HealthTech Hour · 2026-07-07 · 51 min
Key moments - from our scoring
Substance score
62 / 100
Five dimensions, 20 points each
Tom Whicher traces DrDoctor's evolution from a consultancy focused on process optimization (where he met co-founder Ranesh peeling onions at a Domino's supplier factory) to building what is now one of the UK's most successful health tech platforms. Starting in 2012 when the iPhone was still novel, Whicher and his founders saw the opportunity to digitize patient engagement around outpatient appointments. The conversation covers the early barriers - including being told patient portals were illegal and requiring physical servers connected via the N3 network - and the massive shift in policy that has occurred, with the NHS App now mandated to contain patient data. Whicher argues that approximately 40% of current outpatient appointments are unnecessary check-ups ('red' interventions in NHS terminology) that could be replaced with remote monitoring, patient-recorded data (PROMs), and patient-initiated follow-ups. This "between appointment care" paradigm represents a fundamental reimagining of how healthcare is delivered. DrDoctor has processed nearly 200 million outpatient appointments across 37 million unique patients, powering the NHS App as its largest data supplier and delivering 5-8x ROI for hospitals through better attendance, reduced paper, and improved patient preparation.
DrDoctor estimates approximately 40% of outpatient activity is 'red' interventions - appointments that are either routine check-ups without treatment plan changes or misrouted patients - that could safely shift to home-based remote monitoring and patient-initiated follow-ups rather than physical clinic visits.
DrDoctor has processed nearly 200 million NHS outpatient appointments across 37 million unique patients and is the single largest supplier of data powering the NHS App, though the platform is often white-labeled so patients don't realize they're using DrDoctor's technology.
The legal status of patient data access online was genuinely unclear in 2012; the NHS used a private intranet called N3 for patient information, and sharing it via the internet was seen as potentially illegal until information governance principles like Caldecott's duty to share provided clarity that data sharing could be as important as data protection.
Between appointment care combines remote monitoring, patient self-recorded data (PROMs), and patient-initiated follow-ups to replace routine clinic visits, allowing hospitals to reserve in-person appointments for interventions that change treatment plans rather than check-ups.
Hospitals typically achieve 5-8x return on investment through improved clinic attendance rates, reduced paper usage, better patient preparation for appointments, and overall operational efficiency gains.
Our reviewer’s read on each dimension, with quotes from the episode.
The episode contains a mix of substantive insights and considerable filler. Strong points include the specific analysis of outpatient waste (40% of activity is unnecessary), the historical context of NHS data governance evolution, and practical discussion of agentic AI applications in healthcare. However, there are long stretches of meandering conversation, repeated anecdotes (the orange forms story, the onion factory origin), and self-congratulatory tangents that dilute insight density. The discussion of NHS funding incentives and procurement dysfunction is valuable but somewhat rehashed from broader industry critique.
we think about 40% of outpatient activity is red. So all of that can be shifted to at home what we call between appointment care.
EPRs don't save money, they increase clinical safety. There is no return on investment.
While the episode articulates genuine contrarian positions - particularly that EPRs deliver no ROI and that the value layer sits above them, not within them - these arguments are already circulating in UK health tech circles. The agentic operating system concept for the NHS is somewhat novel but not groundbreaking; the application of agent-based AI to operational workflows is an obvious extension of existing trends. The historical narrative about data governance is well-trodden. The critique of NHS centralized funding mechanisms, though valid, is familiar territory for anyone tracking UK health innovation.
our stated aim now is for Dr. Doctor to be the agentic operating system for the NHS.
Foundry is still essentially a reporting tool... Whereas the world we think that we're moving toward very quickly is a world where you have agentic intelligence, which helps administrators and clinicians and patients to do their jobs.
Tom Whicher is a highly credible practitioner with 14 years building scale in NHS health tech, demonstrated by 200M+ appointments processed, 37M patients, and claims of £150M NHS savings. He has genuine operational scars from navigating NHS procurement and regulatory barriers. However, he is also a CEO with vested interests in criticizing centralized funding (which competes with his model) and advocating for approaches that benefit incumbents like himself. His insights are grounded in real execution but not necessarily disinterested analysis. The guest is calibrated and experienced but not exceptional for a B2B episode.
we've done nearly 200 million NHS outpatient appointments on our platform. That's incredible for, um, 37 million unique patients.
We've saved over 150 million pounds for the NHS, over the, you know, the business.
The episode provides concrete numbers on Dr. Doctor's scale (200M appointments, 37M patients, 150M NHS savings claimed, half of UK hospitals integrated). The 40% 'red' outpatient figure is specific. However, claims lack granular support: the £150M savings figure is unsubstantiated; the Palantir COVID dashboard anecdote is illustrative but vague on impact; the '44x improvement' in AI timelines is mentioned but never anchored to specific DrDoctor metrics or timelines. The discussion of NHS funding failures is generalized ('seven attempts') rather than itemized. Many assertions about agentic AI capabilities are forward-looking and unvalidated.
we've done nearly 200 million NHS outpatient appointments on our platform... 37 million unique patients.
over half of NHS outpatient activity flows through our platform.
The host, Steve Roost, asks reasonable open questions and allows Whicher extended narrative space, but rarely challenges or pushes back substantively. When Whicher makes sweeping claims (EPRs save no money, 40% of outpatients are wasteful), the host accepts them without follow-up on methodology or caveats. The host pivots frequently to new topics rather than drilling deeper. Notable example: the claim that centralized funding 'always slows things down' receives only agreement rather than interrogation of confounding variables. The conversation drifts into comfortable mutual admiration and shared grievances with NHS procurement rather than productive tension. The host's own advocacy for suppliers (the KHP bias disclosure is good, but not enough to offset the general lack of rigor).
That's amazing.
Well done, guys. But let's think a bit bolder.
Computed from the transcript - who did the talking, and the words that came up most.
The NHS has invested billions in digital records - but what if the real breakthrough isn't more software, it's what sits on top? In this episode of HealthTech Hour, Tom shares how a naval architecture degree and a chance consultancy project peeling onions for Domino's Pizza led him to co-found DrDoctor in 2012 - and why 13 years later, he believes outpatient care as we know it shouldn't exist.
Transcribed and scored by The B2B Podcast Index.
Speaker A: Hi, this is Steve Roost and you're listening to HealthTech Hour on UK health radio. Each week we give you the best news, views and interviews from the health technology world. From CEOs and founders to entrepreneurs and clinicians, the companies and people that are shaping the future face of healthcare,
Speaker B: all
Speaker A: on the world's number one talk Health Radio. Hello and welcome to this week's Health Tech Hour with me, Steve Roost. Each week we bring you the best news, views and interviews with the founders, CEOs, clinicians, journalists, politicians that are changing the face of healthcare in the UK and beyond. As regular listeners and viewers know, I am a CEO and a co founder of a health tech business myself, which is called pocdoc. POC Doc's Healthy Heart Check is now the number one tool that's being used outside of a GP surgery across the UK to to screen for cardiovascular disease. And if you're interested in your heart health, please feel free to go to POCDOC co to find out more. And thank you as ever to POCDOC for supporting the show. Thank you also to everyone listening live on UK Health Radio. We love love UK Health Radio. We love the fact that it's 247 health content and it's the largest talk health radio station in the world. Thank you. Also, if you are listening on demand on any of the podcast channels, we now get Downloads from over 50 countries every single month. Thank so much for showing up and for engaging and thank you if you're watching this on our YouTube channel, which is ealthtechour, or on my Instagram, which is everoost. So that's all the show admin out of the way and onto today's show. So today's show, uh, is a big one. We've got a whale of a guest as far as UK health tech goes. So Dr. Doctor, um, for those of you I know we're a broad church. Some of you listening will know what Dr. Doctor is, but for those of you don't. Dr. Doctor is consistently held up as one of the most successful UK founded health technology businesses, digital health technology businesses, they've expanded extensively across the nhs. They've really led the industry and what they do. Um, and their founder, Tom Witcher, uh, who is with me today, is consistently held up as a leader within the UK space. So Tom, welcome to the show. How are you?
Speaker B: Thanks Steve, nice to see you. You make me blush with an intro.
Speaker A: It's true. I mean, again, particularly in an industry where, um, the industry itself is looking for people to sort of follow and it's not necessarily been the easiest. A few years and constant upheaval. Dr. Dr. Is a business that everyone I think looks up to.
Speaker B: Thank you, I appreciate that. I mean like all of these things, it's um, uh, tenacity. We've been doing it for a long time. You know, we actually started in 2012, believe it or not, which scares me immensely. Um, you know, when I was quite a lot younger. Um, and, and it's kind of time spent with clients, spent with the market. I think that has, has built us a reputation which I have to say I am, I am proud of.
Speaker A: You should be. You really should be. So back in 2020. 12.
Speaker B: Yeah.
Speaker A: 20.
Speaker B: 2020.
Speaker A: I don't need to do that. 2012. Yeah. I don't need to do 2012. That's different. Back in 2012, what was the world like and how did you kind of stumble upon doing this? Like what's the origin story of Doctor?
Speaker B: I mean, sure. So, so I'm m, I'm a engineer. Right. Um, I'm actually a naval architect by background. So quite an unusual journey to start sort of studying ships and maritime design and all that sort of stuff and end up in health. Um, and it was definitely a non linear journey. Um, you know, like, like all the best. Right. So study naval architecture. I wanted to, I wanted to be a boat designer. That's what I wanted to do. Turns out that that is quite a niche career. Not many people make any money out of it.
Speaker A: Right.
Speaker B: So I ended up working in engineering for a consultancy firm. Um, and that firm was called Newton Europe. They do lots of work in health now. When I joined them there were about 38 people focused majority of like FMCG optimization. So we'd go into a factory, we'd look at what it made and we would do a no win, no fee, uh, efficiency project. So for example, um, I met my co founder Rhinesh literally peeling onions for Domino's Pizza.
Speaker A: Seriously?
Speaker B: Yeah.
Speaker A: Oh, that's amazing.
Speaker B: Right?
Speaker A: That's amazing.
Speaker B: Yeah.
Speaker A: So, so you went into Domino's.
Speaker B: So it was a factory that supplied Domino's.
Speaker A: Okay.
Speaker B: Um, so a large kind of food processing factory, but they made all of the onions that go on top of a Domino's Pizza. Right.
Speaker A: That's so good.
Speaker B: Yeah. So we um, and we went in and that business was, it was losing. Um, and we, we turned it around and it was literally shop floor to boardroom. So walk the lines, look at the onion peeling machines, which by the way is, I mean it's a hell of a Job. Right. Just ton. Whole onions come in, onion rings and pieces come out.
Speaker A: Anyway, how many onions a day, roughly, were they working?
Speaker B: It was hundreds of tons of onions. Of onions.
Speaker A: Wow.
Speaker B: Yeah. It's like the biggest. One of the biggest food processing plants in the uk.
Speaker A: Wow.
Speaker B: Um, it all comes out. You know, they do lots of different things. But the joy of that work was you'd go in, you'd look at the machinery, you'd look at the shift patterns, you'd look at the people, you'd tweak stuff and you could measure the impact straight away. And you'd literally. You'd have your hair net on, you'd leave the factory floor stinking of, like, you know, veg, walk, um, into the boardroom and presently you'd improve the efficiency of the thing. So I was obsessed by this process engineering. That was.
Speaker A: That was your thing.
Speaker B: That was my thing.
Speaker A: Okay. And, um, I can tell you, like, you, I can still hear the passion.
Speaker B: I love it. Um, honestly, there's nothing better than improving. Improving a process in my eyes, and. Which makes me a very sad individual.
Speaker A: We love that. I love that. That's great.
Speaker B: Um, we did that for all sorts of different things. We did nuclear submarines, we did. You name it and M. Then Newton won some health work. And, um, I had no interest in healthcare at all. Like, zilch, zero. I thought it was boring, I thought it was slow. Um, but in consultancy, you get sent where you get sent. And I went and did a project in the Midlands. And. And I won't pretend that I loved it straight away, but I found it fascinating. I found it fascinating how much it was a people and process problem. You couldn't just crank the machine and see the output. You needed to bring people on the journey with you. Um, and literally the first thing I did in hospital was trying to get nurses on wards to fill out a form, a new form. Okay, Right. Which is the antithesis of everything we stand for. Um, but I needed to fill out this form. And if they filled out the form, it meant the patients were better coded. If they were better coded, it claimed more income and it was. It was a net win for everybody.
Speaker A: Right.
Speaker B: Nurses don't want to fill out another form on the wards. It's the last thing they want. And I had two innovations. The first one was print the forms out on orange paper because everybody remembers the orange form.
Speaker A: Nice.
Speaker B: Instead of, like, you know, you've got to fill out the, you know, the comorbidities coding form.
Speaker A: Right.
Speaker B: It's the orange form project and the Other one was going to every single nurse handover with a box of roses. Those are my two things. And it worked. It worked. And we got the form filled out and it was done with a sense of humor and we got the coding results and the project was a success. And that sort of got to me. Got to me that, like, these people sound. The wards are trying to look after patients and there's people like me asking them to fill up more paperwork. So that was like interaction one with the nhs.
Speaker A: Okay.
Speaker B: Then I moved on to doing an outpatient improvement project, um, and did lots of clinic studies, so lots of sitting with doctors, watching what they were doing. Um, and the thing that shocked me was I was there trying to improve this service financially and operationally, and all the patients turning up with bits of paper and having missed their appointments and frustrated or sad or having been told that it had been changed, but they hadn't got the updated letter. Uh, it was just like, it's a shit customer experience. Right. Let's be honest.
Speaker A: Yeah.
Speaker B: So, um, originally I was hoping that we were going to try and build an epr, to be honest with you.
Speaker A: Okay. That was like, in 2020. Why do I keep saying that? In 2012?
Speaker B: In 2012. So I was like, what was it?
Speaker A: Look, that's. That's because people, a while back, people
Speaker B: were doing stuff on paper in this hospital still. Right. So they didn't even have any PR in my head. I was like, why can't there be an EPR that looks like Google that you can just search?
Speaker A: Uh, they had computers.
Speaker B: They were using computers as well. So you had a physical note, you had. I think they had a homegrown EPR in this organization. Um, and then I quickly realized that that wasn't the most interesting part of the puzzle. The most interesting part of the puzzle was, um, could you reach out to the patient, improve the patient experience and in the process of doing that, um, save money and improve the services too. And you have to remember, 2012, the wasted way. Almost. Almost is infectious. Right? Infectious. 2012, the iPhone is five years old.
Speaker A: Yeah.
Speaker B: Okay, so the iPhone is a new thing.
Speaker A: Mhm.
Speaker B: Apps, um, are a new thing. I get my first iPhone, I had a 3. Do you remember the 3G?
Speaker A: I do.
Speaker B: The rounded back?
Speaker A: Yep.
Speaker B: I had one of those.
Speaker A: Wow.
Speaker B: Pretty proud of that. Um, and then, you know, it was rubbish in retrospect, but we, we thought we were.
Speaker A: I think it's a lesson in getting a product out as opposed to trying to perfect it.
Speaker B: It really is. Right. Like it was, it was purposefully hamstrung, but it changed everything completely. Um, and I was sat with this iPhone thinking, oh my God, this is going to change the way things happen. So we, um, like all the best founding stories, um, me, Ranesh and Perrin, who are the three founders, uh, was over a pint, we were like, let's build an app to allow patients to manage their outpatients. So we, that was the idea, that was the founding genesis.
Speaker A: Just so we're all on the same page. Broadchurch. What is the difference between outpatient and inpatient? What is what? Where does outpatient start and stop in this discussion?
Speaker B: So generally speaking, outpatients is you come into the four walls of the hospital to be seen for an hour on the day and you leave again.
Speaker A: Okay.
Speaker B: So it'll be your first appointment where you get an early diagnosis. It'll be the follow up appointment post treatment. So post surgery, all of that sort of face to face action happens in outpatients. And then inpatients will be your ward, um, stays your surgical interventions. And then you obviously have day cases. So um, you know, ophthalmology, they might do the surgery on a day case basis. Kind of sits between the two.
Speaker A: Okay.
Speaker B: And I'm going to say something ironic for a business that spent 14 years optimizing outpatients, outpatients should not exist.
Speaker A: You might have to walk me through that one.
Speaker B: Yeah. So outpatients has been around since really healthcare began. There's a stone bench outside Guy's Hospital, which was put there in the 1600s by Thomas Guy, which is the outpatient waiting bench.
Speaker A: Seriously?
Speaker B: Yeah.
Speaker A: Amazing. M. I've seen that.
Speaker B: You can go and see it.
Speaker A: That's amazing.
Speaker B: They've got a lovely little um, sort of mini museum, um, outside countinghouse at Guy's Hospital. And you can go and see the stone bench and you can see like some of Thomas Guy's sort of statues and stuff. And we've, we've, since the 1600s, we've asked patients to sit and wait to see a doctor. Mhm. 2026. There is no reason that that is still the default way of delivering healthcare. The default should be you're at home, we collect data from you, you tell us how you're doing, we see you virtually if we can. And if you're high priority, we bring you in for an intervention. We don't bring you in for a checkup. That is, that's 1600 thinking not even how many.
Speaker A: How much of outpatients is in this checkupy bit versus the interventiony bit?
Speaker B: Yeah. And this is like one of the big questions that everybody talks about. So nhse have started talking about red, amber and green interventions. So a uh, green outpatient intervention being something which changes the treatment plan. Um, or. Yeah, right. Causes an rtt, um, referral to treatment and non NHS people clock stop or you know, moves the treatment plan forward. And amber being something that kind of was necessary but maybe we could have done that at home, maybe we could have done that remotely by text message. And then the reds of which unfortunately there are far too many. Either I'm just bringing you in to check because I don't have a better method, or I come to see you about my kidneys and it turns out actually I should have been referred to somewhere else and I get bounced around the system. We think about 40% of outpatient activity is red.
Speaker A: Really?
Speaker B: Yeah. So all of that can be shifted to at home what we call between appointment care.
Speaker A: Okay.
Speaker B: So that is a mix of remote monitoring patient, um, self recorded, so sort of proms type technology, um, and then patient initiated models where you request a follow up rather than you're brought in for a follow up. So.
Speaker A: Right.
Speaker B: So that between appointment care paradigm is what we think most hospitals should be shifting to over the next sort of couple of years.
Speaker A: And how. What's the spectrum of openness around this concept?
Speaker B: Yeah, it's changing. Right? It's changing. So to go back to 2012 and I was thrown out of a CIO's office because I said I'm going to put your patient information online.
Speaker A: What?
Speaker B: Yeah, I was told it's illegal. There's no way you can do that.
Speaker A: Uh, don't darken my dogmatic online. What do you like? What do you mean?
Speaker B: So we were going to front appointments through the Internet. So look at them.
Speaker A: Okay.
Speaker B: And I was told illegal as in
Speaker A: someone can just see what uh, their appointment is.
Speaker B: Yeah.
Speaker A: Through a, through a portal.
Speaker B: Through a portal, yeah. Yeah.
Speaker A: And that you were told that would be illegal.
Speaker B: Told that that would be illegal. And I. And I had to leave and don't come back to the hospital.
Speaker A: Oh, wow.
Speaker B: Right.
Speaker A: Yeah. You know I love those stories exactly. Of those myself from a previous life.
Speaker B: But that sort of stuff. Yeah, you know we were.
Speaker A: And did they have a. I mean the GDPR stuff has changed over the years. Were they wrong back then or were they. Were they a little bit. They weren't completely wrong but they sort of.
Speaker B: I think it was really unclear. Uh, is the truth. So we used to have N3.
Speaker A: I don't know if you remember I don't remember that.
Speaker B: This is like, you know, a bit nerdy, so apologies to everybody who's listening. But the NHS used to have a network called N3, which was its private intranet, which patient information could live within. So we, this is before the days of Cloud compute, right. So we, we had to hire a physical server. Uh, we had our own physical server in a. In a physical data center in Reading that was connected by BT to the N3 network in order to get patient data onto us.
Speaker A: I love this stuff. This is like. This is what it used to be like.
Speaker B: Yeah.
Speaker A: And you know what? 2012 is not that.
Speaker B: It's not.
Speaker A: Not that long ago. It's not that long ago, really. Not like you think about. In 6, 14, 15, 16 years, you had a hardwired, Hardwired, hardwired box, a
Speaker B: physical box, physical box you could go and see and touch and, like, you know, plug in and turn off and stuff. So that was the first version.
Speaker A: So the. So the vision was like, wow, we might do one of these boxes for every hospital sort of thing.
Speaker B: Well, at that point, it was really unclear as to how we were going to make data flow. It really was. And, you know, we were the first Us and Patients Know Best, um, were the first two businesses to put data between N3 and the Internet and open up that thing. And that was what people were upset about. They thought that that was illegal and that wasn't allowed. And, you know, 2026, it's national policy that you have to have all your information in the NHS app. So it's pretty cool to see that. That's Journey.
Speaker A: Amazing.
Speaker B: Yeah.
Speaker A: Like, that's absolutely incredible. Uh, it just shows you about the. It always makes me think about how vociferous some of those people can be in that moment. And sometimes I think, look, why don't you just tone it down a little bit?
Speaker B: Right.
Speaker A: Because we don't know what's going to happen tomorrow or the next day. I understand you have concerns right now.
Speaker B: Yeah.
Speaker A: But why didn't we, you know, why
Speaker B: don't we have a conversation about this?
Speaker A: Yeah. Where's the anger?
Speaker B: Yes. Yeah.
Speaker A: Why are we way angry?
Speaker B: And anger was a default reaction. You know, it was. It was really interesting. And then the other thing that, you know, I have to say that the, the information governance community, who still get a lot of, um, they get a lot of stones thrown at them still.
Speaker A: Uh, yeah. Shout out to anyone in ig. Don't have an easy path.
Speaker B: Don't have an easy path. And the journey. That group has been on over the last 10 years is incredible.
Speaker A: Amazing.
Speaker B: We have Fiona Caldecott to thank for so much with her principles. And the seventh one being the duty to share is as important as the duty to keep data safe. I've paraphrased that. Apologies. Any lawyers listening? But the intent is correct. Um, and that. That was so important that she said that in. In 2015 or 14 or whenever it was that she wrote the principles. Because up to that point, the IG community didn't have any guidance on this.
Speaker A: No, they were freestyling it. They were freestyling and also, like freestyling against if you. The downside of getting it wrong was enormous.
Speaker B: Yeah, yeah, exactly.
Speaker A: Absolutely cliff edge.
Speaker B: Yeah.
Speaker A: Like annihilation.
Speaker B: Total annihilation. And your job as an IG professional was avoid that at all costs.
Speaker A: Yeah.
Speaker B: We still have it today. Right. I still think one of the biggest barriers to innovation in the NHS is the risk reward sort of ratio. So if it was a. If it was a balance, it is massively balanced towards do nothing M. Because people lose their jobs or get, you know, hauled over the coals for making mistakes. Really, very few people have the successes they've made celebrated. And that's one of the things that I do believe people are trying to change. But it is what holds back so much innovation in trust today. Um, so thank you, Fiona Caldecott, and thank you so many people that were part of that journey for, um.
Speaker A: Well, particularly thank you to everyone that gave you guys a shout, like a shot back in the day.
Speaker B: Yeah, exactly.
Speaker A: There must have been some people back in the day that really went out on a limb.
Speaker B: Hugely, hugely.
Speaker A: They took an absolute flyer.
Speaker B: Yeah.
Speaker A: With these guys.
Speaker B: Yeah.
Speaker A: With a surfer walking. Right, after this, we've got to stop for our first commercial break. And after that, I want to get into what Dr. Doctor actually does.
Speaker B: Sure.
Speaker A: And particularly everyone listening is a patient of the. Of a healthcare system, lots of people in the uk, what it means to them, and they may have interacted with Dr. Dr. Without actually realizing it.
Speaker B: Almost certainly they have.
Speaker A: So we will be right back after this commercial break with my guest today, Tom Witcher, uh, who is the CEO and co founder of Doctor Doctor. Hello, welcome back to the second part of today's show with my guest, um, Tom Wicher, who is the CEO and co founder of Dr. Doctor. So, um, as we said before the break, there's a really high likelihood that listeners, particularly in the UK, have interacted with Dr. Dr. Without really realizing it. So from the point of which in 2012, you were walking around plugging in physical surfer boxes and being thrown out of CIO's offices. Uh, at what point did that become a really. What was the evolution rather to today, where you really are part of the furniture in a good way. You know, business as usual for so many trusts, so many patients across the uk.
Speaker B: Yeah. I mean, so in terms of today's numbers, so we've done nearly 200 million NHS outpatient appointments on our platform. That's incredible for, um, 37 million unique patients.
Speaker A: Wow.
Speaker B: So it's a big.
Speaker A: That's massive.
Speaker B: Yeah.
Speaker A: I mean, what's the adult population of the UK? 50, 40?
Speaker B: I think it's like 65 million people.
Speaker A: Is it fair? Ah, yeah. So it's still pretty good. Yeah, it's amazing.
Speaker B: Yeah. So we've had this huge percentage of, um, if people have used the platform, over half of NHS outpatient activity flows through our platform. We have hundreds of thousands of people that log in and do activities on the platform every single day. Um, so, yeah, a lot of people will have used it. It's often white labeled. You often don't realize it's us. And that's super intentional. Um, but yeah, it's really cool to have touched that many people's lives.
Speaker A: And what do they use it for? What does it do? Like patients, what are they using it for?
Speaker B: So we kind of, kind of like. And I'll talk about where the product's going, but historically we talked about the platform having three slices. So the core thing that people know us for is patient engagement. Right. So when you get a text message or an automated, um, call or use a portal or use the NHS app, um, that's often us. So we are the single biggest supplier of data into the NHS app.
Speaker A: Cool.
Speaker B: We power the NHS app far more than people realize. Um, YAP is not perfect, but I'm a huge fan of it. Um, so when you're doing those things, it's often through our platform.
Speaker A: Okay.
Speaker B: Um, so that's like our sort of fundamental slice, if you like. And if you're hospital that delivers you a five to eight times return on investment through, um, better attendance to your clinics, through less paper, um, through better patient prep and through all of those kind of like core metrics, if you like. So that's where a lot of m. Our impact comes from.
Speaker A: Okay.
Speaker B: And we measure. We're an impact driven business. We're a B corp.
Speaker A: Okay.
Speaker B: Um, and we measure, um, NHS impact as one of our, like, core things. And I'm really proud to say We've saved over 150 million pounds for the NHS, over the, you know, the business. So we like, we're like super proud of the impact that we have.
Speaker A: Yeah.
Speaker B: So that's the, that's the kind of the core product. Um, and we continue to build on that. So for example, we have a new agentic voice tool which allows patients to ring up the uh, hospital and talk to an AI agent. Now I'm super interested in AI agents and we should talk about that later. Um, the thing that makes Doctor Doctor different is if a hospital has spent three years configuring its scheduling rules, it means that our AI can actually go and action things. So you can ring up, you can authenticate yourself as Steve and you can then get a history of your appointments and you can actually change, you can cancel and it will adhere to all of the booking rules in the RTT and everything else.
Speaker A: Wow.
Speaker B: So it can actually do stuff. And we think that's the, that is the key, right. Is, is giving agents the tools to go and actually do things. Um, so that's, that's sort of the course life.
Speaker A: Then we have that. And is that. That's. That's live or becoming live.
Speaker B: That is live.
Speaker A: That's live.
Speaker B: That is live. So, um, we've got one or three big hospital sites that are going live with it at the moment. Um, super excited by that.
Speaker A: That's amazing.
Speaker B: Yeah. And then I think most of our clients are going to end up taking that over the next year.
Speaker A: And so just to dub. So I can call up for example, and I want to change something.
Speaker B: Mhm.
Speaker A: About my appointment. And it interacts with me as if it's a customer service agent.
Speaker B: Exactly that.
Speaker A: And it actually has the um, the integrations required to actually change things.
Speaker B: Exactly that.
Speaker A: Amazing.
Speaker B: Because we, I mean, I don't know how much you, you know, we, we've thought a lot about agentic and things like the voice.
Speaker A: We just went full agentic. Our entire engineering department is now full agent.
Speaker B: It's incredible, right?
Speaker A: Yeah, it's, it's. I had, we had a, we had a company huddle a couple of weeks ago and um, I had a proper couple of matrix moments where I had to get the dev team to back it up a bit.
Speaker B: It's unbelievable.
Speaker A: I was like, I can't, I couldn't get my head around it.
Speaker B: I'm obsessed by it. I mean, as an engineer, I find it just mind blowing.
Speaker A: Yeah.
Speaker B: Um, and I've got Claude code going in the background all the time.
Speaker A: Yeah, we use Claude code. Yeah. I mean we don't. The core bit around the medical device is not anything around. Our entire software engineering team is now 100% amazing. We think we're probably, we class ourselves as med tech.
Speaker B: Mhm.
Speaker A: We're probably the first or the leading med tech business to do that. Amazing because I think most of them just, they're not, they're just not thinking that way.
Speaker B: M. Yeah.
Speaker A: It's mad you can't you. I don't see we're going slightly off topic. But yeah. Uh, if you have a high dependency in your product around software engineering and you don't go agentic, I uh, don't see how you, you compete over a five year time horizon.
Speaker B: Agreed. It is a huge competitive advantage. Huge competitive advantage. Yeah.
Speaker A: Well, we were talking. My guys. I don't know about you, but we were. They're talking about a 44.0x wow. Improvement in some of these timelines. I mean it's like this is. It doesn't make sense. It's insane.
Speaker B: I don't know if you've had this experience but as a CEO, uh, I find it. Because it changes your strategy because you can do so much more.
Speaker A: Yeah.
Speaker B: Like it completely. And I'm sure you are the same as me and you know, the reason we're entrepreneurs is, is our brains go a million miles an hour and we have ideas coming out of our ears. Um, but the thought that you can actualize so many more of those ideas and sort of broaden what the platform can do.
Speaker A: Yeah.
Speaker B: It's so motivating.
Speaker A: Software development effectively became free.
Speaker B: Yes.
Speaker A: Overnight or to the cost of a token or whatever that. That is. And you're. The cost of getting it wrong is zero. Whereas before you could have invested six months or however much you've invested in a particular roadmap item and then it gets launched and it's very difficult to kind of throw things at the wall. Things have to. Whereas now, I mean it's. It's continuous delivery.
Speaker B: Yeah. And if you're not doing continuous delivery, you're behind. Which is.
Speaker A: Well, that's what. That's. But that's where. That's what we've got. I mean it can't. You're either in the hot air balloon or you're not. I think at this point. And what's been interesting talking to uh, um, our cto who's completely led from the front on this in Medtech is um, how there are some people in software engineering that are pretending this isn't happening.
Speaker B: Yes. Which is fascinating. Right.
Speaker A: Yeah.
Speaker B: There's Absolutely. And within our organization, the people in Doctor's Doctor are phenomenal. But as all organizations, we have a range. We have a range. And it's like if you spent your whole career as a craftsperson and you're now working in a factory. Because that is the analogy, I think it's really hard.
Speaker A: It's brutal.
Speaker B: Yeah, it is brutal.
Speaker A: Absolutely brutal.
Speaker B: So people are having to adapt and having to change.
Speaker A: So what was the reaction around the hospitals, around this A.I. agent, um, like when you went through it? Because, like, on the face of it. Yeah, that doesn't sound like something that they'd be up for, but they clearly were.
Speaker B: Well, so what's so fascinating about AI in the NHS is to our, to our IG story from earlier a few years ago, people were, no, hell no, not here. Yeah, m not doing it right. And look at the reaction that FTP's had and look at, you know, people pushing back. I, I think that the cost, um, of delivering care and the pressures on the system have caused people to need to look to different solutions.
Speaker A: Is one necessity.
Speaker B: Necessity and then I think too is it's become ubiquitous everywhere else. Right.
Speaker A: Um, and actually people in the system are using it every day to do various things anyway.
Speaker B: They're using it all the time. I was speaking to a general manager the other day. He uses Claude to do all of his prep and he was like, this isn't officially sanctioned, but I'm saving so much time. And I have to say, shout out to the NHS managers and GMs, because that job, that job is one of the hardest jobs going. Give these people the tools they need to do their jobs properly. Like, you know, they are amazing, motivated individuals. And so I think people are using it in their personal lives and professionally, sort of in a on the side of the desk kind of way. And everybody realizes they're going to adopt it. And we are actually sort of seeing that as a huge opportunity. Right. So we have, um, half the hospitals in the country integrated with our platform.
Speaker A: Cool.
Speaker B: We have millions of HL7 messages coming in and out of our platform every day with all real time updates on what's happening with all of these different hospitals. We have, um, high trust with our customers because of our history of delivery. And one of the things we haven't touched that makes Dr. Doctor quite different is because of our consulting background, our delivery team is really strong. So we have a thing called Delivery, um, Partner and Delivery Partner is, um, uh, how we implement our products. Um, their sort of motto is change finds a way um, because changing the NHS is really hard.
Speaker A: Yeah. It's like classic customer success.
Speaker B: Yeah, exactly. Imagine customer success, like turbocharged.
Speaker A: That's awesome.
Speaker B: And we have doctors, um, nurses, we have ex NHS managers. We have all sorts of different people in that team. And what we're finding is trusts are coming to us and saying, look, we know we need to embrace AI. We don't even know where to start. Right.
Speaker A: Yeah.
Speaker B: Um. And they're asking us to help and we're like super excited by that, I think. So, not wanting to jump too far ahead, our stated aim now is for Dr. Doctor to be the agentic operating system for the NHS. That's what we believe we can be because we have the data, we have the people, we have the trust and we're building the workflows on it now.
Speaker A: So I think. Which is. Do you remember back in the day when Babylon, right. It was all about building an AI doctor.
Speaker B: They were Class of 2012, Babylon Dr. Dr. Huma, Econsol. There was a few of us that so.
Speaker A: And then. And then at that point there was this vision around. Because that was obviously way pre agentic.
Speaker B: Right? Yeah.
Speaker A: But it was about like building this, this, this AI doctor. Whereas actually now with Agentic, I think Agentic is much more swallowable. Mm m. Because you're building specific things to do specific things that you can build guardrails around that still make everything a 40x100x better, whatever it is, without having to go near this concept of like, oh, well, I means some black box making clinical decisions, which is. That's the. About as scary as it gets for the healthcare system.
Speaker B: Exactly. And so we are very much seeing it as, um, yeah, the agentic system. We talk about the system of action. So being the system of action and delivering all of the operational workflows within an organization. We don't need to cross the clinical boundary at the moment. We may, we may. And we've got an amazing partnership with Microsoft. We work really closely with them. Excited to see what um, Dom King and TM are building in terms of some of the specific models they've got.
Speaker A: Because Copilot just went live.
Speaker B: Copilot just gone live. And look, love my Microsoft colleagues. It's just satin Word. Right. It's not really going to change the world. It's not going to change the world. Well done, guys. But let's think a bit bolder. Uh, um. And again, that's where we think we come in. We have this deep integration into the ehr. So you can ask. We're calling it dot the dot Soto interface. So you can ask dot give me all my patients on the clinic, give me their comorbidities, we can spit out a list, we can then go and action that. So we can say, um, you know, uh, fill the empty slots in the clinic with high priority patients based on these.
Speaker A: Did it, did it require you. This is getting quite geeky, by the way, when listening, but did it require you to do different integrations or. Actually you already had the integration and you've just sort of used a different sort of pathway? I'm just curious.
Speaker B: Yeah. So the answer is, um, there are some new integrations there. So we typically super nerdy, we have demographics, we have appointments, we have an element of clinical data, but we will only take the data that we need to deliver that specific part of a patient's care journey. So we don't have the full record. Um, we can write back as well. So we, for example, if we collect, uh, a patient recorded outcome, we can write that back to CERNA or EPIC or system C or whatever system is needed. Um, and what we're doing now is we're increasing the number of API calls we make. So it does mean expanding our integration surface. But they tend to be integrations we already have.
Speaker A: Thing I really like about this is I don't. Up until about six minutes ago, I didn't realize this was happening. So this is great.
Speaker B: Yeah.
Speaker A: Yeah. But, um, is that those larger systems are so big and monolithic. They are, have, I don't believe, have any ability to do this.
Speaker B: No.
Speaker A: Ever.
Speaker B: No.
Speaker A: But it needs to happen. And I feel like this is the layer, you know, you, you sit in this perfect position.
Speaker B: Yes.
Speaker A: Where you understand and have already done all of the hard yards and the integration and all of the. Everything's required and you're just in this perfect slot.
Speaker B: Exactly.
Speaker A: Whereas if you've relied on Cerner and epic, and that's just not. I mean, they're not. They're not. They're just not.
Speaker B: I mean, I put a pitch deck together. It's funny five years ago that said, um, the value capture will happen in what we were calling the patient layer. At that point I said, you know, had our EPR moment. EPRs are great. They're really necessary. They don't save any money, you know. Is that right? Yeah. NHS England put out a load of reports this year showing that EPRs don't save money, they increase clinical safety.
Speaker A: Wait, wait, wait, wait, wait. Back the trouble. Well, hold on a minute. Versus what? They don't save money.
Speaker B: So Compared to having your previous processes and epr, it doesn't save money. There is no return on investment. There is. Yeah. Right.
Speaker A: Bombshell.
Speaker B: Yeah.
Speaker A: Like, yeah.
Speaker B: Hence, NHSE has changed all of its funding from frontline digitization to frontline optimization.
Speaker A: Okay.
Speaker B: Because everybody has realized. I'm not saying you don't need an epr, they are incredibly necessary.
Speaker A: Yeah.
Speaker B: You need a system of record. You need them for clinical safety and audit and billing purposes.
Speaker A: Has to be digital.
Speaker B: Has to be digital.
Speaker A: Yeah.
Speaker B: And no world do I think that we should be doing everything on paper. However, there is zero evidence that they save the NHS any money at all. Or they improve clinical outcomes or they improve patient experience.
Speaker A: That's amazing.
Speaker B: Right. So that's what we're building. We're building the layer that sits on top that does all of those things.
Speaker A: Is that why that they're not, do you reckon? That's why they're sort of. I mean, we're jumping around a little bit, but there's this kind of like reference dark shadow around the healthcare system in the guise of Palantir.
Speaker B: Yeah.
Speaker A: You know what I mean?
Speaker B: Yeah.
Speaker A: And I don't want to go down, down that road too much. But do you think that that's why NHS England or the Department of Health, they weren't too bothered about picking a local EPR provider for the contract because that's not what they wanted. Because the EPR thing really wasn't where the ball game was.
Speaker B: Yeah, I think so. I think so. And whatever you think about Palantir, they've got some really cool technology.
Speaker A: Oh, God. Yeah.
Speaker B: Right. They've got some amazing technology and the ability to pull data from the various systems of record, put it together in a dashboard, was during COVID something that no one else could do. Right. And that's. That was, you know, we could talk about the FTP story at length and we shouldn't, but, um, yeah, you know, that was its scaling moment, really, was that they gave Amanda Pritchard, who was the chief exec, a Covid dashboard. No one else could do it.
Speaker A: Right. And it's a pretty big proof of concept.
Speaker B: Exactly. And they charged a pound for it and that was really, I think, the inflection moment of the FTP. And does the NHS need a single data platform? Yeah, I think it's important. Um. Does it have to be on, uh, a single suppliers technology, probably to do it? Well, whether or not they're the right choice, who knows? However, Foundry is still essentially a reporting tool. Right. It is a tool where you go and you can see what's happening. It isn't an actioning tool.
Speaker A: No.
Speaker B: And that is kind of a dashboard. It's a dashboard, right?
Speaker A: It's a cool dashboard.
Speaker B: Yeah. It's tableau or power bi. Like super sexy, but it's in that class of product. Whereas the world we think that we're moving toward very quickly is a world where you have agentic intelligence, which helps administrators and clinicians and patients to do their jobs and to manage their care. And that is. That's a totally different paradigm.
Speaker A: Well, we'll pick up on that after our last commercial break. This is our last break and we'll be back again in two minutes with the last part of today's show with my guest today, Tom witcher, uh, from Dr. Doctor. We'll be right back. Welcome back to the last part of today's Health Tech Hour with my guest, CEO and co founder of Dr. Dr. Tom Wicher. So how fast do you think this train is going?
Speaker B: Mhm.
Speaker A: Around agentic in general.
Speaker B: Yeah. I mean, so fast. Right. So we talked earlier about our internal engineering teams. So I had my light bulb moment at Christmas.
Speaker A: Right.
Speaker B: Um, I always do a little project at Christmas, tech project of some sort. And I used Google's anti gravity editor to write some code and I was like, holy, I can do stuff I couldn't do before.
Speaker A: Really.
Speaker B: So that was my light bulb. I was like, wow. And I think if you kind of look at the world, it feels like between November 25th and January 26th there was a, uh, there was a light switch moment with Opus and those new models. Opus 4.6 and the new models. I think that the NHS is just realizing that the opportunity is there. I think it's been fascinating watching the scribes. The ambulance scribes.
Speaker A: Yes. Shout out to Dom, Pmentor and Tortoise and all this stuff.
Speaker B: Yeah, shout out to Dom. Love Dom.
Speaker A: Um, Love Dom.
Speaker B: Fantastic individual. Doing it the right way.
Speaker A: Yep.
Speaker B: I think NHS England has had all the right intent with the scribes and with the AVT registry and everything else. I think it has unfortunately made the situation worse and slower.
Speaker A: Oh, how come?
Speaker B: Well, so Penny Dash, who's chair of nhazee, and uh, I don't think we could have a better chair for nhse. I think Penny is phenomenal. She get on the podcast if you can.
Speaker A: Yeah, well, she just came out. She just, um. We were featured as. Pork Dog was featured as one of the four case studies for the annual Health Innovation Really Prospectus last week, which Penny Dash announced at Confed. So thanks, Penny. For that.
Speaker B: Amazing.
Speaker A: Yep. So, anyway, carry on. Sorry.
Speaker B: The penny's awesome. Penny. Penny, you know, said last year she wanted the scrubs to be one of the things she achieves. She wanted to cut through the regulation and I think she has attempted to do that, unfortunately. Bit of a lesson here, I think, and this is where I begin to sound like an old man.
Speaker A: Um, you've got some scars.
Speaker B: Got some scars. Every time the NHS tries to centrally fund or regulate or legislate for anything, it tends to slow people down, both within the providers and within the supplier industry. And, um, I think they've done a good job of trying to pull some of the paperwork out of the way.
Speaker A: What were they trying to achieve? What have they actually done?
Speaker B: Well, so I think there was a promise of some money for avt.
Speaker A: I remember hearing about that.
Speaker B: And the problem is, if you promise trusts money, they won't spend their own. Right.
Speaker A: Law of unintended consequences.
Speaker B: Law of unintended consequences. So you go, cool, we're going to fund this thing. We think it's fantastic. Everyone goes, fantastic, I'll wait for them.
Speaker A: I am buying it.
Speaker B: Yeah, exactly. Like, I'm not going to spend my own hard earned. When there's money coming for free and then the money for free comes with caveats, it ends up, like, segmenting the market. It comes slower than people expect, ends up being capital rather than revenue and that causes CFO's problems. And every single time I've seen this, and I've probably seen over our 14 year history, I reckon we've seen. It's probably one every two years, so let's call it seven attempts to fund innovation and it always slows things down. So I think we've seen that happen with the AVT registry and the money. I think there's been a lot of noise about a central Microsoft contract that's caused all sorts of problems for the market.
Speaker A: Yeah, that got outed, didn't it? Yeah, whenever it was. That got, um. That got. That got. That got really spicy.
Speaker B: Yeah, it got really spicy.
Speaker A: I was hearing for some people that some people have made some very, very angry phone calls about that one.
Speaker B: Yeah, rightly so. Yeah. You know, I just. And every time this happens, it, like slows the innovation.
Speaker A: So what should they do, do you think, around just take AVT or any of this? What should they be doing?
Speaker B: So my strong view is, as part of the provider contract, NHS Trust should be given a percentage of money to spend on tech and innovation and digitization, with no caveats or rules around it. Other Than, you know, you can't spend it on BAU services.
Speaker A: Right.
Speaker B: And just let them make the investment decisions. It's like you and me. Right. So we both went with Claude code. But imagine if the government was saying, oh, yeah, but if you choose this thing over here, uh, it's not quite as good, but it's free. Suddenly you have to make less optimal decisions.
Speaker A: Yeah. You're skewing the market.
Speaker B: Skewing the market.
Speaker A: You're not letting the market decide.
Speaker B: Exactly. And every time that happens, it slows things down. And I think. I think we've seen that with avt. However, uh, the pull is fantastic.
Speaker A: Yeah.
Speaker B: Clinicians love it and I think that's, like, really important. Right. Our clinician, our clinical teams in the NHS are still burnt out from COVID There's a stat that somebody shared with me the other day, which is the job that 16 year olds most want is to be a doctor. Most doctors want to leave the nhs. Wow. How can both of those things be true at once?
Speaker A: Yeah. That's quite scary.
Speaker B: Isn't that sad?
Speaker A: Yeah, that's so sad.
Speaker B: So we should do everything we can to help our clinical colleagues with their job.
Speaker A: The thing I love about ABT is, is how the market actually decided that that would work. It was basically GPS and frontline clinicians that were like, oh, my goodness, I need this. This is amazing.
Speaker B: Yeah.
Speaker A: Right. And it kind of massively outpaced integrations with the record and all these type of things. It was. They were using it just because they needed help.
Speaker B: Yeah.
Speaker A: And that's how you know you're onto something.
Speaker B: Exactly.
Speaker A: And then I think, obviously there has to be regulation M in some way.
Speaker B: Yeah.
Speaker A: Somehow. But it doesn't seem like the uptake has speeded up.
Speaker B: No.
Speaker A: As a result. Which is weird because we know that the users love it.
Speaker B: Yes. Yes.
Speaker A: Right. So.
Speaker B: So maybe the way to have done it would have been something like, um, I'm just like, making it up, but give every clinician a budget. Be like, everyone gets 500 quid a year or whatever it is. Choose the thing you want.
Speaker A: Yeah.
Speaker B: And I also strongly think that the best thing that our, uh, tech colleagues in NHS England could do would be to stand up as a sort of fabric of APIs to create the connectivity. Right.
Speaker A: Amazing.
Speaker B: So be like, cool. We're going to stop trying to build products. It's such an error when managers England chose to build a product.
Speaker A: Yeah. It's just not their ball game, not
Speaker B: what they do well. Instead, be like, cool, here's an API which Gives you connectivity into all the clinical systems. Um, I don't mind which scribe you choose. It uses these endpoints M. So it can write it all back. Mhm. Here's a budget. And then you just let the market go rather than trying to intervene.
Speaker A: So that's the sort of thing that you could even. And instead of, you know, I think there are so many people at all levels on the health care system that genuinely want to make things better, 100%. And I have to believe that because that's what motivates me to deliver and to perform and to provide them with those solutions. I think there are so many instances where programs are spun up and things are happening and funding's found for things that are just really well meaning but that don't hit the mark.
Speaker B: Exactly.
Speaker A: You know, compasses and passports and, you know, so much work and effort goes into these things by so many great people trying to really help. When actually, if you're a tech business, what you're screaming out for is a sandbox environment.
Speaker B: Yeah, exactly.
Speaker A: Where you can, where you can, you can be allowed to play, to see things in real life. Um, and you can prove to your investors that you've built a bit of kit that actually works, that, you know, that's what you need.
Speaker B: You do exactly that. Like a Spotify sandbox.
Speaker A: Just anything that can stimulate and then you can do hackathons and you can actually get like loads of really cool, exciting people in a room that actually solves stuff. And you know, the, the thing that gets me about the compasses and the passports and things like that is like you're really just putting on layers of regulation.
Speaker B: Yeah, yeah, yeah.
Speaker A: It's really, that's really what it is. Which is you've created another thing that I have to fill out.
Speaker B: Yeah. It becomes busy work. Right.
Speaker A: Yeah, yeah.
Speaker B: Um, everyone means. I think you're right. Everyone means. Well, they do, but the, the, the intent often gets lost. The other thing that I find fascinating is, and it'd be curious to talk to a few other. I don't know if you've experienced this is as you achieve success in the nhs, you're sort of encouraged. Encouraged, Encouraged. Accelerated. And then it becomes a point where you become the enemy. M. And we're experiencing a bit of that. We're like, you know, our clients love us and we have great relationships with people, but people start to look at you with skepticism.
Speaker A: Okay.
Speaker B: Rather than coming to you with like, okay, cool, you've got a really big business and we're going to. Can we leverage it to do more.
Speaker A: Right.
Speaker B: People start thinking, oh, you're going to be, you're going to try and extract value, you're a private partner, we can't trust you.
Speaker A: Wow.
Speaker B: And I find that really, that's one of the things I find most frustrating about our current point in scale. Uh, is I'm like, look, we could help the NHS so much. We are, you know, we are, as I said, we're a B corp. We've had impact, our course since the very beginning.
Speaker A: Yeah.
Speaker B: Um, we measure our ROI on a, on a monthly basis. Um, let us into the room. Don't view us as a sort of, as a scale. And I think this is true of lots of other tech businesses as well. You know, we're not, we're not here to be managed. We're here to do this together. And I, and I. It makes me very, it's the thing that probably makes me most frustrated about the NHS in 2026.
Speaker A: And is it what type of people are the people that think this? Is it like actual trust level customers or is it a different type of person in the system?
Speaker B: I would say it's m. It's more. There are certainly some people in trust that feel that way and, and, but
Speaker A: they probably might not be your customers,
Speaker B: they might not be our customers. And, and even within an organization you'll have a range of voices. Right.
Speaker A: Yeah.
Speaker B: Um, and our most successful projects are the ones where everyone is like aligned and the ones where we struggle are where you've got, it's obvious. Um, a lot of it I think comes from the center. And again, I don't think it's bad meaning I don't think people are, I think they're trying to do their jobs, they're trying to spend public money well and they're trying to follow procurement rules, but in the process they shut down the ability to do more. And that, that is, it's a loss for British innovation, it's a loss of British health tech and it's a loss for the nhs. And that is, that is the thing I would, I would change the most is open the doors, stop viewing the supplier community as, uh, something to be managed and you know, viewers as partners that want to like make the NHS work together.
Speaker A: So I think this is, I could talk for ages about this. So, um, because I've, I don't come from a health background. Like I didn't build naval ships, but I didn't come from a helicopter background either. And, and it seemed to me to be counterintuitive that you Would not want to extract as much information as wisdom from the suppliers in general to educate yourself. And you don't need to work with them, but you might be able to learn something. And m. Even if you wanted to, like skunk works it yourself, you could probably get a bunch of suppliers in to basically tell you how to do it and then you can do it yourself. So that's not great behavior. I'm not suggesting that is recommended.
Speaker B: Yeah.
Speaker A: But like that would be how I would sort of be. Be thinking. Um, and I uh, sort of, I believe that one of the areas, um, this probably happens to you as well. You get asked in panels or separately. People are like, oh, you know, I'm going to go meet such and such. You know, is there anything that you would change or you know, what would you change? What would you change? What would you change? And I think the thing if I could change anything and I appreciate that the system is massively under resourced and everyone's extremely stressed and fatigued and in terrible situations. I totally get that. But I think that there is a lack of ability for, or any forum for suppliers.
Speaker B: Yes.
Speaker A: To interact with senior level people within the NHS system. Senior customers.
Speaker B: Yeah.
Speaker A: To understand and to actually scope problems beyond the point at which they say, right, well I'm going to do a procurement for a widget because I need a widget.
Speaker B: Yeah, buy an outcome.
Speaker A: Um, exactly. Way more upstream and actually trying to find a way to bring people into a room to talk about these things. Open the kimono, whatever metaphor you want to use. And that is really lacking. And I don't think in any other industry that would be lacking.
Speaker B: No, I agree.
Speaker A: I gotta think if you're building nuclear power stations, you're not just doing it off your own bonds, you're bringing in people that understand how to build a reactor. And yeah like, you know, and then
Speaker B: you have the thing that we're all doing this really because we feel purpose. Right.
Speaker A: 100%.
Speaker B: We're much more willing to do things for free than in other industries. Imagine if you got yourself Jacob From Accurate M us, uh, Paul from Nerve Center Dom in a room together and said, Guys, the NHS needs to save $5 billion pounds in the next couple of years. How do we do it? You make so much progress.
Speaker A: You would. And I think that there must be customers and we know some and I'm just sure there must be people in the system that want to have that conversation.
Speaker B: Yeah.
Speaker A: Partly because it's a fun conversation to have.
Speaker B: It'd be great, wouldn't it?
Speaker A: You know, it's a super cool thing to have. So I completely agree with that. And then I don't know about you, but I think the other area where there's a big gap is, um, I don't really see the senior customer groups within the NHS that have real serious buying power. Not the center. Because to your point that they don't really fund businesses usually. Really.
Speaker B: And nor should they.
Speaker A: No, absolutely. Nor should they completely. That's not what they're. They're not picking winners. Shouldn't be happening. Those senior level customers are not sitting with the venture capital funds, the major investors, to communicate effectively about what problems the system will pay to solve and, um, what they won't pay to solve. So I think at the Moment in the UK, particularly, a lot of VCs have invested in things that they thought would be good that weren't.
Speaker B: Yes.
Speaker A: And things that could have been good haven't received the investment that they should have done.
Speaker B: Yeah.
Speaker A: And I think that's due to asymmetrical, uh, information flow.
Speaker B: I think you're absolutely right. You're absolutely right. That's, you know, the nhs. The NHS really needs a VC fund that's tightly linked with it. Right. And yeah.
Speaker A: Which was what? King's Health Partners, Meridian.
Speaker B: And to be honest, they picked some great winners. So there's something in it. Scale that up, you know, Penny, Jim, that's your opportunity.
Speaker A: Yeah. I think with, um. If they could scale khp. We're a KHP company, so I'm slightly biased, but if they could scale that, I think that that would make a lot of sense and it brings it more into line with the US Model.
Speaker B: Yeah, yeah.
Speaker A: Where at a regional level they are prepared to back winners.
Speaker B: Yeah. Interesting.
Speaker A: But the thing there is that they've got so much commercial scale M that you. But you can actually deliver really meaningful revenues.
Speaker B: Yes.
Speaker A: By doing that within a region.
Speaker B: Yeah, yeah, I agree. The funding landscape is. I mean we've all. You've probably experienced it. Right. The VCs that say we won't fund NHS.
Speaker A: Yeah.
Speaker B: You know, I think that pendulum's come back a bit now. Recently.
Speaker A: Yeah. I think.
Speaker B: But there was a period.
Speaker A: But, you know, there's been, you know, there's you guys in a few others. And that's what I meant when I said the show, like. Yeah, these are the winners, you know, the people that are really winning the market m. That we need and we need more. More, you know, more doctor doctors.
Speaker B: I mean, I certainly think. I hope you do too, that the nhs, the UK could produce several international unicorn scale businesses.
Speaker A: Yeah, it should. Yeah, it will, it has potential. Right, for sure.
Speaker B: Um, but we, we seem to cut our winners off when they get, uh, you know, a couple hundred million pound valuation, you know, tens of millions of revenue, maybe 50, 60. And then we seem to hit this sort of scaling limit. We don't, we don't go, this is amazing. We're gonna, we're gonna grow and export it.
Speaker A: I think whisk. I think there's a scared. I think it's two things. One is there's no structure, and I wrote about this on LinkedIn the other day, there's no structure that allows NHS customers of any kind to buy British.
Speaker B: Yeah, I saw your post.
Speaker A: Yeah. Legally or even sort of, you know, conceptually, like they can't do that. So how on earth can they, like, think about those things and they're like constrained, you know? Um, so I think that's. Yeah, I'd love to try and figure that out, but obviously you don't want to go too far into like market manipulation or anything. But. Yeah, I don't know. I also think finally we should, as an industry be looking because there are businesses that make huge amounts of money selling to the nhs. Yeah, they're just not, quote, unquote, health tech. Yeah, right.
Speaker B: Yeah.
Speaker A: I'm on the NHS England Advisory Board. There's a guy on it, Danny, and he's the largest supplier of milk in the Southwest. Yeah, he supplies like 5,000 liters a week to every single hospital in the Southwest. He's like the king of milk. Yeah, let's go learn from him.
Speaker B: Yeah, cool. Respect, Danny.
Speaker A: Not agentic, but it's good. Um, right, so we're in the last minute of the show and I asked this of all my guests on your journey, what has the self talk that you use, the motto that you go back to that's kind of gotten you through all those tough times that you would share with people that they might get some benefit from?
Speaker B: Um, stay curious and stay humble. You know, I think the curiosity takes you so far and, um, hubris and too much arrogance doesn't work in the NHS market. You can be disrupted at any moment. Listen to the people in the organization you're working with. The person who's on the lowest band, who seems to do the most simple job, is where the insight is. And keep going back to that.
Speaker A: Great. Thank you so much and thanks to everyone for listening. Oh, if they want to learn about Dr. Doctor, where do they go?
Speaker B: Go to our website, www.dr. Dr. Which is DrDoctor. Uh, co UK. Follow us on LinkedIn. Um, I'm on Substack and Twitter as well.
Speaker A: Okay, great. Well, thanks very much and thanks to everyone for listening. We'll be back again next week.
Speaker B: Thanks, Dave.
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