Entrepreneurs can make the NHS better

Overly long sales cycles, inappropriate frameworks, onerous processes and unhelpful procurement departments. The feedback from attendees at the NHS Commissioning Board’s “Entrepreneurs Day”, on the trials of selling to the NHS, painted a picture of the customer from hell.

‘My phone is always ringing from hospitals internationally but never a hospital in England’

Yet last week, 50 entrepreneurs, mainly small and medium-sized enterprises, from most areas of the country came to London to an event hosted by the NHS Commissioning Board, in order to help the board understand how it can help private sector companies work with the service to improve outcomes.

National director of patients and information Tim Kelsey articulated a very clear vision: “Transparency and participation mean the NHS needs innovation and partnership with for-profit and not-for-profit entrepreneurs.”

As well as Mr Kelsey, two of its the board’s key directors, Beverley Bryant and John Coulthard, were in attendance. Both pledged to do all they can to reverse the situation: “We have a year to change this,” said Mr Kelsey.

Nurture innovation

Ms Bryant articulated the problem as being twofold: 

• procurement rules make SME entry difficult if not prohibitive; and
• the private and voluntary sectors do not have access to the right people to understand the agenda and rules of engagement.

She explained the Cabinet Office is working on the former, while Mr Kelsey has charged her and her team with solving the latter. 

A former entrepreneur, Mr Kelsey outlined a number of ways in which he will nurture innovation in the private sector. He set up the information company Dr Foster in 2000, in which he no longer holds any shares.

He said he was reviewing some of those frameworks and his team are in talks with Leeds city council about opening up redundant NHS office space to become a “tech hub” for budding businessmen and women. “Economic growth will be a fundamental way of measuring success,” he told the group.

The first part of the meeting consisted of what Ms Bryant described as a “cathartic free for all”; an opportunity for attendees to vent their anger at what’s gone before.

Saying no to ideas

One participant lamented the lack of proactivity from the NHS: “My phone is always ringing from hospitals internationally but it’s never been a hospital in England.” 

‘Many organisations have been burnt by partnerships with the private sector that didn’t work out’

Another experience that struck a familiar chord with attendees was of NHS trusts saying no to an idea, on the basis that either “it’s been done before” or “it’s not been done before”.

Technology companies expressed frustration with IT directors who didn’t understand their products blocking sales because their ideas didn’t fit in with their five-year plans − even when clinicians recognised their products’ value.

One of the many clinicians in the room called for more support for doctors with great ideas to bring them to fruition. It was agreed there was a general suspicion within the NHS of medics considering making a profit out of an idea, however modest.

This was acknowledged as a major obstacle to start-ups, but one that was changing with the younger generation of doctors. NHS managers are equally frustrated that they cannot always procure the solution or the supplier they’d prefer.

Test and learn

However, the conversation was generally positive and helpful, with people sharing thoughts and ways to meet customers, such as implementing “test and learn” projects, not contracts, or finding the right person in the organisation to talk to rather than bombarding the CEO. 

Ms Bryant accepted the NHS needs some help accepting things are different: “Many organisations have been burnt by partnerships with the private sector that didn’t work out,” she said.

‘Entrepreneurs want to continue to work with the NHS and sell their products and services to it’

Academic health science networks caused confusion. Some saw them as the answer, but some thought they were a distraction − another dead end serving only to divert time and resources. All agreed the name was misleading and clarity of purpose was needed.

Commissioning support units, in contrast, were seen as a gateway to the commissioning world. Mr Kelsey promised introductions to both. 

Wanting to work

The second part of the afternoon saw groups try and solve potential problems. How do we engage clinicians? How can we navigate procurement? How can SMEs carry the risk? And how can attendees, as early adopters, keep the conversation alive? 

The conclusion of the day: entrepreneurs all want to continue to work with the NHS and sell their products and services to the service because they believe they can make the NHS better.

Mr Kelsey and Ms Bryant promised to keep the conversation going and create an information exchange so small business and the NHS can more easily share insights into services and needs.

For Tim Kelsey it was simple: “I want to see patient outcomes improve and I want a more effective, high-value health service − it’s all of you who will make this a reality.”

Alex Kafetz and Gita Mendis are directors at ZPB, an SME that helps healthcare organisations use data and marketing to improve care. Declaration of interest: they may well benefit from the changes the NHS Commissioning Board wish to implement