Innovators often wonder why the NHS fails to adopt their products when to them it seems to be a ‘no brainer’, but I always make a point to ask them “have you actually expressed a clear Value Proposition?”

Features and benefits are the things most often focused on but are you clear that your message is focused in the right places. Many of the innovators we meet have high level statements linked to the NHS Long Term Plan, however, does their innovation fit to the specifics of the local customer’s structure. We often discuss that many of the statements made by innovators can be challenged with the question “so what?” to which the innovator struggles to find an answer.

When thinking about your marketing messages and pitches can you be clear that you have covered these five points:

1. Setting the scene – A chance to paint the picture of how the current system operates. It’s always best to avoid highlighting failings with the NHS system, most people working in the NHS are already aware of these and it won’t feel constructive.
2. What is the problem – Outline what the identified problem is for the potential customer with the current situation.
3. What is the consequence – Just because a problem exists it may not actually have a consequence for the potential NHS customer, have they identified that this problem is impacting them in some identifiable way which they need to fix?
4. What is the intervention – This is the opportunity to describe the proposed intervention or product offer.
5. What is the impact – This is the chance to describe how the proposed solution will benefit the payer and whether the solution is addressing something that is currently a priority for them.

The often-overlooked parts of this are what is the consequence and what is the impact. Nobody comes to see us suggesting they have a new innovation which is more expensive and has worse outcomes for the patient, in fact with the amount of savings we have seen suggested over the last few years the NHS would be running on a tiny budget. The reality is somewhat different, the NHS system cannot realistically carry out every new treatment or intervention produced due to limits of capacity and the onward impacts in both health and care systems. Just because something is better for patients it doesn’t follow that there is a system benefit and when cash is tight the health and care system will be looking for both in projects they want to take forward.

The reality check is many innovators fail to make expected progress and some will fail because:

•  the intervention doesn’t match a problem
• the (wider) intervention is not affordable
• the intervention doesn’t have the impact they believed it would
• NHS staff cannot see the benefits and/or don’t understand what they are or don’t believe the claims being made.

Within the value proposition, the five questions should also be considered from the angle of the patient, the local NHS service and the national agenda. Many of the innovations we see have focused only on the patient and/or the technical abilities of the product which in reality could be classified as research. Be honest with yourselves, does this look like your messaging:

• It is simple and lightweight solution backed by powerful modern cloud-based systems
• A better option to those that already exist
• These figures are supported by the NHS Institute for Innovation and Improvement and the NHS Information Centre
• This is mentioned in the NHS Long Term Plan
• There are no similar products on the market
• Rare Disease diagnosis is a top priority in the UK
• We provide a cheaper option
• Our algorithms can be adjusted for any given user case or requirement.

These sorts of statements have little or no influence on potential buyers and are all too commonly used.

Mapping pathways and understanding the budget impacts of changing these is key because cost effective may not equal affordable, remember economic impact and ROI are useful to know but insufficient to drive uptake. The Budget Impact Model (the numbers behind the story) tells both buyer and seller what will be needed to bridge the resource gap between current and future steady state. When presenting these do not forget to include the often-hidden costs such as ongoing training, licencing, maintenance etc. to maintain the future steady state.

It is also important to add in transition costs - The initial implementation may need to manage an existing higher or lower demand as well as having two systems running in parallel for a time before achieving a steady state. Often forgotten is the cost of change, made up of the resources required to deliver the change (possibly via an AHSN), such as clinical leadership, training and education costs, data collection and analysis.

In practical terms what can this look like,

The theory

By using this product fewer patients will need to be seen by a GP.

A GP session costs £40, so for a mid-sized practice serving a population of 45,000 patients, their annual savings will be 2,000 visits @ £40 = £80,000 savings. Our products costs £25,000 outlay (product life 5 years) plus £5,000 consumables a year. Our product is cash releasing in year one.

In practice

GP practices are funded by list size (number of patients who are registered at that practice), how well the GPs meet (record) QOF (Quality Outcome Framework) activities and some income related to ‘incentive schemes’.

Fewer patients needing to attend doesn’t necessarily mean fewer payments to the practice. GP practices may not be the buyer of the product (it may be the Clinical Commissioning Group – CCG). Unless there is a reduction in costs, the product, in spite of being ‘cost effective’, may not be ‘affordable’.

Overall, if you get your Value Proposition right then the system will see where the real benefits are and will be far more likely to adopt your innovation.

Remember the AHSN can support you developing this and don’t forget to challenge yourselves with any statements and claims you make with the question “So what?”

Author

Nick Brown, Commercial Manager