NR entrepreneur: “We never set out to ‘crack the NHS’, we set out to help people. Start with that”
Entrepreneur Ian Pearce shares the lessons he learned on the journey to establishing his innovation, Neuro ProActive, within the NHS.
My journey for the last six years has been interesting. After my father had a stroke, I experienced a lot of the frustrations that hundreds of thousands of people do each year.
It seemed to me that while many of these challenges needed basic solutions, those challenges were numerous and long standing.
In late 2017, while having a shower, I started to think about a single digital platform which would be all encompassing for NHS and private practice clinicians, as well as patients and family members.
Most of my best ideas happen in the bathroom. It’s the only place where men can multi-task and escape young children.
For any potential supplier to want to “crack” the NHS, I’d make two points. Firstly, this is the wrong mindset. The NHS doesn’t want to be “cracked”.
Secondly, it’s a huge mistake to see the NHS as one organisation. It’s also important to appreciate that the views in this article are my own, based on my experiences over a five-year period.
They are not the views of the NR Times. I only mention this because some people (not clinicians or patients) consider me as arrogant… but that’s only because I’m better looking than they are.
The neurorehabilitation community is sometimes its own worst enemy. It operates in silos arranged by condition as opposed to delivery of therapy.
When you look at the economic cost to the UK of the six most prevalent neurological conditions, it is estimated to be £74bn (billion with a ‘B’).
That makes addressing the needs of patients and families not just the right thing to do, it’s also the smart thing to do.
So, a bond trader wanders into the field of neuroscience having failed his first aid exam at the age of 14; and he didn’t have a technology background either. Perfect for the field of health tech, then.
Technology delivers the most value when it does simple things well. I’ve seen first hand financial institutions with poor/non-compliant infrastructure and it’s miserable for all concerned.
One of our patient consultants who had a stroke eight years ago is currently trying to get an appointment with an orthotist. It’s not clear to me how artificial intelligence can help her.
What’s needed is actual intelligence in the form of resource and connectivity to that resource. You’ll meet a lot of ‘experts’ on your journey.
You’ll know they’re experts because they’ll tell you they’re experts. Genuine experts don’t need to tell anyone they’re experts. That’s what makes them experts.
If anyone tells you they’re an ‘innovation expert’ they probably have a degree in Hungarian basket weaving.
I have been fortunate enough to self-fund Neuro ProActive, partnered with some of the most selfless and dedicated people I have ever met.
But remember, I worked in investment banking. The bar was very low. I don’t work for NHS England, the NIHR, NICE, an NHS trust or Central Government.
I get to talk with clinical teams and patient groups, hear their frustrations and opinions and shout them from the rooftop while building something real. In short, I can do and say what I want. And I do.
People have been trying to copy Neuro ProActive for years. They’ve made a dog’s dinner of it. Frankly, it’s been highly amusing to watch. We never set out to “crack the NHS”. We set out to help people. Start with that.
Neuro ProActive is the top-rated platform for neurological conditions and, thanks to the Department for International Trade, has attracted a lot of interest from overseas.
Ireland, Turkey, Brazil, Qatar, Saudi Arabia, Singapore… if your innovation is relevant to one country, it’s probably relevant to others.
Guy’s and St Thomas’ in London is one of several NHS institutions that Ian believes helped to shape his enterprise.
“There’s no such thing as the NHS”
Every NHS Trust has its own chief exec, and finance and technology departments. There are approximately 219 NHS trusts. That’s a lot of ground to cover.
When deciding which trusts to approach, focus on those with a reputation for excellence in the field your innovation is geared towards. Other trusts will pay close attention.
The National Hospital for Neurology and Neuro Surgery, Queen Square, was a brilliant partner for us as we developed Neuro ProActive.
It’s where the initial idea for Neuro ProActive evolved. Over the following year, other centres of excellence also contributed which allowed us to build consensus.
For anything in digital health, ORCHA is pivotal. ORCHA independently reviews digital platforms in healthcare and is now utilised by over 90 per cent of NHS trusts when deciding which are safe and secure.
You can learn more about ORCHA and their work here.
Going round in circles? Stop!
NHS England has a million ‘sign posting’ services. Some will send you to one group only for them to send you back to where you came from.
I dread to think how many brilliant innovations have been lost in the ether over the years. In my opinion, the best example for a group which adds very little value is the AHSN (Academic Health Science Network).
There are 15 of these split regionally all over the UK and very few of their staff have clinical or lived experience.
“What goes on tour, stays on tour”, said one AHSN after recommending an expensive but useless conference in Germany.
Innovators can waste tens of thousands of much needed capital on conferences and exhibitions. Equally, I don’t see why the AHSN should be afforded taxpayer funds for ‘jollys’ here, there and everywhere.
Despite NHS England making substantial cuts recently, there’s obviously more that can be done at a time when NHS trusts are running deficits. Get the clinical teams on board.
That should be your number one objective.
Address the need
For every innovation that’s signposted into middle earth never to be seen again, there’s a company or individual that’s invented a shiny widget with no clinical need.
There is no quick fix or shortcut to developing a good innovation.
It has to be done from the ground up involving clinical teams, patients and, where suitable, family members.
Families are frequently forgotten. In neuro-rehab, family members are included in NICE Guidelines. You have to be prepared to spend months, even years, consulting with your end user base.
Listen and try to develop a consensus among them. Understand from the outset that your own opinions in the product development stage are irrelevant.
No “clients” or “customers”
Treat your relationships as partnerships. We can justifiably say that UCLH, Guy’s & St Thomas’, NHS Wales and Leeds Children’s Hospital have contributed to Neuro ProActive’s development.
How many companies/products can say the same? Understand that from the outset you will have to offer your product or service for free in the NHS.
A trust, CCB or ICS will not support a procurement without clinical efficacy evidence or, at the very least, senior clinical support.
This takes time to achieve. Any research study needs to be truly independent to be considered valid. The ‘hard sell’ is a massive channel changer for the NHS.
US companies, in particular, fall flat on their face here (assuming they respect data protection legislation, which they rarely do).
What worked in Minneapolis won’t cut the mustard in Manchester. Many companies look at the NHS with $$$ signs in their eyes.
The NHS spends an eye watering amount on healthcare software. Neuro ProActive possesses a suite of functionality which is expanding.
Why would the NHS procure a piece of software that only delivers video calling for three times the cost? Deliver value in the form of improved patient outcomes or clinical team efficiencies. Ideally both.
Opening doors: The NHS does not want to be ‘cracked’, says Ian Pearce. “We set out to help people. Start with that.”
Adapt
It’s almost guaranteed that version 1.0 of your innovation will be on v 1.5 in 12 months time. This is because no matter how much consultation you carry out with your end user base, they won’t know for sure what they want until they use it.
Embrace this fact and see it for what it is; a huge help, not a hinderance.
We’re about to embark on v3.0 of Neuro ProActive and already thinking about v4.0, v5.0…Development is perpetual.
As one of my old bosses told me, “the thing about technology is that it never ends”. This is true, although John’s solution was to never start.
“It’s Dragon’s Den”
Except, it isn’t. Both UKRI and the NIHR have funding schemes where a team of ‘experts’ will decide if you’re worthy of government funds.
Frequently, the feedback on applications is absolute tosh and demonstrates a lack of even a basic understanding of the problem your innovation is addressing.
I’m still perplexed as to why NIHR members wear “I am NIHR” badges. That’s just bad grammar. They need a thesaurus.
And if they don’t know what that is, get yourselves a dictionary and work forwards. If you’re applying for funding schemes, be highly selective.
It’s easy to waste days on these applications only to receive the kind of feedback which would be offensive to my four-year-old daughter.
In neuro-rehab, the NIHR is particularly good at articulating and listing decade old problems without delivering solutions. What is the point of research if it doesn’t change the landscape?
It’s (not) all academic
The academic research community can be utterly savage towards each other and anyone else they deem inferior.
I’ve heard one senior professor refer to a senior clinician and team as “Guardian readers”.
That clinician and their team are world renowned. This professor is not. I read the Guardian too, by the way.
I had a meeting with that same professor and their university’s ‘venture capital’ group. The main issue was that their VC department had no capital.
As someone who worked in the City of London for 20 years, I found this an… interesting… approach. I suggest you read the Financial Times, professor.
Some of my comments on academics might seem harsh. There are some superb academics and we’ve worked with many of them and read their published papers.
However a particular low point came last year. In a keynote presentation on innovation at a neuro-rehab seminar, one academic, an ‘innovation expert’, was presenting on innovation in the NHS and then proceeded to spend the following 40 mins inducing snoring among the attendees with an overview of research grant schemes.
They ended their presentation with, “how to achieve mass adoption in the NHS”, recounting no examples of why innovations fail.
The sum total of innovations by this individual that have achieved mass NHS adoption? Zero. The professor then went on to recommend two technologies, neither of which had an ORCHA Baseline Review score.
It then emerged that they were a shareholder in one of these technologies. Credibility is everything.
In summary
Forty per cent of the people reading this will be in full agreement. Forty per cent will have found it helpful and will think on the points raised. Then there’s the other 20 per cent. And they’re furious. I wouldn’t have it any other way. Good luck.
