I’m currently sat on an early train to London. It’s one of those perfect mornings; cold, bright, fresh and full of optimism. Out of the window, I can see a deer navigating the soggy Lincolnshire fields, hesitantly placing one foot in front of the other to test the ground. It’s a great time to reflect on my journey over the last couple of years, the life of a startup and how maybe we’ve got a few things in common with that deer.
Two and a half years ago, I had the opportunity to take voluntary redundancy (VR). I loved the teams I was working with and our clients but was increasingly frustrated by my lack of ability to make a larger impact on society. I was a cog in a much larger machine. A machine focused on margin and mergers, and not in a position to really respond to what the market needs.
In contrast to the area of healthcare tech I love, which involves building solutions that can keep our friends and loved ones well.
I’d managed multi-million-pound programmes, with thousands of resources involved, but could see that bigger was not always better. For healthcare, the ability to start small and quick, apply an agile mindset and get close to your users is more important than ever. I couldn’t do that anymore in my job, so I grabbed the opportunity for VR with both hands and Upstream Health was born.
We needed a place to live and after receiving a recommendation from a client, I turned up at the Centre for Digital Innovation (C4DI), which is now a proud Barclays Eagle Lab.
I was surprised by what I saw.
I’d come from an organisation that was like an elephant - an organisation that could easily and steadily plough through the field but struggled to turn and run, that struggled to get it’s (big) ear close to the ground.
What I found at C4DI was a community full of deers. Deers are agile, they are light, they can pivot, turn, run and leave little trace. The deers at C4DI came from all different sectors with different business models; app developers, social media marketers, graphic designers, robotics engineers, firmware designers, rapid prototypers. C4DI is a hive of different small companies - companies that have great ideas and the ability to quickly implement them. Each moving from idea, through to proposal and providing a solution within weeks.
But, what was special to me was how they came together to collaborate and work with a shared purpose. A vision for Hull to lead the way in technology innovation; the idea that we could come together and achieve amazing things.
We’ve been based at C4DI for two years. Our business has grown from a team of one (me) in the coworking space with the simple objective of using tech innovation to help support the move needed to preventative care, to a team of six in our own office in the top floor, supported by all the great organisations around us. We’ve embedded ourselves as the leading health technology innovation partner in the region, we’re revenue making, we’re supported by Microsoft and NHS England, and we are set for an amazing year in 2020.
But it has not been easy. The life of a startup is a constant juggling act. Balancing client commitments, product roadmap delivery and cashflow/fundraising at the same time are hard. As the boss of the startup, the pressure is on. You must deliver because you believe in the mission, but it’s just as important to provide for your employees, suppliers and family.
So here are a few of the things I’ve learnt along my journey that may help you.
You’re not the smartest (and you don’t want to be!)
When you walk into C4DI, there’s a key message on the wall. One that John Connolly (C4DI’s Managing Director) likes to remind us about.
‘If you’re the smartest person in the room, you’re in the wrong room’
This resonated with me. I’m good at most things, but not exceptional at many.
You need to quickly figure out what you’re good at, and for the areas you’re not good at, get in a room with someone that is. For me, this means help with design, and detail, and I’m thankful every day to be working with some truly exceptional people.
Get known and build relationships.
I spend about 50% of my time building relationships. Relationships with clients, partners, suppliers are all key to a startup. They help you with traction and to be bigger than you are. Whether those relationships are local with organisations in your building, or global like the partnership we have built with Microsoft, they are equally important to help you get stuff done.
We also invested in understanding who the key players are in the region, introduced ourselves, listened and learned about the challenges they’re facing and then, in many cases, received their support for our own applications for grants or government funding. Recently we gained support from NHS England and the SBRI HEalthcare initiative. Below is their visit to kick off our Bridgit project that we’re running with the Hull Local Authority.
Know how to get paid.
This one seems simple, but in health technology, in the UK whether it’s NHS or Local Authorities the majority of work will come from the government.
This one seems simple, but it, of course, varies for different startups. In health tech (in the UK), it’s the NHS and Local Authorities where most of your work will come from. In order for us to win contracts and get paid, we must be on certain frameworks and be known in the industry. We invested upfront to win places on key government procurement frameworks. It’s not easy and it’s a lot of paperwork, but without that work upfront, we would not have been able to sell our solutions or services.
Getting investment is hard.
When I started Upstream, I thought that getting funding would be easy. I’d seen on the media reports of increasing investment into health tech. When I looked at the tech getting invested in, I wasn’t impressed. I saw investment going to simple concepts, with minimum impact. So I thought that someone with 15 years of experience and some innovative ideas, VCs would be throwing money at us. It turns out that an idea isn’t worth anything.
Initially, my ideas were too complex and too large. It was only when we scaled back our ambition and focused down on a single solution that we really started to get traction and understanding from the VC community. Realistically, if you want investment, you need to have gone some way to turn your idea into a reality, proving the market will buy it and have a crystal clear proposition.
For us, by the time we got to that point, we didn’t need the investment anymore. It’s a bit of a cache 22. When you really need cash, you’re too risky. If you manage to survive to the point where you’re less risky then you may no longer need the cash.
I’ve just jumped trains and should be in London in an hour. I’m meeting with Microsoft and NHS X and it should be another amazing day. Two years on and it feels like we’ve made great progress. Yes, there have been tough times, but easy isn’t fun either.
If you’re reading this and would like to find out more about us, or would just like some advice/support for your own ideas then feel free to get in touch.