How to sell services to the nhs
Selling to the NHS: a how to guide w/ Tom Sheppard, HealthBid
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Timecodes:
okay so i'm joined today by Tom Sheppard from HealthBid, Tom welcome and thanks for thanks for
speaking to me today um first of all just tell me a little bit about yourself and a bit about
HealthBid and what you guys do yeah well thank you for having me first lloyd uh i uh i appreciate
it um uh well as you said i'm Tom Sheppard i'm the managing director of HealthBid we're a
bidding organization based in leeds who helps out
clients looking to work with the nhs across the uk so we've been going now for getting
on for six years uh with the largest specialist healthcare bid company in the country uh we employ
uh around about 15 people uh up here in Leeds and we're really specialist in in
staying in that health lane really helping our clients to to grow and to win contracts
okay fantastic yeah really um really really interesting that you've got that that focus and
actually that brings us to kind of the topic of today's discussion right which is all about
how to sell effectively to the nhs and you know tom and i had a bit of a pre-chat before this
before this discussion and i'm thinking back to times that i've spoken to people about selling
to the nhs and really understanding how the nhs works and for me it's really it's really
mind-blowing the difference all the different parts of it and how complex it is so i'm really
happy to be speaking to an expert who really understands all of this all of this stuff so
yeah let's um let's let's kick off with my my first question for you then tom so that the first
one is how does selling to the nhs differ from selling to other public sector organizations well
i mean um i'm pleased you're bringing me on as an expert because i feel like i like still quite
a lot of expertise it's the nhs is so complex and healthcare is so complex as a sector that i
think it really taps into that that question that you you've asked there's there's no simple way
of selling to the nhs because it's so uh it's so interconnected with lots of different other things
and fundamentally doesn't really want to be sold to and that makes it
quite hard as people who want to sell products to uh to the nhs to to break into it so you know we
do quite a lot of work for for local authorities because public health sits with local authorities
and we see a real difference to the way the nhs tenders and the way that local authorities tend to
local authorities tend to be a little more open a little more
give you a little bit more flexibility and how you want to to deliver a service
the nhs tends to be a bit more rigid and have some pretty strong ideas about how a service
wants to be delivered so there's definitely differences there i suppose the other thing
which is more a difference in the type of service you're selling but in the nhs a lot of what we do
is the selling of services rather than products and that is a totally different challenge from
a sales point of view you know if i'm selling gloves to the nhs then they want to know are they
safe can they be delivered on time are they good value if you're selling smoking cessation services
there's so many more factors there about how you reach difficult communities how you uh
ensure long-term outcomes that the difference is quite stark i think with of organizations
yeah that's what's really interesting i i want to just i want to just pick up a point
you made there actually and obviously the nhs is something which is very close to people's hearts
in the uk right it's quite a kind of protected organization that people feel close to so
you mentioned something about the nhs not wanting to be sold to so i just wanted to dig into that
a bit more what exactly do you mean by that well i mean i i definitely wouldn't describe
them as hostile to people selling to them but i think there's a there's a suspiciousness of the
public sector versus the commercial sector and you see that quite often manifested in the way
that they they approach the market so you know if you're commissioning a service in the nhs
um then you want to have a lot of people bidding because that's good for the market it's good for
the value but more importantly it's good for the quality of what you're delivering
you can look at a range of options in how to so smoking cessation is a great example of where
there's quite a lot of different ways to encourage people to quit some better for rural communities
some better for inner cities you want that wide market instead what we see quite a lot is them
being very closed with the way that they want to engage with the market
because i think they're worried that they're going to be tricked into something
now you know in my experience of working with a lot of both public and private sector bidders
there's no huge difference in terms of what people want to get out of it
they the overwhelming majority of people we work we want to improve services for people
you know yes some of them want to make some money while they do it but none of them as far as i know
we're sitting in the bahamas on the profits that they're making from smoking citization contracts
and i think that there's that perception that the the private sector sort of out to get you somehow
uh within the nhs interesting that that's interesting as well that kind of that plays
across from a kind of societal view if you like into the organization as well because i think as a
if you look at that on that kind of society level some people are obviously clearly quite against
you know um selling to the nhs nhs being privatized et cetera but even if we had a
nhs with very little privacy private citation there would still be you know
suppliers providing services to the company so and there's you know there's definitely there's
the nhs is inherently bound up with politics and that's obviously a very political question about
who should provide services but i think that what the public perhaps doesn't appreciate is
how many services are and always have been provided by the private sector you know gps
the overwhelming majority have never been directly employed by the nhs they've run as
effectively small businesses uh pharmacies similarly you know they
obviously people know boots and lloyds but they don't think about that when they're
when they're going to pick up a prescription well that's the private sector companies so
i think that you know it's that that view of the private sector is sort of being out to get the nhs
is i sort of think they would have done it by now if they really were about to get there
and again there's not really enough money in healthcare for that to be very
attractive to people okay good all right well look i'm i'm kind of saying this on a slight
segue for a second actually because it was the second thing that you mentioned which in
in the first bit of discussion we had that i thought was interesting and i wanted to bring up
as long as i understand it properly to make sure that others do as well and that is this idea in
in the health service that the the nhs is effectively bidding on its own work in a lot
of cases versus private sector companies right if i understand that right and that isn't that
isn't something you see in local authority or in other so yeah can you just talk to me a bit about
the reality of that what happens and how you experience it as a company helps others bid
i mean it definitely it definitely does happen i think that the nhs is more developed in this
regard than a lot of the public sector just because you know market forces were introduced
into the nhs in the in the early 90s really and so that split between the commissioners buying
stuff and providers providing stuff is quite well established um and i think that where in local
authorities where they've split out the provision of certain services uh those have gone straight
to the private sector and effectively disappeared out of the public sector entirely whereas you know
there's a lot of the nhs that you just cannot get rid of out of the public sector even if you
go back to the politics even if you wanted to do that um so definitely private sector organizations
bid against public sector organizations for nhs contracts however i don't think it's
particularly bad news for private sector companies because firstly nhs organizations i think
have a better idea about what they want to provide and what they don't want to provide so if you look
at the local hospital here here in leeds you know they want to provide well they may not want
to but they don't have a choice about providing things like a e and operating theaters and stuff
like that and for everybody other than one or two massive private sector providers they don't want
to provide that anyway if you look at stuff like smoking station sexual health services things that
are out in the community then there's quite a lot of innovation both in the in the private sector
and the third sector and i think that the nhs has got past the point where it thinks all innovations
sits within the nhs they do see that there are other ways of doing things in those types of
roles so i think what's happened especially over the last 10 years or so is the nhs has slowly
let itself lose those services you know it could bid on those things but it's not bidding on them
because you know it's not what it sees as its core purpose
the bad news is for the private sector is on the occasions where they are bidding
against the nhs it's tough to win it's always going to be hard to win against the home team
effectively when you're bidding against an nhs organization so so on that tom just to dig into
that a little bit further does that mean for a lot of organizations in their kind of bid no bid
process or their gated process that they're going through finding out that there would likely be
a a kind of nhs bidder would that be one of the reasons why somebody might not want to bid for
sure and it's something which we see all too often actually is that people approach us to write bids
and they haven't done that process of bid no bid i think that amongst new providers there's
a certain amount of naivety that you can just bid on a contract and win it and therefore you
are running millions of pounds of services and you know that does happen but it's uncommon um
the sales side of a bid can't be neglected you know and i say this is somebody who's selling
bids you know you can't just come to somebody like healthbid and just win you know we need to know
why should you win this who are your competitors you know if you're a new startup how are you going
to be an nhs provider who's been there for 30 years and has established relationships
the truth is you're probably not and they're better opportunities for you somewhere else
so i'm a big advocate of of pre-sales in bids that before you get to the bid side you've done that
research and that's something we help clients with and i think as you say is something which
needs to be relatively sophisticated to make sure that people aren't wasting either money
with an organization like us or just their own time to to write bids it takes a lot of time
good stuff great great um great intel on that one tom thank you very much
um so the next question i wanted to ask you was about um the structure of the nhs one of the from
people from the outside who don't understand the nhs one of the most kind of baffling aspects of it
so many different organizations there's ccgs trust there's all these different terms for different
parts of the organization can you try and give us if it's possible quite as quite a succinct summary
of kind of the structure of the of the nhs and i suppose in the context of how it's important
to people who want to kind of you know get their products and services into the nhs to help with
patient outcomes sure i'll keep it brief so let me take three or four hours i think um
as i say i've been working in healthcare both in in the nhs and out of the nhs for
20 years and i'm still not sure that it's it's very clear to anybody including people
who work in the nhs i think the the fundamental thing the basics to understand are that there's
commissioners and providers and as we alluded to earlier in most other sectors there's a really
clear split you know people are buying stuff and then people are selling to those people in the nhs
it's less clear-cut because as you pointed out the people selling are often the nhs themselves and so
the nhs is buying from the nhs so getting getting that split between commissioners and providers is
the first most important thing the second thing i think is really useful for people to understand
is that most entrants to the market are not going to be selling stuff to
a hospital you know those there's big logistics firms huge manufacturers who are providing most of
what a hospital wants to buy so you know although because hospitals are a very literally a visible
part of the nhs i think people think that's where the commercial opportunities are and i'm you know
i'm not saying they're not there but they're harder because you know a hostel is a massive
hotel a massive healthcare institution a massive waste producer it's just too big for a lot of
providers where the opportunity lies i think is in the community provision and so people when
they're thinking about the nhs structure you've got commissioners and then you've got providers
those providers split into what you call acute care or secondary care which is hospitals and then
community provision which is often called primary care or community care and that's gps it's a
whole range of community nursing services public health um and then the things that support that so
innovative i.t systems things like that so you know that's those sort of splits commissioner
versus provider and then types of provider are probably the best place for people to start
a lot of the rest of it you just need to work out which of those boxes it sits in
so there's a lot of talk about uh ics's at the moment which is the new
thing uh integrated care systems or services depending on which days of the week it is uh and
so you know people get really obsessed with what is that what does that mean for me buying stuff
at selling stuff sorry well the first thing to do is to work out are they commissioning things are
they buying things or are they providing things and who's doing what within that organization
i always think it's a mistake to get too far ahead of where the nhs is we've had some
very enthusiastic clients talking about that ics strategy and that's great but it's going to take
the nhs a while to to implement this stuff and in that time you don't want to neglect the facts
that you could still be selling to other people so those commissioners the people that you're trying
to sell to fall into a couple of camps there's as you said tcgs so clinical commissioning groups
they're purchasing on behalf of uh a region uh a relatively small region usually so uh
leeds wakefield london they split into a few different ccgs and then you've got obviously
uh rural ones as well they're a good place for them to start looking at where opportunities lie
they're commissioning lots of services they're buying lots of stuff
and they present you know multiple opportunities a year plus there's a hundred and something 170 odd
of them and so you've got all those opportunities multiplied by all those ccgs
if your organization's got a national footprint there are lots of opportunities there the second
place to have a look is in some of the provider organizations so people like gp practices need to
buy stuff now some of that stuff you know is done centrally but a lot of fit and maybe a surprising
amount is done locally so if you produce a piece of software that really helps gps to
make better clinical decisions or to prescribe the right type of medication first time then
there is there are opportunities there to sell directly to gp practices they do exist one of the
advantages of the nhs being so complex as i said is that there's in some ways surprisingly little
central purchasing that's being done so you know if you find if you're finding it hard to sell your
product and service to your local ccg there's the next door ccg and there's the other one next door
to that and you know there's some there's less crossover between those than than you might think
so yeah structurally i would say commissioners providers different types of providers and
then work out where the organization you want to talk to sits within that
okay great thank you some really some really good insight there and i think yeah the idea of kind of
okay there isn't this centralized kind of holy grail of this is who you go and speak to to sell
right but that's also balanced by there's lots of different opportunities potentially at community
level at local level where things are being done maybe in a kind of you know in a very nice way
and the example i always use when i'm talking to people starting at health bid is that is toilet
paper you know every sort of few years there'll be a report into procurement in the nhs and they
say well you know why can't we just buy the same rolls of toilet paper for every single nhs trust
fundamentally that's very difficult because the nhs if you did that would be like
the largest single purchaser of toilet paper in the world or in the top two or three and
so there's only one or two companies who can literally provide that amount so if people are
daunted looking at the sort of scale of it you can break it down into smaller constituent parts
and that sometimes especially for smaller uh healthcare organizations coming into the market
um is a good way to go you know rather than aiming at the edit you know when on dragons
then they say we just need one percent of the entire boardgame market it's like well
that's an enormous challenge you don't need to provide it to all of the nhs certainly to
get started you need to just find you know one or two of the smaller organizations to do it
great advice great advice okay so next let's talk a little bit of data and that's obviously
very close to our to our hearts at tussle so what role do you think that data plays in
in selling to the nhs so i mean first and foremost i think that it plays a big part in the
the bid and no bid decision making you know if if you look at data and it says the same
organization has won this contract for the last 30 years and then the next door organization uh
has been to a different provider five times in the last 30 years then i would always go
for option two because it tells me that the person buying that is willing to change so you know first
and foremost does the data help inform me about whether i should bid on a particular contract
when you're doing the pre-sales pre-bid work in the in that sort of sales phase as well if
you know that a contract isn't due up for another five years then there's no point in wasting time
in the nhs it's unlikely it'll be the same people running that contract in five years time so
even if you thought well i'll play the long game here it's usually not worth it um so that type of
data is really helpful in informing whether or not you should bid secondly when you get to the bid
data both that you you have on yourselves but also that you have on the competitors and the
commissioners is super helpful you know anything you can do to to show that you have insight into
what they need is that's a day-to-day challenge for us with our clients so you know we're writing
a bit at the moment for an organization who's who's bidding on a community service
part of our job is to make sure we understand the data for the local area so it really sounds
like a bid for that place rather than sounding like a generic bid that could be for anyone so
i would say that that that really helps with the bid process the final part is if the data
is telling you something about how the contracts will operate then that helps you to price it well
and i mean that both pricing to win but also pricing so you don't ruin yourself and and end up
going bust and it does happen so you know i would say pre-sales great for bid no bid during the bid
process great for winning the bid and then during that sort of solution design and into the contract
section you've got to know what you're going to be able to how you're going to be able to deliver
it within the budget yeah so a great a great mix of you're talking about kind of some more kind
of deeper more qualitative stuff um on on the kind of the needs of the organization as well versus on
the kind of competitive market intelligence side just that information on who holds the contract at
the moment how often they've renewed et cetera yeah that's um yeah and also you know if you
look at that if you look at those competitors and their small businesses or their local businesses
or their massive multinationals you know those are things that tell you something about how you
should write the bid if we're writing against a massive multinational company then we're all
about localism and the fact that this contract's super important you know when we're writing for
massive multinational companies where they're talking about the size and the resilience of that
organization so you can only do that if you've got that insight into who you're up against
okay so um let's talk a bit about kind of advice that you might give to others who are
looking to break into the nhs for the first time because i think we you can have this for companies
of all different sizes and we hear often talking to to companies who are interested in the nhs we
hear a lot of kind of we've tried and it's too complex or just kind of they're nervous about
kind of breaking into the nhs as a or the healthcare market in general as a
as a new challenge so what what kind of three key bits of advice would you give for a company who's
looking to break into the nhs for the first time yeah i think
first and foremost you've got to understand what your products and service is and make sure that
it does solve a need that the nhs has we hear quite a lot from new organizations especially
software stuff where people have come up with a good idea often that's based on the problem
they've personally had with the nhs and they think well i've invented a new way of measuring
you know your heart rate or something and it will save the nhs billions and all the rest of it well
that's that's only helpful if it's solving a problem the nhs has you know there's there might
be a million other bits of software that do that already and they're being produced by you know
whoever huge multinational companies who can make sure it never goes wrong when they needed to go
uh to work um so firstly you've got to understand your products and service and make sure that it's
you know it's it's something that is viable in the nhs it's not good enough to just know a gp
who tells you yeah it's a good idea you know that gp's speaking for themselves they're not
actually buying anything so proper market research i think is really really important
secondly understanding that it's a it's a long game it's very rare that somebody comes along and
just immediately breaks in i think especially with things that are tender that are bid for
there's a perception that if you just write a great bid then that's all it takes
and it's not true you know you we have i like to think the best bid writers in the business
and we can't win everything because sometimes it's just not what the person buying wants to buy and
so you know it it takes multiple attempts it is sometimes a little bit uh dispiriting
because the nhs again doesn't always like say no it would be nice sometimes if they just said no we
don't want to do that and instead they'll invite you in for a meeting and they'll give you a demo
and then you you're getting excited and six months down line you're still getting excited
but there's no sale being done so be prepared for the long haul and then thirdly i think
try and speak their language somewhat it's not easy uh because there's a lot to learn but
try and understand that selling to a gp practice for example is very very very different from
selling to a hospital and you need to understand their language they they see that i think as the
credibility that you're bringing to the table most people certainly clinicians working within the
nhs haven't worked in ever you know they've only worked in the nhs or for another healthcare system
abroad so they don't have an mba and understand sort of mba type language they understand nhs
type language so you need to be able to speak in that way it's not say you need to be an expert
you know it's it's it's perfectly possible to pick stuff up but you've got to be ready to do the work
to understand their language and their challenges in in those terms yeah and i think it's a good
the first one if i just circle back to the first point you made as well it's incredible how many
organizations struggle with just what do we do and who do we do it for and is it clear
and then as you say the second part of that does somebody really need to somebody really need this
and it's interesting that that that that kind of i guess that plays across for organizations in
private or public sector but you see it as so important in the nhs that people come up with
these ideas and they think i suppose because it's health and it's so emotive that people think this
is going to be game changing but actually they need to just test that idea a bit more right
yeah and to think through the implications of the product or service they're trying to sell
so you know if you want to bring in a new bit of software for the operating theater and it makes
things safer for people and it saves money you know you think to yourself well this is obvious
like it makes sense it's safer and it saves people money but it's incredibly complex how that
operating theatre runs so you know adding even like a browser extension something super simple
can't be done because their systems have to work in a particular way every single time because
that's ultimately what the surgeon's relying on to make sure that that they're treating somebody
uh to the best of their ability so you've got to think through how your products and service links
with other products and services and therefore is the cost of this just the cost of buying my
product or actually is there also you know 10 weeks of management time in which case you know
the nhs got to pay for that i don't know if people know but the nhs is super busy at the moment
so do they have the time to do that it's there's a lot of inertia there that you've got to overcome
and what what what's an example of something that you see organizations doing wrong so and
we've talked about some some advice you would say about the things that they would do if they wanted
to break into the nhs for the first time but what do you see that organizations have kind of
you know ideally of all different sizes that you see them doing wrong regularly that actually
stops stops them being more successful in nhs yeah i think what we see really often and an
easy one to correct as well is that people think of the nhs as a single national organization and
so they're trying to sell to the nhs which is not true you know it's not true and it's not possible
every every part of the nhs apart from a few very small bits is localized and so you know
i'm not trying to sell to the nhs i'm trying to sell to a group of gps uh in south leeds or i'm
trying to sell to an nhs hospital in hull that's those are two very different things from selling
to the nhs and selling to those smaller units so when you're preparing a sales strategy when you're
going through the types of data that you need you know whole hospitals aren't bothered about the
national data that supports you because they've got to make their budget work and work for the
people of whole so you need to come at them with good local knowledge uh and then when you come to
to selling and writing it's about making sure that you reflect that knowledge in what you do
you know it's no good going to a potential sales target in the nhs with
here's to saving the whole nhs would get or here's a service that works really well but it assumes
that everybody's got good public transport to their local hospital you know those things might
be true to some extent in london in birmingham manchester but they're not true if you go to
uh to a smaller town and so you know you've got to make sure that what you're selling is localized
to the bit of the nhs you're trying to sell to yeah that is that's really thanks for sharing
that time that's a really powerful bit of insight i think and that that plays into how people set
up their sales teams right and their entire kind of organization it feels like something which is
much more localized and focuses on what do those individual communities need and is there a kind
of community or grouping focus that you can set up your sales team in that way that sounds like
a much better recipe for success than saying where's this one organization that i want to go
and sell to yeah and i think people especially in the world that i'm in with bids and tenants they
get blinded by national frameworks so they see there's a national framework coming out for but
there's one that just opened yesterday actually for digital outcomes so you know it's a it's a
consultancy type framework uh and people say right all i need to do is be on that framework
and you know it's good to be on that framework i'm not dissuading people from going on it but
you not even half done the job by getting on that framework because people underestimate how much
local power people have not just to decide which framework they use and say well i'm not interested
in that one i'm going to use this other one but also just to buy stuff outside of that process
because you know they've found a great provider and so the best way of doing that is to actually
get three quotes rather than using the framework so you know it's you can get blinded by the nhs
as a national organization and say i mean this framework says it's worth 120 billion pounds
it's like well how much is it actually how much money is actually being done through it
and how much of that is not being done by the big five accountancy firms you know
brilliant well i think that's uh i think that's a really good good note to end on is
understanding you know where to put your focus this kind of community community level selling
that you're talking about and i think that there's been some really really powerful insights in this
chat tom say thank you very much for for coming on and talking to us and um yeah for everyone going
go and check out HealthBid we will drop a link in our in our blog when we write this up but tom
thanks very much and i hope to speak to you again soon thanks so much lloyd appreciate your time
