By Dr Anne Blackwood, Chief Executive at Health Tech Enterprise
Healthcare is one of the most fertile grounds for innovation. From AI diagnostics to liquid biopsy tools, new technologies promise better outcomes, faster pathways, and improved value for health systems. Yet, many innovators find themselves in the same frustrating trap: their product is welcomed into pilot projects and feasibility studies, only to stall when it comes to real-world adoption.
This phenomenon—sometimes called “pilotitis”—is increasingly common across healthcare systems, including the NHS. Everyone is happy to trial your product with support from grant funders, but moving from proof-of-concept to procurement can feel like hitting a brick wall.
So why does this happen? And more importantly, how can innovators avoid getting stuck?
The Barriers Beyond the Pilot
- Evidence: Never Enough
Even after a successful trial, buyers often ask for more data:
- Clinical evidence: Will outcomes hold at scale, across diverse patient groups?
- Operational evidence: Does it fit seamlessly into existing workflows?
- Financial evidence: Does it reduce costs or free up resources in ways that are measurable and sustainable?
In practice, early pilots are usually too small to provide the breadth of evidence that decision-makers need. Without robust multi-site data covering all three dimensions, innovations risk being seen as “interesting” rather than “essential.”
- Implementation Complexity
Scaling an innovation isn’t just about proving it works—it’s about proving it fits.
- Integration with electronic patient records (EPRs) is notoriously challenging. IT departments are risk-averse and often under-resourced, and interoperability hurdles can slow adoption.
- Staff training requires time, resources, and cultural buy-in. A tool that feels intuitive to a pilot team may overwhelm a larger workforce.
- Care pathway redesign is often the biggest barrier. Introducing new diagnostics or tools may require upstream or downstream changes that ripple across multiple departments or healthcare settings.
Healthcare is a system, not a collection of isolated parts—so even small changes need big coordination.
- The Pace of Healthcare Procurement
Health systems, and especially the NHS, are cautious by necessity. Procurement is governed by risk management, evidence thresholds, and budget constraints. Even if clinicians are enthusiastic, organisational buyers may hesitate unless the innovation clearly aligns with local priorities, reimbursement models, and strategic objectives.
How Innovators Can Avoid Getting Stuck
- Build Evidence with Scale in Mind
From the earliest pilots, think about what evidence buyers will want later. Multi-site trials, economic modelling, and real-world evidence collection can strengthen your case for procurement.
- Speak the Language of Value
Attaining regulatory approvals for your product does not guarantee reimbursement. Procurement teams want to know not just that your product works, but that it solves their problems. Tailor your messaging to:
- Clinical priorities (better outcomes, safety, faster pathways)
- Operational goals (reduced burden on staff, improved flow)
- Financial impact (cost savings, return on investment, efficiency gains)
Frame your story around system-level value, not just product features.
- Anticipate Implementation Barriers
Don’t leave integration, training, or workflow redesign as afterthoughts. Build clear implementation roadmaps that address IT compatibility, user training plans, and care pathway alignment. Showing that you’ve thought through these challenges makes procurement teams more confident.
- Get Ready for Procurement
The UK’s NHS procures medtech products via several routes: Government tenders, NHS tenders, NHS Supply Chain and regional or local approaches via Integrated Care Boards (ICBs) and NHS Trusts. Each route has distinct requirements, timelines, and criteria, making informed, strategic engagement essential for success.
In addition to tracking which tenders or frameworks may be relevant for your product, you’ll need to gather together the documentation required to meet pre-qualification and compliance standards, including product efficacy evidence, health economic data, CE/UKCA marking, cybersecurity credentials, and alignment with frameworks like DTAC (Digital Technology Assessment Criteria) and Evergreen Assessments.
5. Manage Your Own Expectations
Adoption in healthcare will almost always take longer than in consumer tech. Planning for a longer runway—financially and strategically—can reduce frustration and give your innovation the resilience it needs to succeed.
Escaping Pilotitis
Healthcare desperately needs innovation, but the journey from pilot to procurement is rarely straightforward. The innovators who succeed are those who combine great technology with strategic insights, robust evidence, and a deep understanding of healthcare systems.
Pilotitis doesn’t have to be the end of the story. With the right approach, it can be a stepping stone toward meaningful, scaled adoption—and real impact for patients and health systems alike.
