Ask Hardian: How to ensure your product solves a real NHS problem
Many startups rush to build products without deeply understanding the NHS problem they are trying to solve. This can lead to poor adoption, even when the technology itself is strong. Innovative design and sound engineering do not guarantee traction if those working within the healthcare system cannot see a reason to use the product.
There are numerous instances of this trap. For example, a technically impressive product may fail to gain traction because it addresses a problem that - while perhaps valid - is not seen as urgent or actionable in the NHS. If there is no clear unmet need, or the problem is not seen as a high priority, it’s likely to mean the product struggles to secure attention or resources. NHS staff have many competing demands on their time and attention, and if a product does not demonstrably address a clear need, it will struggle to find a champion within the system and its adoption is unlikely to be prioritised. The product remains a pilot or sits unused despite its technical merit.
Another common situation is that the benefits of the product are diffuse, and it’s unclear who should bear the cost; or else the main beneficiaries are not the same as those who make the spending decisions. If a product creates a small but not overwhelming benefit to lots of stakeholders, or primarily benefits staff who have little influence over decision-making and budgets, there may not be a sufficiently strong voice in the room arguing for resources to be allocated to it.
A further example is where a well-designed product struggles because existing NHS solutions are already in place and are considered good enough. Even if the product is polished and clinically useful, entrenched solutions and ways of working can block progress. Without mapping stakeholders and understanding existing care pathways, and clearly articulating how the product fits within those pathways, adoption may quickly run into roadblocks.
Why the NHS is different
Adoption in the NHS is shaped by complex decision-making, fragmented budgets, entrenched clinical pathways, lengthy procurement processes, and demanding evidence requirements. The NHS is not a single organisation with a unified budget but an ecosystem of organisations with different levels of independence and overlapping responsibilities. Budgets are split across primary, secondary, and community care, with different owners who may work to differing priorities. On top of this, evidence requirements are demanding. Pilots and anecdotes may enthuse clinicians, but without rigorous data the system rarely moves to scale.
Start with the problem
Founders must anchor products in urgent NHS priorities and clear needs within pathways. That means engaging early with clinicians and patients to understand the pain points and unmet needs, not just testing the product once it has been built. It also means defining a clear Intended Use and building a business case that makes sense for the NHS context. Co-design ensures the offer is grounded in real needs and avoids the trap of building something elegant that the system cannot or will not adopt.
Six questions to ask yourself before building
Before committing resources, every team should ask six key questions:
Have we clarified the problem, who is the owner, and is there a clear budget holder?
How can the product link directly to measurable outcomes that matter to the NHS?
How is the problem currently managed, and what barriers exist to changing that?
Who are the champions that can support adoption, and which groups of staff and care settings should we target?
Have we mapped the adoption and procurement routes?
Have we planned for the evidence that decision-makers will require?
These questions highlight whether a product has a genuine path to impact or risks becoming another stalled pilot. They are also the first steps in building a go-to-market strategy that aligns with NHS priorities.
Building with the system
Success comes from relevance, realism, and relationships. Founders who build with the NHS system, not just for it, create products that fit within priorities, pathways, and procurement. Adoption is planned alongside design, with evidence generation built in and assumptions tested against system realities.
True innovation in health tech is not measured by novelty. It is measured by adoption that leads to impact. The trap is building something new without ensuring that it is also necessary. The opportunity lies in creating genuinely value-adding tools that the NHS can and will use. That is the foundation of any viable market strategy and the only way to achieve lasting impact.
Hardian Health is a clinical digital consultancy focused on leveraging technology into healthcare markets through clinical evidence, regulation, health economics, market access strategy and intellectual property.
