Working with the NHS - doors are opening for innovative small firms

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The health service is increasingly relying on small businesses to meet its needs. But how can entrepreneurs find a way in

As the fifth largest organisation in the world, the NHS can provide lucrative opportunities for small business. But from the outside, it’s often seen as an unwieldy, unnecessarily bureaucratic body that’s difficult to break into.

For Jason Williams, business development director at seeDATA, a partnership came about through an agreement with the local academic health science network (AHSN), which the company had worked with previously to build a bespoke customer relationship management platform.

“They came to us with the idea of developing a system that could be used in the south-west to help hospitals run patient safety improvement projects,” Williams says. “In working with them, we realised there was also a much wider need in other parts of the country as well. [We found] a gap in the market.”

The result, the Life QI System, allows NHS organisations – from hospitals to GP practices, AHSNs, clinical commissioning groups (CCGs) and other healthcare providers – to share findings and best practice. There are 310 groups now using the system, across 10 of the country’s 15 AHSNs, which were set up three years ago to enable healthcare innovation to be adopted quickly across the NHS.

Williams believes the scale of uptake would have been impossible for a small company to achieve on its own. The south-west AHSN made introductions, and promoted the platform in other parts of the country.

“It would be a mammoth task for us to go to 200 hospitals and set up a national procurement exercise,” says Williams. “You think of the NHS as one organisation, but actually it’s lots and lots of organisations, with lots of levels within it. Understanding the hierarchy, and how various parts of it work, can be difficult.”

Life QI’s success, Williams says, is due to the way the company worked with the NHS to identify and solve a problem it had. For other firms looking to make a move into the area, he advises doing “something relatively small that you can get off the ground, prove it works and grow it from there, rather than trying to solve world hunger all in one go”.

Identifying opportunities

Perhaps the more traditional route to working with the NHS has been through the tender process. The government spends £230bn on the public sector every year and has a target that 25% (pdf) of that goes to small businesses. It claims to be exceeding this at 27.1%, although only 10.9% is direct.

In 2011, in a bid to improve the chance of small businesses winning tenders to work with the public sector, the government launched Contracts Finder – a site for contracts of more than £10,000 with the government and its agencies in England. Scotland, Northern Ireland and Wales each have their own procurement websites. 

One firm with vast experience of the tender process is the public sector consultancy Prederi, which has worked with clinical commissioning groups and NHS foundation trusts. It’s a competitive environment, and managing director Stewart Johns says small businesses have to network to get advance notice of upcoming opportunities.

While small businesses can win tender bids, many will already be skewed towards the big firms by the time they reach procurement websites. Prederi’s team have had to become adept at spotting the signs. 

“We read the requirements very carefully,” says Johns. “Firstly [we look for] whether there’s an incumbent, which happens quite a lot, as they’re likely to get the tender again. There can be questions about the number of people they might want at any one time, and if the bid has to be in within a week that might make you think someone is in line for this already. It’s experience that tells you.”

To be in with a chance, he explains, entrepreneurs have to “be proactive, get out and talk to people, and explain why you’re the experts, you’re the people who can help, you’re the people who’ve done it before”.

Unlocking innovation

There is arguably a growing sense in the NHS that innovation needs to be embraced. In 2015, the NHS innovation accelerator (NIA) programme was launched by Sir Bruce Keogh, national medical director of the NHS commissioning board. One year on, 345 NHS providers and commissioners are using NIA innovations. Participants are given access to mentorship from high-profile experts, advice on procurement, marketing and economics, peer-to-peer support and access to a bursary of up to £30,000.

At the 2016 NHS conference, Keogh said: “The NHS should be ideally equipped for the uptake of new innovations, but it’s a nut that we’ve found really difficult to crack over the years. Through the NIA programme, we’ve been able to match entrepreneurial endeavour with need in the NHS… [and have] been able to show very real and tangible benefits for patients and rapid uptake of new innovations.” 

One such business is HealthUnlocked, co-founded by Matt Jameson Evans, an ex-orthopaedic surgeon. The company has developed a social network for health, providing peer-to-peer support and promoting self care. Its online forums are embedded into the NHS Choices website (under the community tab) and the recommendations platform HealthUnlocked Local is being piloted by South Devon and Torbay CCG and Dorset CCG to help doctors prescribe social solutions (referral to a community group, running club or charity for support, for example) where appropriate, rather than medication.

“We know that 70% of people have never met someone with the same medical condition [that they have] before,” Jameson Evans says. “We’re providing a bridge so that people can access a mentor through [what is] often quite a long journey through illness.”

HealthUnlocked is now the most visited social platform for patients in the world, attracting 5m visits a month across 600 communities. The model works, Jameson Evans says, because of the collaboration with patient organisations, which are experts in their fields and monitor the forums. While the majority of traffic currently comes from the UK, the company has recently opened an office in New York and is planning on taking the model there. 

Jameson Evans knew more than most about the NHS due to his background as a doctor, but says that in general working with the organisation can be complicated for entrepreneurs. “They’ve realised the barriers to entry for small businesses are incredibly hard in the NHS,” he says. “[But] I think the doors are opening. It’s a good time to be an SME that has solutions. No one’s saying it’s easy, but it’s a really good time.”

Source: Emma Sheppard - The Guardian

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