Starting your NHS approach with the most powerful story possible - a guide.

Earlier this year I wrote an article about things that many, if not most, founders and healthtech leaders can fall foul of. Here it is:

In private discussion a handful of founders have actually come back to me with their tally and a wry smile. Often the seasoned ones looking back on the early years before they became hardened, cynical creatures like me.

Very few #healthtech companies have a guiding method in the madness of trying to work out how to work with the NHS. And over the years and in supporting 30 companies in a range of ways, I've started to collate and structure my approach into something that is half philosophy, half methodology.

Getting into the NHS doesn't work based on method, and it doesn't work on madness, you have to have a blend of the science and the art. This year I'm putting my money (and time) where my mouth is and I'm building something that I hope will go some way to democratising some of this learning (beyond the constant articles I put out). Nothing left on the pitch. I'll come back to that later.

First I'd like to give you some of the good stuff, and today I'd like to do it in the form of a logical chain.

Start with the ABC - Always Be Collateralising

...or if you want a grammatically correct motto then Always Build Collateral. But I like brand new words.

If you talk to any of my clients, or listen to my talks, you’ll hear that I’m obsessed with assets.

By this what I mean is creating things that will work for you, and in the right kind of way. I’m not just talking about a website or a cheeky video explainer or LinkedIn post (although these are of course useful assets), but the things that you can build and use proactively to invite, intrigue, empathise, validate, assure, comply, prepare and support those who will help carry you further into being part of the NHS.

Proactive organisations create assets.

And true to the word assets are things that work for you, and hopefully produce compound benefits.

As someone who has done reviews for MANY healthtech companies I can’t tell you how little collateral I usually find, and that to be candid is focused on the wrong things in the wrong way.

I also find that many organisations have too much 'scatter-lateral' - OK I just made that up, but I kinda like it - by this I mean that there's a mess of documents and stories that don't correlate to a cohesive, laser focused story.

But around the problem

Exactly. Ten points to Gryffindor. 🪄

Nobody likes an incohesive messy rant, switching from topic to topic at a whim, unless you're one of those people who likes watching my cemetery videos. In which case you're the ones who need to know this.

Your collateral will absolutely not inspire and validate if it's not centred around the problem statements you serve.

So many companies I see and work with seem to follow the following pattern in their narrative, their decks, their pitches, their posts...

1. Hello this is our product - here's the sparkly features of it.
2. Dramatic statement about changing the face of healthcare etc.
3. These are the areas you can use it - points at Elective care, primary care, virtual wards etc.
4. Some statement of outcome.

I'm sorry that whilst I'm no Gary Vaynerchuk, have never read his books, or watched a single video of his etc. even I know that the above is breaking the first rule of sales (or any pitch that is trying to advocate something)...

Validate the problem, and carefully bridge to the solution!

So, within moments of talking to a healthtech company I will test their ability to detail 3-5 problems they solve (since they usually don't have it on their website). Ideally clearly articulated problems.

This usually becomes the BACKBONE of work I often do, and the production of a great approach is around meeting people where they are, and demonstrating you understand and know their pain points, needs, aspirations and other such circumstances.

It also gives you lots of things to write about in collateral, but more importantly when flipped and transitioned to strategic priorities it becomes the central tenet of your business case.

Whose problem?

As much as people think that everyone harmoniously shares strategic problems in the 'one big NHS family', it's not true, and will differ from provider type, to provider, to organisation type, to job description.

So this is where the hard work comes in, you need to work out who pays, who champions, supports and advocates, and who governs, and try to resonate with problems they share, but in a way that mostly resonates with the primary decision-maker. This is where the art comes in because it's hard to get on the nail. I would say that this is where I find I offer the most value in my own self perception of artistry. Practice makes... you know... less imperfect.

If you don't know whose problem you should be focusing on or you're too general then you're at risk of being messy. Many organisations fall very foul of this, because they're trying to hit too many nails with the same hammer, but ultimately turning their hammer into one of those ineffective, floppy comedy hammers.

Now the ideal is that your problem-to-strategy-to-solution is constructed in a way that inclusively brings together the key people in a common cause, all violently agreeing with the logic of it.

But that may not be possible if they have very different views of the world.

You need to know this, and you need to try and decide how to accommodate this in your approach.

Worst case you can create direct perspectives and briefs in you collateral and narratives that focus on stakeholders with different views or concerns.

Can you answer and address the problematic?

Yes, let's talk about concerns. It's very rare that you'll have the perfect thing where nobody has any concerns. The NHS is too interconnected, complex, siloed and political for that.

So it's likely there will be some elephants in the room, or some key points that you want to tackle head on, and offer your positive perspective on addressing.

Here's the more general article on Elephants:

But within the context of your problem-to-strategy-to-solution approach, I would ask myself the following question (s):

What is risky and problematic, that we can potentially transition from being a weakness to a strength? How would we approach it and integrate it?

Why wouldn't you use your central narrative to not just gather interest and support, but also to remove some obstacles along the way.

Making a compelling modular case

At some point the narrative will be swapped for strategic cases. Or at least hopefully, because this is when you're actually getting considered.

Everything I've swept through up to this point is readying for this moment, because otherwise it's all pointless if you face-plant at the last hurdle.

Doing business cases is NOT separate from marketing, PR and engagement. It's the culmination of that very work.

The central problem-to-strategy-to-solution story should be consistently building up to the placement within a case, within a governance process.

Yes, many companies think it's some separate thing where they get someone in to say what they think the commissioning organisation wants to hear.

That's nothing more than a poor, reactive approach. Elite athletes don't train for the run up, and then wing the final definitive race, so why would you do it.

I've written a lot about business cases over recent months, so I'll divert you to those below, but for reemphasis your case should be the top of a cohesive pyramid of activities, where everything spins around the axis of a cohesive central narrative, in which the nucleus is the problem exposure.

If you do that then you'll be making a case that truly stands out during all the phases of your engagement journey, and especially at the final, most important phase: budget and project sign off.

But why modular?

Because you're always building collateral that increases your ability to prove you're ready for the next strategic rung of your ladder towards being properly integrated into the NHS.

And always building your collateral to provide the best possible level of proof is what gets you to the next rung.

Proof? You mean evidence or compliance right?

Nope, the various forms of evidence and compliance are hugely important, and semantically, yes they play into proof.

But there is a third less defined and visible pillar:

You can prove the clinical evidence.

You can prove the ROI for the commissioning or procuring organisation.

You can show you've done all the compliance activities required.

But can you prove that you're not too risky or difficult a project, that you're not going to require huge amounts of energy in implementing, situating, transforming and integrating.

Because given the competition for money right now, anything that feels like it has unknowns to be navigated may go in the 'too risky' or 'too difficult bucket'.

I could all be for nothing.

So...

Why would you produce something static, when every week and month is a chance to find ways to improve how valid you are.

Ideally you'll want your approach at various stages to be like the Fairphone: designed to be upgradable when required.

Ergo. Modular.

Ideally you want your approach to be easily personalisable and customisable for specific target organisations, so you can closely resonate with THEIR exact reality and issues if needed.

Ergo. Modular.

If you don't design your cases and narrative for modularity then you're creating more work for yourself, and it will sit half way down the to do list.

End with the ABC - Always Be Collateralising

Assets and collateral. If these words aren't regular memes in your internal meetings, where everyone is rolling their eyes because it's used so much. Then change this. It needs to be in your DNA, and at the heart of your method.

Because in assuming this ambition you're inviting yourselves to always be thinking of new ways to expose and enrich your narrative.

Liam be... building assets.

Why do I write articles on LinkedIn?

Yes, because I like to. It makes me feel happy and make friends, and speak up about things I believe in and care about.

But it's also a balance sheet, where I can find ways to get to the heart of your problem, and help you to see a way forward.

Helping people find a way forward in the NHS is how I pay the bills.

Nowadays I find most people approach me having followed my stuff for a while, and then there will be a particular topic where the problem I expose resonates enough with their reality, and they want a discussion.

But now I'm pretty much constantly full, and my prices can be prohibitive for smaller startups who are bootstrapping.

So what do I do?

Well... here goes...

The points I've taken you through are a whistlestop preview of some of the big areas I cover in my own current Sistine Chapel: trying to codify the lessons and intelligence, tips, tricks and nuance that I regularly share with my many lovely clients over the years.

But I'm bringing it together in one practical, cohesive and visual TSUNAMI of intelligence, and in a way that hopefully fulfils a long missing piece of the jigsaw, and helps organisations of any size to affordably build a proactive approach to NHS readiness.

UPDATE OCTOBER 2024 - THE COURSE IS OUT AND IT'S MASSIVE SEE BELOW

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Liam Cahill is a trusted adviser to frontline providers and national bodies on all things digital, with nearly two decades experience of doing tech stuff in the NHS. He has mentored and advised some of the best known names in Healthtech, and they've usually said some nice things about his work. He regularly posts content, ideas and advice on LinkedIn. Check out his other numerous articles and videos here, and subscribe to his LinkedIn newsletter here.