Beyond the pilot: designing health tech innovation to scale

The UK has a thriving health tech sector, with businesses developing solutions to some of health and care’s most pressing challenges. But developing a good product and proving that it works is only part of the journey. For many innovators, the much harder question is how to turn that early success into wider system adoption.

That was one of the issues we kept coming back to during our discussion on scaling innovation at the techUK Health and Care Summit on 8 October.

For SMEs especially, my view is that you need to think about scale from day one and before a pilot begins, not once it has succeeded.

Start with the route to adoption

Understandably, a lot of attention at the beginning of a pilot goes into demonstrating that the technology works and delivers the intended outcomes. But there is another question you need to explore at the same time and that is, if this works, who is actually going to buy it?

That means understanding where the budget might sit, who will make the decision and what evidence they will need. It is also worth asking whether the organisation you are piloting with is representative of the organisations you ultimately hope will adopt the product.

Without that thinking, you can end up with a very successful pilot that works brilliantly in one setting but is difficult to reproduce elsewhere.

The same applies to evidence. Agreeing what you want to measure and making sure you can access the right baseline data from the outset makes the conversation about value much easier further down the line.

Co-design, but think ahead

Working closely with NHS organisations can be hugely valuable. It gives SMEs a much better understanding of the problem and gives NHS teams an opportunity to explore what technology could make possible.

There is a distinction between working with a potential customer to understand a problem and getting so close to the development of a solution that it creates challenges when that organisation later needs to procure.

SMEs should be thinking about those boundaries early, rather than discovering them at the end of a successful pilot. Getting good legal advice early can help innovation move forward, rather than simply being something you do when there is a contract on the table.

Choose partnerships with the next opportunity in mind

For some SMEs, scaling will not mean going it alone.

Working with other innovators can bring complementary capabilities together, while a partnership with a larger organisation may offer an established route into the NHS. Both are good options, but the arrangement needs to work beyond the first opportunity.

Collaborating through shared heads of terms is an option. These do not necessarily need to become lengthy negotiations at the outset, if the principles are agreed.

Procurement has a part to play

Scaling innovation is not solely a challenge for suppliers. Buyers have an important role as well.

Good market engagement can help NHS organisations understand what industry and third-sector organisations can offer before deciding exactly what they want to procure.

Where possible, starting with the outcome that needs to be achieved, rather than defining the solution too narrowly, gives innovative approaches more room to emerge.

That matters particularly for smaller businesses. Procurement requirements that are out of proportion to the opportunity can make it unnecessarily difficult for SMEs to compete, even where their technology offers a strong solution.

From a successful pilot to sustainable adoption

These issues feel particularly relevant alongside techUK's From Analogue to Digital: How the UK Technology Sector Can Deliver the 10 Year Health Plan, which considers what is needed to support the move towards digital delivery across health and social care.

There is clearly a significant opportunity for healthtech innovators in that shift. But a successful pilot, on its own, will not be enough.

Before starting the next pilot, I would encourage an SME to ask a simple question:

If this works, who buys it, from what budget and how does it get implemented? It sounds obvious but most pilots still begin without an answer and then, everyone is surprised when good results end up sitting in an evaluation report.

Thinking about that at the beginning does not guarantee that an innovation will scale. But it gives a good innovation a much better chance of becoming something more than a good pilot.

Gayle Curry is a commercial health and health tech partner at Mills & Reeve. She advises health and care technology businesses on collaborations, pilots, commercial agreements and NHS procurement, helping innovators navigate the legal and commercial considerations of bringing solutions to market and scaling them. Listen to Gayle discuss NHS pilots from a tech supplier’s perspective in episode 12 of the Talking digital health podcast.