In this month’s guest blog, we hear from Adam Lester-George, founder and Director of LeLan, a unique social enterprise established to help healthcare innovators navigate the NHS and public health systems in the UK. If you’ve ever wondered how to sell to the most difficult customer, then read on…

If you speak to a senior clinician anywhere in the world, it is almost certain that they will be familiar with at least one UK institution: It’s one of the largest employers on the planet and has generated some of the best-trained professionals, finest research, and strictest quality standards to be found anywhere; it represents the most comprehensive system of universal healthcare in the world; it makes 9 out of every 10 Brits proud; it has just celebrated its 70th birthday.

Three white letters emblazoned on a blue background, the NHS looms large in the national consciousness and on the international stage. An immovable granite monolith.

Or is it?

If (like most people) your main experience of the UK healthcare system is as an occasional patient, you probably hear the term “the NHS” and picture a massive national organisation, a single entity that controls the extensive network of GPs, hospitals, and other crucial healthcare services.

For companies aiming to sell a new healthcare product or service into the UK health sector, “the NHS” can look like a captive market, an obvious target for every plucky little SME with the next brilliant idea in MedTech. That revolutionary widget that she knows will improve patient outcomes while saving the beleaguered system buckets of much-needed cash: with an annual budget of £130bn, the NHS will surely buy it — it just makes sense!

Except, as the title of this blog suggests, the NHS does not actually exist.

Rather than being a single, centralised organisation, in reality the NHS is more like a brand name that is licensed to hundreds of different “franchisees”. These include 195 CCGs (Clinical Commissioning Groups), 236 Acute (hospital) trusts, 9 ambulance trusts, 6 Mental Health trusts, a range community health organisations, all funded through the Department of Health, each one semi-autonomous in its procurement decisions with minimal information-sharing between them — and that’s just in England!

Factor in Scotland, Wales, and Northern Ireland, and in total there are around a thousand individual organisations to which our Innovator can sell her new MedTech product.

So, the UK healthcare landscape is vast but entirely Balkanised; how, then, can she actually successfully sell her widget to one organisation, let alone the wider Imaginary marketplace that is “the NHS”?

While it is fully possible to navigate such complexities alone, there are different pathways that SMEs and solo innovators can follow. The following list is not exhaustive but it does represent the gradient of options available to our hypothetical Innovator— from the lowest to the greatest level of support:

  1. Individual procurers: she can directly approach NHS commissioning bodies (CCGs) one at a time with her product pitch — this is the most common tactic but also the most frequently unsuccessful. Procurers will expect to see evidence of the product’s efficacy, safety, and cost-effectiveness, usually from a formal clinical study. If she is able to successfully have her widget commissioned, she will likely need to repeat the entire process with the next CCG, and the next, etc.
  2. Innovation funding programmes: there are a range of competitive grants and loans available to help innovators develop, test and/or evaluate their products in an NHS setting. These include UKRI, SBRI, Nesta, NIHR i4i, ITT, ITP, NIA… the list goes on. Each of these organisations periodically launches challenges on specific topic areas and successful applicants often secure access to support and insights unavailable elsewhere.
  3. Academic Health Science Networks: another scheme (part-)funded through the NHS, there are 15 regional AHSNs across England (and similar organisations in the devolved nations) with the remit to support the adoption and spread of new innovations into the NHS. They have dedicated teams ready to provide free assistance with identifying funding, providing mentoring, advising on commercialisation, and establishing partners with critical NHS stakeholders.
  4. Private consultancies: there is a range of business analysis consultants who specialise in healthcare innovation and can help directly in identifying and completing funding applications, accessing their NHS networks and advising on best practice.

So, there is a range of ways to promote a new healthcare product to the NHS but, ultimately, the first step must be to realise one critical thing: there is no NHS.