Oliver Pickup
Human-Work-Evolution Storyteller
Britain invents, funds and proves new healthcare technology, but almost nobody can say who decides whether it reaches a patient. Closing that gap requires more than evidence, according to industry leaders.
This is what healthcare innovation looks like: a patient in intensive care with severe respiratory distress could die within 72 hours without the correct treatment.1 Treatment depends on quickly knowing the patient’s detailed, underlying condition.
A test, built by the Cambridge diagnostics company EDX Medical with the UK Health Security Agency, Cambridge University and Thermo Fisher, now gives clinicians at Addenbrooke’s, the city’s teaching hospital, that answer.
It took several years — fast for a medical innovation — thanks to what Mike Hudson, EDX’s chief executive, calls strong collaboration and a “no us and them” attitude between partners. Most ideas from Britain’s research base take longer to arrive. Many never do. Dutch humanist Desiderius Erasmus wrote that ‘prevention is better than cure’ five centuries ago, and healthcare still has not answered who pays for preventive care and who is accountable for delivering it.
Slow progress in NHS prevention plan
The 10 Year Health Plan committed the National Health Service in July 2025 to three shifts: from hospital to community, analogue to digital, and sickness to prevention.
Yet, 470,000 more working-age people have left the workforce with a long-term illness since the pandemic,2 and the public health grant, the main channel for prevention funding, was worth just 2.2% of the NHS England budget in 2024/25, according to the Health Foundation.3 The overall bill is starker still: ill-health now costs the UK economy an estimated £212 billion annually, equivalent to 7% of GDP, according to the Keep Britain Working review, published in November 2025.4 You would expect a system facing costs like that to move fast on anything proven to work. It does not.
Lung cancer screening: 15-year rollout
Low-dose computed tomography (CT) scanning was proven to catch lung cancer early enough to treat by the mid-2010s. A pilot followed in 2019.5 A screening committee recommended a national programme in September 2022. Ministers announced the rollout in June 2023. Full coverage is not due until March 2030. That took 15 years, on the one case everyone agrees worked.
Four people were asked why, from four different vantage points in the system. None of them pointed at the evidence.
Britain is not short of ideas
“The UK science base is one of the highest-performing, most productive research communities in the world,” Hudson says. “We start a lot of things, and of course, everybody feels their baby should get to the next stage.” What is missing, in his view, is a robust and transparent selection process that enables the best innovations to be prioritised and moved forward in a joined-up fashion.
That abundance of ‘ideas’ is itself a problem. Hudson describes a crowded field of early-career researchers, often pursuing innovations on a part-time basis and with minimal funding. “There is a big temptation to keep all the options open by avoiding those critical that will provide a yes or no answer,” he says. “The starting line is chaotic at the moment.”
More pilots should fail, and sooner, in Hudson’s view. Patients willing to try something experimental are finite, and one spent on a weak idea is one lost to a better one.
Pilots stall without standardisation
Rebecca Parkin, associate director of digital health at the Association of British HealthTech Industries, hears a different complaint. Her members prove their case, and their pilots still fail to reach commissioning. “You do a pilot, and you fall off a cliff, or you do a pilot, and then you die,” she says.
Contracts run in 12-month cycles, and providers are, in Parkin’s words, “stuck in this cycle”: proving savings for a decades-long condition inside one financial year, while the benefit often lands in a different budget.
Where Hudson would rather see sharper triage, Parkin wants better collective memory: failed pilots take their lessons down with them, and successful ones rarely spread beyond the organisation that first ran them, so the same ground is paid for twice.
“There is no standardisation,” she says of the local champions who often decide whether a technology survives. “It is so dependent on luck.” In Canada and the United States, she notes, clinicians hold formal qualifications in digital adoption, so the champion is there by design.
Evidence was never the blockage
Suzanne Wait, co-founder and chair of The Health Policy Partnership, watched the lung cancer decade unfold up close. “There was extremely compelling evidence that low-dose CT scans for lung cancer screening were effective and cost-effective, from all over the place, including in the UK,” she says. “There was 10 years of evidence, and yet that evidence just was not translating into political will.”
What stood in the way was not data: stigma attached to a disease linked to smoking, a fatalistic sense that nothing could be done anyway, and GPs nervous about a conversation they felt unequipped to have. “System, human, cultural,” Wait says. “Trust in the technology, trust that it will work, trust that it is right for me, trust that the evidence is meaningful.”
Manufacturing gaps stall pharma innovation
Alastair Florence, director of the medicines manufacturing centre CMAC at the University of Strathclyde, names the same gap from the supply side. He asks: “Who owns the win?” His own sector shows the cost, he says, citing that many UK pharmacies report shortages, and around 60% trace them to manufacturing.6
The UK science base is one of the highest-performing,
most productive research communities in the world
Britain is not alone. Every economy Florence deals with across North America, Asia and Europe complains about ideas that never land. “Nobody is good at this.”
Nobody has told the story
The same trust problem plays out on the supply side. When Florence’s centre used robotics and AI to design tablet formulations, the public reaction stopped the team cold. “The analogy some members of the public drew was with the Post Office scandal,” he says. “Everyone was told to trust the technology, and people’s lives were ruined.”
His prescription? Tell a better story, earlier. “Is the general public aware of what could be possible with improved diagnostics, improved testing, wearable technology?” he asks. “If the public wants to see it, that is what politicians like. An academic asking for more money will never be a headline anywhere.”
Additionally, a business case has become compulsory. “Thirty years ago, few people presented an economic case,” Wait says. “Now, everyone has to.” Florence worries focusing on numbers ignores the people it is meant to serve. “For all of the sophistication, the technologies that work, and the complexity of the science, it is all about helping patients,” he says.
Wait sees the same problem from the funding side. Whoever holds the drugs budget answers for drugs, and nobody answers for the system as a whole. “It is almost impossible to have that systemic view on the impact of new innovation,” she says, “and no one has ownership for that cross-system impact.” Prevention, split between local authorities and Whitehall, is the clearest casualty.
Where it does work
At Addenbrooke’s, this is what ownership looks like: Hudson credits the hospital’s chief medical officer, who also ran innovation there, close enough to believe the science, senior enough to move it. It is exactly the kind of champion Parkin says the system usually leaves to luck. The arrangement itself is innovative: instead of EDX validating alone and selling a finished product, hospital and company share the risk of an unproven test and the reward if it succeeds.
Asked for one fix to improve healthcare innovation delivery in the UK, the four experts’ answers diverge. Parkin would build a national “repository” so a lesson learnt in one place isn’t relearned and paid for elsewhere. For Wait, it is trained “navigator roles” that walk patients through a maze nobody designed on purpose. Florence wants a government that keeps funding new ideas, even knowing most will fail. And Hudson calls for pushing money and decisions to the regions, so “the postcode lottery” stops defining the boundaries of healthcare innovation.
No two of those fixes look alike. What they share is a name attached to the decision. Most British healthcare innovation is still waiting for one.
[1] Stapleton, R.D., et al. 2005. Causes and timing of death in patients with ARDS. Chest vol. 128,2 (2005): 525-32. doi:10.1378/chest.128.2.525
[2] Atwell & Vriend, 2023. What we know about the UK’s working-age health challenge. The Health Foundation. tinyurl.com/ehzm73h9.
[3] Charlesworth, 2024. NHS funding has to translate into improvements the public can see. The Health Foundation. tinyurl.com/mv2kjecf.
[4] Keep Britain Working, 2025 report. tinyurl.com/77hepkur.
[5] Lee, R.W. et al. 2026. Implementation of the NHS England Lung Cancer Screening Programme over 5 years. doi.org/10.1038/s41591-026-04292-y.
[6] Gov.uk, 2025. Managing a robust and resilient supply of medicines. Policy paper. tinyurl.com/2avm367m
