this is a key prerequisite to seeing success

“If companies are not part of the NIA, then ensuring that they employ leaders who have a robust understanding of the NHS and have credibility with the NHS, is very important. Finding local champions in key NHS organisations is also crucial – AHSNs are set up to help and there are a range of incubators, accelerators and digital networks set up to support you to succeed.

Laying the foundations and driving scale-up

Healthy.io raised $12M Series A funding round in mid-2017. We focused on the NHS to build our use cases and produce evidence of outcomes to give us credibility in international markets, and of course, to grow revenue. We are laying foundations in other parts of Europe, for example, the Dutch government and the National Kidney Foundation have sponsored a roll-out of screening for chronic kidney disease (CKD), and the US National Kidney Foundation and Geisinger are rolling out a study of CKD screening in people with hypertension, using our kit.“However, it is our work with the NHS that will create the foundation of our work globally. The acceleration that we have had through working with the NIA is helping to drive scale up – including staff recruitment – to help keep on pushing those rocks, and keep up with them as they start rolling…”