The Healthtech Podcast · 2026-09-10 · 48 min
Key moments - from our scoring
Substance score
62 / 100
Five dimensions, 20 points each
Dr. Kanani brings a unique dual perspective to prevention - shaped by her NHS roots, COVID-era innovation leadership, and now work scaling preventive screening through Neko. After six years at NHS England managing everything from pandemic response to the vaccine rollout (eventually 3,000-5,000 vaccine centers nationwide), she stepped into the private sector to learn how tech-enabled prevention could work at speed and scale while maintaining clinical rigor and member experience. Neko's year three data from 80,000 scans reveals that approximately 1% of scans detect life-threatening findings - a clinical finding that validates prevention screening at population scale. The conversation tackles the tension between accessibility, cost, and equity: Kanani argues that affordability alone misses the point; real barriers include trust, community relationships, and whether services exist on people's high streets. She emphasizes building anonymized datasets (Neko's now massive) to make the evidence case for prevention investment, echoing global research that "unless we invest in prevention, we will never deliver prevention." Neko balances cutting-edge tech with clinician time and holistic assessment - members report valuing not just the scan but the education and relationship. For NHS leaders, primary care innovators, and prevention-focused operators, this episode unpacks how digital screening, clinical partnerships, and community trust actually drive behavior change in real populations.
Approximately 1% of Neko scans detect life-threatening findings, according to their year three data covering 80,000 scans.
Neko has established an NHS partnership where members can be referred back into the NHS for exceptional care following preventive screening findings.
Trust, community relationships, clinician availability, location accessibility (being on your high street), and word-of-mouth recommendations from people members know are the primary barriers - not price alone.
The 80,000-scan dataset builds evidence that global research shows is essential: without data proving prevention works, funders and policymakers won't invest, perpetuating the cycle of reactive rather than preventive care.
Neko is launching in New York later in the month of this recording (after being already established in Sweden and the UK).
Our reviewer’s read on each dimension, with quotes from the episode.
The episode contains several concrete claims about Neco's data and preventive care philosophy, particularly around the 1% life-threatening disease detection rate and 2.5x engagement lift in those with chronic disease. However, substantial portions involve personal narrative (COVID experience, pharmacy background, parenting) that, while interesting, don't directly educate a B2B operator on healthtech or prevention strategy. The data insights are present but diluted by extensive context-setting.
every year we still find about 1% that are life threatening
people with chronic disease got kicked into gear two and a half times more than those without
The guest recycles familiar prevention frameworks (accessibility, community trust, data-driven innovation) without sharp contrarian takes. The public-private partnership model is sensible but not novel. The guest's framing of prevention as a trust and relationship problem rather than purely a cost problem is somewhat fresh, but the episodic discussion lacks the specificity or rigor needed to constitute original thinking. Much relies on personable storytelling rather than new strategic insight.
unless we invest in prevention, we will never deliver prevention
it is not just because it's good for you or you're being told to
Dr. Kanani is a genuinely senior operator: NHS England leadership during COVID, architect of the UK vaccine rollout, current Global Medical Director at a $7B unicorn, NHS GP, board member of NHS Online, and founder of a women's health startup. Her track record of executing at national scale and her ability to bridge public health policy with commercial innovation is rare. She is a practitioner-executive, not a pure theorist.
I settled five health secretaries for primary care
we stood up a vaccine program that could deliver in all parts of primary care
The episode grounds itself in Neco's Year 3 data (80,000 scans, 1% life-threatening detection rate, 2.5x engagement in chronic disease cohorts, HDL improvement patterns). The host shares personal scan results and lifestyle changes. However, the discussion of these data points is often exploratory and speculative (e.g., 'we're not quite sure' why HDL plateaus on year 3 scans) rather than definitive. Concrete specifics exist but are sparse relative to the episode length.
80,000 scans in 2025
1% in 2023, 1.2% in 2024 and then last year 1%
The host asks reasonable follow-ups on data quirks (e.g., the HDL plateau on third scans) and pushes gently on the 'worried well' criticism, but rarely presses back hard on claims or explores tensions. The conversation is warm and collaborative but lacks the productive friction of a skeptical interrogator. The host often pivots to personal anecdote or high-level themes rather than drilling into specifics. A few moments of genuine curiosity ('what changed internally with the $700M raise?') but mostly softball territory.
One thing I spoke to uh, Yamar about last time was worried. Well, and that being an obvious, you know, are you perpetuating this, that and the other
I only zoned in on it because it's the thing that I'm focused on, which is the HDL cholesterol. Um, and there's just an interesting quirk
Computed from the transcript - who did the talking, and the words that came up most.
Dr Nikita Kanani MBE is Global Medical Director at Neko Health and still a practising NHS GP. Before Neko she was medical director for primary care at NHS England, through the pandemic and the vaccine rollout, and she and Dr James Somauroo start there because it explains everything that comes after. She is precise about what those years were actually like. Two or three in the morning on Teams in her pyjamas, her daughter building a diorama of the Roman empire beside a call with the Prime Minister, and her mother running the family pharmacy without PPE while her father shielded. She was asked to join the vaccine programme the week before Diwali, argued for delivering it through primary care rather than around forty hospitals, and ended up with thousands of sites and a map on the wall. The second half is Neko's year three data, which James had read on the train in and came armed to argue about. More than eighty thousand scans in 2025. Life threatening findings holding steady at about one percent across three years, which is her answer to the charge that scanning more people only finds more noise.
Transcribed and scored by The B2B Podcast Index.
Speaker A: Every year we still find about 1% that are life threatening.
Speaker B: That's very relatable because my last scan had a raging cholesterol.
Speaker A: Unless we invest in prevention, we will never deliver prevention. An NHS partnership, NECO and nhs, where anyone we see can get referred back into the NHS and get exceptional care.
Speaker B: Geeta Kanani, welcome to the HealthTech podcast.
Speaker A: Oh, I'm so excited to be here.
Speaker B: A long time coming, this, isn't it.
Speaker A: It has actually, yeah.
Speaker B: Um, loads and loads and loads for us to talk about. Firstly, we're going to talk about your background. Then we're going to talk about some of the stuff you've been doing at neco. I've got all of your data here that I'm going to quiz you about your year three data.
Speaker A: I'm ready for a quiz.
Speaker B: Yeah, we're going to talk about that. M. I, uh, might use you as a GP to just go through my own scan results that I have this year.
Speaker A: Also here as a NHS gp. Fully validated, don't worry.
Speaker B: Yeah, ideal. And then just looking at my stuff. Yeah, we got loads to talk about. Right.
Speaker A: Parenting tips.
Speaker B: Parenting tips. Absolute. Absolutely. Yeah. But let's start with your background. Okay, so, because I. I don't think I've actually heard you explain all of this, but I was reading your background on the train on the way in this morning and actually looking at everything that you've done and I knew it. I, uh, knew you'd been part of NHS England and the whole Covid stuff and all of that. I just, I hadn't really appreciated or put it together that you, you've been in some serious leadership positions in some serious times, in what will go down as like, human history, pretty much, which is wild. Um, and now you're at Necco. 7 billion valuation, allegedly. 700 million raise you doing some crazy stuff. But where does all this begin? Because at some point you did medicine and a gp, you were a medical student at some point in your life. So did you see all of this in your future?
Speaker A: I mean, maybe doing crazy stuff is just the header. Did I see it in my future? No. But when I look back with that beautiful kind of retrospectoscope, um, it sort of makes sense. Uh, dad was a refugee from Uganda, spent six months in a tent in Newham. Mum was an economic migrant from Kenya, somehow navigated their teens here in the uk, in Sunderland, where I'm now a visiting professor, which is beautiful. What a full circle. But anyway, became pharmacists, had a community pharmacy. So I actually Grew up in their pharmacy in the wire basket on the side of the till, um, to the point that sort of families still knew me just as they were. They were retiring sort of 40 odd years later. Um, grew up only speaking Gujarati, Um, went to nursery and my mum dropped me off and they were like, no, no, take her back. We don't. You don't understand who she is. But my point being, I was, I grew up in a community full of other communities and I think that very much means that what I do now and what I've done sort of, you know, the career you've described makes a little bit of sense, although it's always been a little crazy paving.
Speaker B: Yeah.
Speaker A: Um, I was a medical student once. I was a medical student, unsurprisingly, who loved to do everything, every, every job, every exposure, every opportunity. But it was really when I was doing house jobs that I realized that I could do more alongside my clinical career. So I've always stayed a practicing clinician, whether that was in hospital medicine, um, general practice, and I'm still an NHS gp and I love that, I really do. And there's more to do, there's always more to do, whether it's the person in front of you, the community, the population. So, yeah, eventually my career went from sort of local to local sub regional to regional to national. And that's where I ended up at NHS England for about six, seven years. Um, carrying through kind of those, um, different, uh. Yeah, pretty significant periods of time.
Speaker B: Yeah. Building a heck of a lot of resilience, I imagine as well.
Speaker A: Yeah, we're still a good thin skin. I think it's a lovely mix.
Speaker B: Yeah. Yeah. I want to talk to you about that to begin with because, um, I, I don't think that could have been easy. I think everyone in those types of positions was doing everything for the first time. There was no playbook for how we were going to get through a pandemic. And you find yourself in a leadership position of the entire country, having to negotiate COVID testing for an entire population and do all of that stuff. What was that like? How did you practically. How did you do that?
Speaker A: I mean, still one of the darkest times of my career and my home life. We had incredible support, and by that I mean both at work and at home. Um, which sounds odd because we were all kind of tied up and hidden away at home. We were all doing it for the first time and I. That gave me enormous strength. I would be in my pajamas at home on teams meetings or. Well, it was a mix of teams and all sorts of modalities then, not as easy as it is now, but 2 or 3am, um, in pajamas with all sorts of people around the country trying to make sure that we were ready for the next day, then wake up a few hours later, get back into the NHS England offices, which we'd sort of commandeered for core personnel only, um, to make sure the next protocol was ready, the next approach, um, and make decisions that were genuinely the toughest I've ever had to make. Things that really, um, still hit me. So, um, NHS England was there to deploy whatever came out of sort of COBRA and Cabinet. But we were making decisions as well as making sure things happened in a kind of operationally robust way. And by that I mean we talked about, um, things like, you know, when do we close general practice? Um, not fully close it, but close the doors to protect, um, staff, to protect patients so that we, you know, reduce circulating Covid, uh, delivered load within a practice. It was constantly making decisions that had impact one way or another, obviously at a country level. But one of the things was, you know, how do we protect general practice? The people within the teams, people who were coming into surgeries. Let's close the doors, let's triage, which brought in digital triage, which was fantastic. You know, it was, it wasn't happening before then. Um, but then we keep community pharmacy open and my mum was running our community pharmacy because my dad was shielding. And my mum would call me and say, will we get any PPE yet? And I would say, well, not yet, because we had to prioritize what was available. So, you know, there was these kind of macro population level decisions and then really micro personal decisions. But, um, how did I navigate it? Uh, as I said, people, community. Even though it was virtually, um, the kids were still in primary school. So, um, my daughter spent Most of her 6 year, ages 6, 7, 8, sat next to me. So when I worked from home I would do kind of, um, a lot of our, ah, government facing cabinet facing meetings either at number 10 or at home. And she would be building a diorama to showcase the fall of the Roman civilization. And then listening to kind of, you know, Boris Johnson give a view on something we might need to do. Um, so it wasn't, um, you know, it was the most unusual of times. Um, but the end of that year was proper shining light. So, uh, the one thing that it is worth really, uh, remembering is the week before Diwali when I was asked to join the vaccine program. Um, and we were planning to roll out the vaccination in, uh, 40 eventually 40 odd hospitals. But because of the work I'd done around primary care and primary care networks, um, there was a thesis that we could actually roll it out in primary care and get much more geographical coverage, which means access, which means immunity. And we did. And um, within a few weeks we stood up a vaccine program that could deliver in all parts of primary care. And I remember having these A3 maps on the wall and trying to figure out like, where else we needed to have vaccine centers because in the end we had 3, 4, 5,000. But at that point it was, you know, one by one. And I was looking at this place on the map and going, we need one there. And everyone's like, that's the Lake District, there's no one there. And I was like, I don't care, I want a vaccine center everywhere. Anyway. Um, and then that was incredible because we had not just uptake, but we were able to work with min ministers with cabinet to actually, you know, encourage people to do something really meaningful with community. So I spent six, seven weeks with the prime minister on a Sunday, going in every week m him in his pajamas because it was his home. It was his home talking to people.
Speaker B: He could have got dressed though. Come on.
Speaker A: Well, do you know it was stripy. It was all stripy. So it worked. But genuinely it was incredible because what was important about that was stuff that we've talked about before. What convinces somebody to do something for their health. It is not just because it's good for you or you're being told to. There's a, there's a whole bunch of other things. So with faith groups it was about talking to faith leaders, Pastor Agu, who ran 2,3000 black churches, working with him about why this was important. What else would we bring? Would we just have one intervention with the community? Would we make a promise and disappear, which is what often happens, or are, ah, we going to have a relationship over time, over years and years? And that was the sort of conversation that we put in pace. And it was very much a legacy piece which really, um, which really uh, struck me as the most important thing we should be doing in healthcare. Which makes sense as to why Necco is so important to me now.
Speaker B: Yeah, that does make a lot of sense. Community relationships, trust and actually, you know, going through faith leaders to access people that really don't trust the healthcare system. All of these are themes, uh, that I can certainly get on board with. One thing that you said earlier actually was that you used the phrase which brought in digital triage, you know, that, that element of just, oh, it just was a good idea. So we just did it and then it worked and we were allowed to do it. Seemed like that was such a bizarre time for innovation to actually just, oh, if it makes sense, let's just do it. And you and I, uh, operate in, in this evidence base as clinicians anyway, in this completely evidence based world where getting anything done beyond the norm is just so difficult to do because of evidence and regulation, all that sort of stuff which all has its place. But I suppose seeing that level of innovation must have, you must have got bitten by the bug in some way given the wave, ended up. Because actually seeing what could then be done at massive scale so quickly.
Speaker A: Yes.
Speaker B: Has kind of plotted the path to where you are now in some respects.
Speaker A: Oh God. I mean that is a great, a great call. So I think a couple of things, I did grow up on the remodified N64, so I do think there was something about that kind of creating something, you know, within me. But interestingly, when we, when we brought in digital triage through the pandemic only weeks before, I'd been negotiating, I've been trying to negotiate its entry into general practice as we knew it then. And there was a lot of anxiety and a lot of concern and completely understandable, you know, both, do we have the tech infrastructure? Is it safe? Will it work for clinicians, will it work for patients? Very understandable questions. And genuinely weeks later, you know, the negotiating committee for general practice saying, we need this digital triage. We cannot just bring everybody in untriaged, um, through our doors. So it was a very bizarre scenario. And I also had these amazing tech leaders, you know, calling up saying, we want to offer our services, our product for free will also help people on board. We will come together as a, um, sort of like a consortium or a community of offers. So I wasn't just looking at one or two, I had 10 or 12 around the virtual table, table saying, okay, we could do that bit. Okay, you do that, but we could do this bit. So there's intense collaboration within the kind of private digital leadership community as well as, ah, a need, ah, you know, a safety need within the wider kind of health community.
Speaker B: Yeah, wow. So plot the path then to Necco.
Speaker A: Uh, I had done six, seven years. I had just finished the vaccine program and then worked through a big um, merger program in the NHS through NHS England. And I stopped feeling like I could do the things that I feel I'm built To do, you know, you get pretty good sense after 10, 20 years that the areas where you're good, the areas where you're less good, where your energy comes from, how you help other people through complex change. And I knew I needed to step out before I could step back in. Um, I'd settled five health secretaries for primary care as well so I really felt like I'd done my time.
Speaker B: But these days that's actually not a good marker of a long span of time. It's the time of a health secretary,
Speaker A: one a day, day, five days. So I really felt like um, I had more to learn as well about um, health innovation, about tech, about how to take people with me in a partnership session is a sense and not just in the public sector. I wasn't looking to work in the private sector. I just needed to learn more, do more, have kind of tangible fast impact. Um, so two things happened. One um, I set up a startup in Women's health which was phenomenal. It was the best experience ever. I absolutely loved it. I loved being a founder, I loved being, I loved growing something, I loved molding something around people, around communities, around women in this case. Um, and secondly I was introduced to Necco um, by a mutual friend. A friend who works for Daniel said this company is launching in the uk, you should come and get involved. And at that point um, I still have good relationships with stakeholders, regulators et cetera. So um, I started working with Neko actually um, just as we were well before we were launching here in January so started working with Necco in January 2024. Um and then last year M met Yama again uh just before the summer, um, saw how fast we were growing and got the bug again and loved what we were doing. Um, not just in terms of growth but kind of very much balancing quality of care and that member experience. And I thought that was really phenomenal because we don't talk about that very much in the NHS and that's very understandable. Many incumbent systems have got so many pressures that what that member experiences isn't the top of the list. But we know, we know through ah, design led experience based um, evidence that that experience is what keeps somebody engaged in coming back. So the opportunity to work with neco, with incredible tech, incredible people, an organization that genuinely puts a person at the center of what's being designed. Um, well I mean it was a no brainer. So um, I've, I've had a phenomenal journey with Necco both as an advisor now as a substantive part of the team and we're growing in Sweden, in the UK and um, around the world. So later this month we'll be launching in. In the U.S. in New York.
Speaker B: Amazing. Um, and there are some even more things that you do which will. Which I'll probably come to after chatting about this for a minute. But, um. Okay, let's talk about Necco. So preventative health. You're an NHS gp. What did preventative health mean to you before joining Necco and what has it meant to you since joining Necco? And by the way, reason I ask is obviously we did the event together, which had so much interest from, you know, senior NHS people in primary care, from so many GPs. And one thing that I, I think noticed in that room more than I noticed anything else was actually how, like it sounds like. I mean, it sounds like I'm sort of making this up, but like it was, it was collaborative in the sense that there were so many gps. Just went, hold on a minute, we can learn from you and perhaps you can learn from us. And there's something to do in the middle here. And there's just. There was just a really interesting vibe to it that I think it changed people's perception of what preventative health care actually is. From that longevity tech bro, live forever billionaire. Uh, like everything in that kind of Venn diagram on that side of anyway, to then this kind of. There are NHS health checks. There is just looking after yourself. There is only looking for what is actionable. There's all the stuff over there on that side. Chronic disease and preventing that stuff. There's all that on that side. And there was a lot that got demystified in that room.
Speaker A: Good.
Speaker B: But I'm interested in what you thought of it before and after enduring and what your journey's been for it.
Speaker A: I mean, it's a great question because I commissioned the NHS health check for years.
Speaker B: Yeah. Okay.
Speaker A: So there's another lens there as well.
Speaker B: Interesting. Yeah.
Speaker A: Um, but I'm a. I'm a child that was brought up in an Asian family. Yes. In a pharmacy. So I would see, you know, parcels of medicines being handed out. But I also grew up where, you know, community, uh, and movement and. Okay. Huldi dud would all be part of keeping well before you got unwell. Um, now we know that isn't always what plays out in South Asian communities, but the philosophy around looking after yourself, around keeping well was definitely, um, yeah, part of. Part of my DNA. So it very much felt like I was coming home to an organization that was building with prevention in mind. I just didn't know what that was until I understood what Necco was. It was taking everything that we've learned about prevention and that wide spectrum that you describe and kind of going that's over there, lets us build up from the beginning the tech, the um, data points, the information we'd need to genuinely improve people's ability to be healthy and to get healthy. For me, that's why this intersection is so interesting. Um, absolutely. We get people coming in asking all the time about sort of methylated, uh, DNA on the more longevity side and we ask people very much focus on systolic BP on the really kind of more traditional prevention side. What's important here is that we offer something that is accessible to members. And by that I mean any member that comes in, no matter your starting point. So wherever you start with us, we can take you on a journey where year after year you can get better, you can get more well, you can get more healthy. And that's what our data's showing us year after year.
Speaker B: The accessibility piece is really interesting because I've done a fair amount of work now on, I suppose almost like academically looking at prevention and looking at the various governments that have suggested certain things with prevention. And there was a point in time where a report was written and it, it, and it basically said either you focus on it or you're going to struggle. And then here we are 20, 30 years later struggling, quite literally and the accessibility being, um, part of it. One of the points that I think I've learned in my work is that, and um, research on this is that the price point and how much it costs someone. Because let's be honest, you're in both worlds here of the NHS when it pays and NECA where people do. But that's often, I think, what people are fixated on and they, and it becomes a binary.
Speaker A: Yes.
Speaker B: Of is it paid, is it not?
Speaker A: Yeah.
Speaker B: And paid actually runs into the tens, hundreds of thousands or Brian Johnson's, you know, multiple millions a year spent on that side of thing. And, and it's, and it's interesting to me that there are companies that are trying to really drag the price down and that R and D that's happening on that private sector side then dragging the price down and that being something that was interesting to people at the event as well, of going well actually that's people that then come off the NHS health check waiting list or it alerts them to it and they tell other people that it's. So there's, there's a Lot. There's a lot in there. But as someone that clearly cares about community and accessibility and has a lot of NHS values to you, where do you. And this by the way, is a question I got, I got criticized after the event for, for not letting you speak enough. So that's part of the reason for Bashti to come on there. I, I'd love to know how, how you think about all of that.
Speaker A: Uh, it's such a tricky space, isn't it? To your point, if we think about access, just about cost, then we've missed the point. And that's something that, as an NHS person through and through, I have to keep reminding myself cost always feels like an ugly piece, uh, an ugly word, an ugly way to frame things. The things that I keep reminding our clinicians, and I'm pointing because we're not far from our clinic, is that this is our opportunity to offer not only excellent care and excellent information to our members in a way that helps them to get more and more well, but to build a massive anonymized data set which will make the case for prevention. And the report you're referring to an actual kind of global and national studies, since have very clearly said that unless we invest in prevention, we will never deliver prevention. And the argument will be then, well, where's the data? And there are no data sets that are as big as the data set that we're building. Our year three data for 2025 looked at more than 80,000 scans. 80,000 scans is a huge number, and that's just year three alone. Um, so for me, and actually I talk about equity and equality a lot at home, particularly with my daughter. So it's quite, you know, it's quite interesting to kind of tease out what are we trying to do? Are we trying to make it affordable for everyone, for the people who need it most? Are we trying to remove kind of systemic injustice where people haven't access to healthcare because of trust, because of relationships? And we've talked before, that it isn't just price that stops people coming forward to have a health check or a vaccine or a prevention intervention, whatever we want to call it, it is about, you know, is that offer, uh, on my high street, is it something that I've heard from someone meaningful? Now, today, someone meaningful is usually somebod on social media. And, um, one of the reasons we have such an, uh, all encompassing, uh, social media presence is people who've come in and who talk about us, because that encourages other people to come in and experience the scan and the Minute you're in, it means that we can give you a baseline and start helping you become more and more. Well, um, interestingly, when I talk to people about the price and I talk to our members a lot, as you'd imagine, the price often doesn't feel particularly prohibitive. What people want is that holistic assessment. So everything done in one place at one time and then brilliantly for a tech company. And I think we've got this really interesting, uh, balance here. Amazing tech, amazing experience and time with the clinician and more and more. What I remember say is your tech was amazing, your experience was great and I got time with your clinicians and they were knowledgeable and they had time for me and they could walk me through what was needed. And that becomes a generational intervention. And by that I mean somebody who didn't trust healthcare or the idea of early access to prevention led services, has time with a clinician with amazing data and goes away and tells other people, they tell their family, they tell their mum. My son just turned 18 and he had his first scan at 18. He has arguably hundreds if not thousands of data points about himself in a way that we never would have had growing up. And I think that is what's gonna change community and their relationship with healthcare and prevention.
Speaker B: Do you see the day where, say, NACO and the NHS are in a working relationship?
Speaker A: Absolutely. And I'm so excited for it. So, um, at our event, as you know, lots of people asked about what the relationship between private and public sector loads.
Speaker B: Like a genuine surprising volume of people. Yeah, like multiple tens of people.
Speaker A: Yes. Yeah.
Speaker B: Just for an intro to you, I
Speaker A: mean, the queue is still so long and I'm still kind of working through how to have really, um, meaningful relationships. I want to be a responsible private provider in this space and private partner. So we do. And I understand that. I've been in the startup world, you know.
Speaker B: Yeah.
Speaker A: People coming in and disappearing. We can't do that. We have a responsibility to the nhs, to patients, tell the clinicians. Um, but we have a number of, uh, partnerships that we're working on, one that's definitely further ahead than the others, which, you know, at the right time, you'll hear about it first. But an NHS partnership, NECO and nhs, where anyone we see can get referred back into the NHS and get exceptional care. What that means is, is that people, um, who come in through, you know, through their own means are not worrying about follow up care in the private world. If they feel they can't afford that, they can get that Follow up care through the nhs, but in a partnership way. We're not just dumping stuff back into the nhs, which we've been really cautious not to do. And in fact we consume a lot of our own smoke. The majority of people we see that need a follow up of any sort will repeat the bloods at our cost, will do the echo or the ecg. We will work them up as far as we reasonably can. We'll do the repeat skin images. So people who then touch the NHS or indeed the private sector, uh, genuinely need that care that further diagnosis or
Speaker B: treatment hadn't appreciated that was so close to happening. If you're talking about. So what's the, what's the difference that. Forgive this for being a stupid question, what's the difference then between what you just described and what happens now? So when you talk about a partnership model, are we talking about like an economic model here? Like what's the what.
Speaker A: So what, what we're talking about with our, um, most likely kind of relationship that I'm, I'm talking about that this calendar year, not, you know, pie in the sky next year, in a few seasons or quarter. The idea is that somebody who we see that needs NHS follow up care. So it might be with a dermatologist or a cardiologist or an endocrinologist, given the things that you've seen in your scan, will get direct access to them. So still keeping the GP in the loop in terms of the information and the information flow, but not asking somebody to go back into their nhs, um, practice. Then you've got a member of the GP team, then having to review them again, do another bit of admin, put them back through into the service and, you know, that is a boggy, rubbish experience for the member. But it's not great for general practice either. Even though we do all the referrals, we do all the paperwork. So this will kind of cut through all of that, make sure people can get seen, you know, within a standard T week weight pathway, um, if it's derm, um, um. So brilliant experience for the members, um, the clinicians that we've been talking to already love it because the people that we refer. So with dermatology, the people that we refer almost always, um, you know, turn into a melanoma that needs a removal. We have such qual, great stats in terms of the people that we see the number needed to excise. So our kind of global data, if we look across UK and Sweden, um, we need to refer kind of maybe five or six members for, uh, A melanoma to be found more globally. If you look at general practice, generally, you're talking about 15 or 20. So we already have, um, NHS general practice teams who, uh, might have some of our staff working with us, coming back to us and saying that our staff are now so well trained that they have the most exceptional kind of numbers needed to excise referral, uh, rates within the practice, which is, again, phenomenal. And so the partnership isn't just a partnership for the member. Our clinicians work in the nhs, they refer in the nhs. So it means that, uh, if we upskill our staff, the uk, the NHS has an added benefit as well.
Speaker B: That's a real unintended or not an unintended benefit. It an unpredicted benefit.
Speaker A: I think from our perspective, I was pretty clear, um, and we've touched on this before, that people who work with NECO need to still have a foot in the nhs, whether they're practicing general practice or somewhere else. Partly to understand the community, the kind of existing pressures in demand, but to take stuff back into the NHS as well. We're starting to see, uh, the fruit of that.
Speaker B: M. Right. You mentioned the data. Let's talk about some of the data. So. So, um, when I looked through this and I looked at it last night, I looked. I read it again in more detail on the train this morning. The main thing I got from it is that this kicks everyone into gear.
Speaker A: I love that. Yes.
Speaker B: NECA just kicks everyone into gear. And I think, or m. Maybe not even saying Necco, a scan or review of your health clearly kicks people into gear. People with chronic disease got kicked into
Speaker A: gear more two and a half times more than those without something.
Speaker B: Two and a half.
Speaker A: Two and a half times more. Yeah.
Speaker B: Right, okay. And. But everyone comes back better off for their. Well, not everyone, but most things are
Speaker A: improving across anything that is, um, kind of modifiable, statistically significant things where the data is showing that an intervention makes a difference. So systolic bp, your HDL going up, your non HDL going down, you know, across those things that we know make a difference. Yeah, we can see that improvement.
Speaker B: And that's very relatable because my last scan had a raging cholesterol M. Yeah, that was not. I didn't think, anyway, was particularly conducive with my lifestyle. Turns out, uh, if I actually put a magnifying glass on my lifestyle, you can't drink three or four pints of whole milk a day.
Speaker A: And three or four pints.
Speaker B: James loved it. And, uh, have loads of red Meat.
Speaker A: Yeah.
Speaker B: Also blah, blah, blah. Like packs of Doritos at a weekend because I deserve it.
Speaker A: Which flavor?
Speaker B: Uh, I actually eat. I started going on the hard stuff, like the. The red was almost a gateway to them.
Speaker A: Yeah, yeah, yeah.
Speaker B: The purple.
Speaker A: Yeah, that's. Isn't it. My kids have started making nachos with it and lading those up and I'm like, so can you just stop here? You guys have use on your side.
Speaker B: And the thing is, it initially it's. It in anesthetics, we call it tachyphylaxis.
Speaker A: Yeah.
Speaker B: It starts. It starts off having a really big effect on you, and then you just crave it.
Speaker A: Just get more and more used to the really harder. Okay, so, uh, less milk, less red meat, less.
Speaker B: Basically, I cut out saturated fats completely.
Speaker A: And. And this is from your last scan, which is last year, which was last year in November.
Speaker B: Okay. So cut saturated fats out completely.
Speaker A: Mhm.
Speaker B: And a whopping reduction in.
Speaker A: Well done. Well done. That's amazing.
Speaker B: Thanks. Also lost 8 kilos.
Speaker A: I was gonna say, you're looking ready. Trims.
Speaker B: Yeah. I didn't think I had it to lose. Turns out I obviously did. Cropped off on me. But what I'm saying is, though, Mike, like, this matches my experience. Yeah. And they. What I also noted was that you've added in lipoprotein. A. Yeah. Ah. Or apoprotein, I should say, as well.
Speaker A: Yeah.
Speaker B: Um, you've brought it down, broadened out. It looked different. There was. Was a big screen in front of me with everything going on. There was microvasculature on my feet going.
Speaker A: Yeah.
Speaker B: From your position as clinical in all of this, um, how do you make those decisions as to what you add?
Speaker A: It's a really iterative, thoughtful process, which is exactly as it should be. So, uh, some of it will come from innovation. So things have been, uh, seen out there in the big wide world that just looks incredible, has incredible data and outcomes already be. Okay, what are we missing? Why aren't we offering that? Some will be in the, um, head of Yama. He'll sort of think like an engineer and kind of go, well, hold on, if we can do that and that, why can't we do that? And I think, uh, you guys talked about this in the podcast. He'd. I think his brother had said something about how one assesses a patient and talks very much about data points. And then Yama was saying, well, hold on. Looking at a patient is a data point. His brother was like, yeah. Oh, okay. So that sort of thinking when you bring together clinicians and engineers and innovators, you're constantly thinking about what can you do next and differently. There's a proper process in there as well. What do our members say? Uh, and not just what do our members say in terms of evidence based changes. What else are our members asking for? Because actually the reality is the noise out there is huge. Not doing things just because there's no evidence isn't the full story. Now we are evidence based in terms of, um, bringing in interventions that are, that will give us modifiable information, things that we can do something different. And we are an organization that is building a data set day after day, week after week, month after month, and now year on year. And we're the only people who are publishing this data openly and saying, okay, this is what we're seeing, this is what we're founding. Because we don't have all the answers, nobody does. But unless we collect that data and go on that journey, we, we can't. So what our data will now tell us is, okay, now let's focus our R D in this area and in this area, um, let's build out in this way. And because each of our um, clinics is like a live R D lab, properly consented, properly thought through. But actually how, how incredible is that? We can keep building on that offer. It does mean that we then have to refit our clinics. So what you experienced this morning, you were one of the very first in the UK to have a. You scared? I mean we've been doing the training internally, but first members of the public to have the new scan with the new blood test. So our team have been trained on a whole new flow, a whole new scan, a whole new experience. So that, that innovation doesn't just sit in somebody's brain or on a, you know, in some sort of cool software or even in our production company in Stockholm. It is here it is live and rolled out to you year on year actually. That's the ambition.
Speaker B: Nice. So just because I had the scam this morning, I'm still gonna give you a bit of a hard time.
Speaker A: Okay, go for it.
Speaker B: On the data.
Speaker A: Yeah, please.
Speaker B: One thing I spoke to uh, Yamar about last time was worried. Well, and that being an obvious, you know, are you perpetuating this, that and the other. And Yamar's answer at the time was that we only test what's actionable. M. There's also an element that you do detect potential life threatening disease as well. Well, and that's shown up in the data. So what can you say about worried? Well, and all of that stuff as a criticism when you look at this year three data.
Speaker A: So luckily my personal position on worried, well, um, kind of makes sense in the context of Necco. I've always found it a really frustrating term if in surgery, in GP surgery, somebody comes in and they're worried about something, they're worried about something. They might be well today. But if they're worried that, uh, if you believe in that kind of mind body connection, then that worry is for a reason, reason and will have an impact. So people who are worried do need a way to navigate that and a safe way to navigate what they're worried about, why they might be worried and how to make sure they are on the most healthy track possible. That's thing one, thing two, uh, unsurprisingly, Yama's right. We do look at only things that we can modify and that now shows up in the data. So just for listeners or we. I was going to say readers, but listeners or viewers maybe readers because this data report that James is looking at, ah, looked at about 80,000 scans in 2025. So that's across UK and Sweden. That's a mix of first time, second time, third time uh, recipients, about 9,000 having their third scan, um, which tends to be obviously mainly Sweden, quite a few in the UK now as well. Some of us are ah, well into, well, I don't know how many scans I've had now but you know, people are hitting their third scan. What we're learning is that where no matter the volume, as in every year we see more and more people, the number of people we're picking up with life threatening illness and let's come back to what that means is about 1%, 1% in 2023, 1.2% in 2024 and then last year 1%. So that lifetime condition pickup is staying steady no matter the volume of scans. So we're not finding additional incidentalomas. The more we do, we're not finding more false positives. That is actually really critical from a kind of clinical robustness point every year we still find about 1% that are life threatening. We're not just finding what would traditionally be called worried.
Speaker B: Well, interesting. I noticed when I read it there's a really interesting quirk on the third scan and I only zoned in on it because it's the thing that I'm focused on, which is the HDL cholesterol. Um, and there's just an interesting quirk that it doesn't improve as much on the third?
Speaker A: Yeah.
Speaker B: Also what's interesting to me though is that what you said previously, that this information then directs your R and D and it will change your practice. This is a dynamic way that you're now looking at this stuff and so this just becomes information that you then act on. And by the way, like, you know, I'm looking at everything else and everything else goes in the right direction broadly. It's just that there's obviously these quirks. But is that the sort of thing that you look at it and go, hmm, is there some information intervention that needs to then be done around this specific thing? Is there a way of doing that for people that are partners with us?
Speaker A: Because we don't know what people like outside of neca, we don't know how people behave year on year. We don't have anything to compare this to. So the fact that we're not quite sure. So maybe, uh, year four. Does, uh, uh, does HCL improve again? Does it, does it drop off? Okay, so it's been one of the livest conversations we've been having internally. Do we have to ask different questions now that we integrate wearables? Where will we focus? What is the sort of conversation we have in the debrief? How is it different? Do we do something and what does the evidence say and what does our kind uh, of anecdote say where people have improved their hdl? What do we do differently was that uh, you know, we can drill now in an anonymized and really data conscious way. We can drill right down and go. Actually this pattern of practitioner had this impact on HDL over these many years. Ahaha. Those are the things. And then I was sort of joking with some of our clinic leadership team yesterday. So in the NHS general practice kind of consultation model, we talk about the neighbour, uh, Roger neighbour model, don't we? Um, of the consultation style. You know, we are developing our own unique consultation style now because we will think to ask and pick up and prod on different things as we go year on year. So that is exciting.
Speaker B: That is really exciting. By practitioner is a very interesting way of like scoping that and seeing like, you know, some exceptional people that are what, and asking them what are they doing differently.
Speaker A: But this is how curious we are. You know, I have uh, flown out to Sweden for one of our, you know, we've got somebody, well, we've got many exceptional practitioners. But I, I was like, okay, and you do that. And then you had the. Oh, right, okay. Then you can take that back to the training and education team. Right. Can we modify the debrief in this way? Can we build this in then it's, can we scale that to all of our teams? Because you know, our teams are growing quickly. Can we make sure that as people on board with us, they learn this new technique and can we make sure the cpd, the continuous professional development is there as well?
Speaker B: Absolutely. Couple of questions before I let you go. Um, raising 700 million that, I mean it didn't come out of nowhere, but that was a whopping sum and some, some incredibly interesting people that, that were part of that round. What's changed internally? What, what, what do you guys do? I mean that must change the pace of things quite quickly.
Speaker A: Yes and no. Um, we're still, one of the things I love is that we're still very values driven. We know what kind of drives our value in our behaviors. So some of the sort of relational, behavioral things just haven't changed. We're like, we were already striving for 10x for doing the best we possibly can. We don't have time to lose. We have people that have to have access to our scan all around the world yesterday. So that hasn't really changed in many senses. What it has allowed us to do is think very carefully about kind of what comes next year and the year after. We already had a plan. We already want to grow, we already want to deliver an exceptional and high quality experience. But can we go faster? Can we push more? Can we do more? How do we do that in a way that doesn't undermine that member trust in us and takes our clinical teams with us as much as our innovators and engineers? Um, and so yeah, we're doing, thinking about how we grow faster and safely hand in hand. Um, and that diversity of investors will look, this is something that we want to be, be for everyone. And different voices, it's back to where we started. Different voices appeal to different people. It can take a footballer or a 10 star or somebody on the street or a faith leader. We need all of these people advocating for proper prevention so that we can offer it to as many people as possible.
Speaker B: And I think this is the thing that's exciting for me and I hope that we can, you know, do more events like we did previously because uh, I do think particularly around the faith leaders thing. And you and I, you know, know, both have, you know, certain genetics that means that we're susceptible to certain things. And I, and I know that those communities are also happen to be the ones that don't often trust the healthcare system and actually finding ways to get in, to actually spread that message and, and build that trust of the system is, is genuinely so exciting. And just before I let you go, um, I do just want to tell, like, show. I was, I was going to say readers then, listers and watchers. You also, you're on the board of NHS Online and, um, you are helping young girls in STEM as well, in whatever on earth is your spare time. The NHS Online thing, that's super interesting. Given everything that's in your orbit at the minute, that must just. Does it just slot in and is this all synergistic?
Speaker A: It is all synergistic and, and, uh, I mean, what a fantastic thing to be part of the first proper foray into kind of a. Not just digitized nhs, but an NHS that is truly accessible in a way that we just hadn't kind of thought about when it was constructed. Because most of these modalities, well, all of them were pretty much not around. So. Yeah, building out NHS online as a non exec is incredible. And one of the great things is there's a real appetite for that public private partnership and we haven't worked out how yet, but we know it's going to need to take a lot of people to get this right for the, for the population as it changes and grows. So that feels genuinely innovative and NHS facing.
Speaker B: Well, yeah, the people on that board, the group of people on that board, I mean, I don't think you want
Speaker A: to imagine those conversations.
Speaker B: It's so, I mean, you can explain it probably better than I can, but the backgrounds are not the traditional. Oh, it's them role. It's like. Well, you can explain something.
Speaker A: Yeah, I mean, just, I mean people have just done, um, some pretty amazing thing in all of their fields. I won't, I won't name all of them, but each, each one comes with this incredible background experience. Something very different. So all of us coming together is some. It's like, um, I don't know, gold dust, fireworks. I'm terrible at analogies because of the Gujarati background, but it does, there's a spark. And you think, oh, can we do that? Can we do this? And now we've got Caroline Clark as our chief executive tech. That's going to be really good fun as well as super like another super smart, brilliant woman. So, yeah, I'm very excited.
Speaker B: People that really understand consumers is what I picked up from. Yes, that's being the real difference. Obviously your, your work on both sides of that world in healthcare and, and the NHS side and, and with Necco as well and looking at from that side. But so many people that have exited and sold businesses that have, that have done that exceptionally well and just bringing that, that element to the nhs. That's, I think, the bit that I'm most excited about. I always get excited when worlds collide,
Speaker A: therefore, ideas and an acceptance of it. Whereas before the very traditionally kept all these things apart.
Speaker B: You would intentionally keep that.
Speaker A: Yeah. And when I was asked if I would apply, I, I, I was doing this job and I was like, oh, I'm not sure. I mean, I can, you know, I can declare and everything. They were like, no, no, bring your whole authentic self. I was like, well, that I can do.
Speaker B: Wow, that's awesome. Um, and final question then. Your spare time. Inverted commas. Uh, is it with your sister?
Speaker A: It's my baby sister. So she's the real superstar here. She's an astrophysicist, uh, writes loads of children's books, does lots of stuff about, um, diversity, inclusion and representation in, um, STEM. And so it was more than 10 years ago now when they added the, well, not they. And M M was added to stem. So instead of STEM with one, it was two. Medicine was added and we kind of went, oh, we can do something together. Um, so it's about, about creating opportunities. My sister and I, we didn't realize it, but we grew up with nothing. Mum and dad, dad worked all the hours. Mum did every, like many of our families. Um, but we had opportunities just to see that there was something possible. Mum always said we could do anything. So we kind of went forth and we wanted to create that opportunity for others. Um, and then we also get to have a podcast. Nothing like yours, but we get to have a podcast together where we also do kind of smashing, traditional kind of memes and tropes and stuff, or whatever the word is, and just talking about real life stuff. So just trying to kind of, to your point, bring worlds together because none of us are just our work self or our home self or whatever. We're all a mishmash of how we're brought up and what we bring. And I think that's what makes us the best agents for the people we're here to, to look after.
Speaker B: Amazing. Um, I'm gonna steal one more question from you. What is one thing that you're excited about at the moment, given everything you do, everything you're part of, everything you're seeing, seeing what's exciting.
Speaker A: Um, you will probably want me, or you probably think that I'm going to come up with something cool in the tech space. But the problem with that is, given my job, um, there are too many things, as you say. I look at our product roadmap, I genuinely feel tearful because I didn't even know some of this stuff was, uh, doable or feasible, let alone bringable to many to a population. So that for me, whenever I get, get anywhere near to what's coming, um, you think this was a, you know, a mock up the next year, the year after. What that brings for people is incredible. Um, I'm, I'm. Look, I'm, I'm also. I wouldn't be. I wouldn't be me if I didn't say I'm also hitting a new phase of life. My first kid goes to uni in a couple of weeks, so I'm, I'm trying very hard not to be consumed with grief and instead be, um, excited about what that brings next in, like, our family dynamic and stuff. So. So, yeah, it's all change. Um, there's plenty of time in New York the next few weeks and months as it has been. I'm really looking forward to what our us teams are able to do because again, that's a whole different dynamic. What people want and need, how clinicians are trained. So it's been really fun thinking about how to bring that to life. Um, but, yeah, we are, you know, I can confidently say I'm part of a company that is doing something really meaningful and I can't wait to see what we do next.
Speaker B: Amazing. Uh, if people want to learn more and they want to get in touch with you, what's the best way for them to do so?
Speaker A: Uh, through you.
Speaker B: Yeah. And that's what happened last time.
Speaker A: And that usually LinkedIn. LinkedIn is the best way to go.
Speaker B: It's been a pleasure. It's been a long time coming, but glad to have you on.
Speaker A: Loved it. Thanks, James.
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