Funding future generations

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Directors’ Responsibilities: Not Just a Free Lunch  

Nathan Elstub 

A long time ago I wrote a blog on board information as a guide to our team and for people we invest in to help them design effective information packs for boards.  This was intended to be one of a series of blogs on the topic of effective governance, the rest of which never got written.  I have now been prompted to correct this, so here goes with round 2 of the series – what is the purpose of a board and  why do we need directors in the first place?

There are two interlinked answers to this question.  The first is a legal, technocratic one which is that in many legal jurisdictions including in the UK, a company has to have specified people (or companies) who formally hold authority, responsibility and to some extent liability to act on behalf of a company and to ensure that it is run in accordance with the law and with its own constitution.  

This means that as a director of a company you must have a fairly decent understanding of the various laws that govern company behaviour, such as responsibility for transparency and disclosure (accounts etc.) and for the wellbeing of stakeholders (health and safety, product liability, social and environmental obligations etc.).  Get this wrong and you might be banned from acting as a director, fined or even in some circumstances imprisoned.  

Whilst this is a responsibility to take very, very seriously, in reality this is probably the smaller of the two roles of directors.  The second, and in my eyes more significant one is that as a director you are responsible for setting the direction of the company and ensuring that the company makes progress towards its intended destination.   

Each company will set its own destination and goals.  In the first instance these are set out in the company’s constitutional documents – every company has an “Object” or series of Objects that set out what it exists to do.  These are sometimes drafted very widely, sometimes very narrowly, but in all cases everything that directors allow or instruct the company and its employees to do have to be in line with the company’s Objects.  These Objects are also the crossover between the legal framework the company operates in and the boundaries to the strategic, operational plans that the directors are responsible for creating and delivering.  

The company’s strategy should be a statement of the board’s intended destination and goals, in line with its Objects, together with an assessment of how its current resources and capabilities can be used and extended to enable the destination to be reached and goals achieved.  Ultimately the company’s success or otherwise in setting effective goals and destinations and achieving them is your collective responsibility as a board and your personal responsibility as a director.  

So why is it important to set out this stuff?  Well, in my experience, many boards don’t act as if they genuinely understand these roles and are not chaired in a way to ensure that they do them really well.  In many, many companies attending a board meeting feels like a tick box exercise, an opportunity for a bit of ego massage, an excuse for a nice lunch, or a way of earning a nice sum for doing not much work once you have got bored of having a full time job and are on your way to retirement.  

As a director your role is to ensure that the company, its management team and employees are optimising their performance in achieving their strategic goals in a way that complies with law and best practice.  Being clear about this enables you to focus your time and energy on identifying where this is being done well so that you can encourage more of it, and spotting where things are not working so you can support management as they work through how to do them better.  A management team’s time is a limited resource.  Preparing for, and spending time in a board meeting is a big draw on their time.  Directors, and particularly the chair, should be ensuring that every agenda, meeting, discussion and board information pack is single-mindedly focussed on identifying and enabling performance enhancement opportunities – this ultimately is your purpose.  If you can have a decent lunch and massage your ego on the way, even better!


Productivity: supporting young people into work

Nesta backs to create pathways to employment

It’s common knowledge that the pandemic has exacerbated inequalities in our society. This impact is particularly evident in the challenge young people now face when identifying job opportunities and a career pathway that suits them. Recent education leavers and young black workers were hit particularly hard through this period. ONS figures in March 2021 showed that almost two-thirds of people who lost jobs in the UK during the pandemic were under 25. Moreover, these past 18 months have fundamentally disrupted the career choices and progression routes of those leaving education. Covid also disrupted traditional entry routes into early employment, for example, many young people lost out on invaluable work experience opportunities. As we return to some semblance of normality, a new issue seems to be arising around a lack of job candidate supply with a boom in available vacancies.

The need therefore to support all young people (and employers) as we come out of the pandemic is acute, particularly in terms of ensuring social mobility and overcoming the Digital Divide. With more entry-level job application and interview processes shifting online, it’s more important than ever to ensure accessibility and equal opportunity for all.

With this challenging reality, we are excited to announce Nesta’s additional investment in, the UK’s leading jobs platform helping young people from all backgrounds to connect with the right employer, and offering employers the ability to both broaden and improve the quality of their hiring.

GetMyFirstJob’s impact

Since Nesta’s original investment in the platform in 2014, GetMyFirstJob has supported more than half a million young people by providing career guidance and support in finding relevant job opportunities. Despite an incredibly challenging 18 months navigating the pandemic, GetMyFirstJob has delivered 30% growth in sales, helping over 40,000 young people into roles in that time.

The company works with schools, colleges, training providers and employers to help connect young talent with apprenticeship, graduate and other entry-level opportunities. Its employer clients include Microsoft, Accenture, BT, DHL, Direct Line Group and CCEP. It also works with Further Education (FE) colleges and training providers to help young people into work. All of GetMyFirstJob’s clients recognise the need to do things differently in the post-Covid age, particularly by embracing digital solutions and AI to attract candidates or help them visualise opportunities. This approach has been proven to increase the diversity of employees. For example, some application rates from candidates in the lower Socioeconomic Status (SES) groups have almost doubled for some clients. You can read about one example with Microsoft here.

Supporting Nesta’s missions

Nesta’s new strategy launched in March this year, contains a focus on boosting productivity in the labour market as part of Nesta’s goal for a Sustainable Future. A key aspect of this strategy is to support people to navigate the world of work and support skills development to ensure people are equipped to adapt to the fast-changing needs of the economy. GetMyFirstJob plays an important role in supporting this mission by ensuring that young people from every background are inspired and able to connect with opportunities and employers that are right for them. This helps boost individual career prospects and overall social productivity. Nesta and GetMyFirstJob have already collaborated to explore interest in ‘green apprenticeships’ – exploring motivations around green jobs for young people.

Nesta’s follow-on investment of £125k, made alongside a further £125k from an existing shareholder, will allow GetMyFirstJob to extend its work in an important and expanding market, as young people and employers adapt to the roles required in the future workforce. We look forward to achieving more together with the GetMyFirstJob team.

This blog has been produced by Nesta Investment Management LLP for inclusion on its website (refer to the Terms of Use).  The content is for information purposes only and should not be used or considered as an offer or solicitation to purchase or sell the securities mentioned or subscribe to the Nesta Impact Investments 1 LP (an ‘alternative investment fund’ and ‘Non-mainstream Pooled Investment’, ‘NMPI’).  This blog is only intended for persons who may receive it under Section 238(5) of FSMA and COBS 4.12.4R.  Investment in early-stage companies involves higher risks such as illiquidity, lack of dividends, loss of investment and dilution.  Past performance is not necessarily a guide to future performance and investment places capital at risk.

Skin in the Game

We recently made a £500,000 follow-on investment in Skin Analytics, who are world leaders in using AI to help clinicians diagnose skin cancer, and so I sat down a few days ago to write  about the deal. Despite my massive and genuine excitement about this investment, I must admit that I’ve been putting off actually writing about it for a while. In these circumstances I find myself producing a sort of gushing boilerplate: Outstanding Management! Huge Market Opportunity! Game Changing Product! I do really think Neil and his team are world class, that they have the best evidenced and closest-to-market solution for AI dermatology, and that this could do a huge amount of good. But I always sound like just another VC shilling for his latest deal. 

However I woke up to see that Google had released a skin condition AI diagnostics app. To be honest I’ve had better starts to the day, but at least it gives me a chance to write something less predictable – what it feels like when Google comes to eat your lunch. 

As the day went on the board began to chat with management, and emails flew back and forth. The picture that emerged was, in the end, far more positive than we initially thought. Indeed if anything it left me with a higher level of conviction in the investment thesis than I’d had at the beginning. I wanted to expose the reasoning behind this to check if this is confirmation bias on my part; Am I being  foolish for being encouraged by the entry of the world’s largest tech company, with the richest body of AI expertise, into the area that our small startup is working on?

Firstly, let’s look at what Google has actually produced: a free app that is aimed at consumers and for a broad range of 288 skin conditions.  This is significantly different to Skin Analytics’ goal, which is  to produce a clinical grade device that sells into hospitals and health systems with, for the moment, a focus on skin cancers and pre-cancerous lesions. 

For Melanoma, which is far and away the most clinically important condition, Google’s published performance is pretty poor. It only catches 15% of melanoma as a primary diagnosis, and 60% as one of the top 3 diagnoses that their AI comes up with. This is a long way from being acceptable for clinical use. Skin Analytics achieves 95%. 

One of the things that we worked hard to establish at initial investment was that what Skin Analytics (SA) had managed to do was hard to do, and hard to replicate. Although Google had a different goal in building an app for a broad range of 288 conditions, I can’t believe Google will have been thrilled with an app that put out numbers on this level. Although SA will have to continue to develop and improve if they are to maintain their edge, it does give one some comfort to know that they are ahead of the curve. 

Secondly, there was no sign that Google is going after the clinical market for the time being. Developing what they have into a clinical product would take years, no matter how much money was invested into it. It would require a lengthy and fairly onerous prospective clinical study, which would take a year or two to complete and publish, as well as a host of other regulatory qualifications that are rightly associated with a medical device. It also requires software that integrates with clinical workflows, works in all clinical settings, on a range of devices, and offers the full feature set needed; a product as much as a technology. 

Thirdly, an app like Google’s will likely generate a lot of demand for dermatology appointments, going into a service that is already considerably overstretched in most countries. There will be an increased need for a clinically reliable triage tool in primary care, which is exactly what Skin Analytics have. 

So, if Google is going to enter your market area, it’s great if they do so by publishing evidence that they are not great at what you are very good at, and don’t seem to target the same customers you do, and are likely to increase demand for your product.

Of course there is risk that Google (or another competitor) catches up in performance and feature terms. SA will have to work hard to maintain their differentiation over coming years, improving the range and accuracy of their offer, and their product market fit. Further, there are still plenty of challenges for the company to overcome. But I’m somewhat more confident than I was two weeks ago that they can manage it, and a little nervous about being so!


eExperimenting with MEL Science – Nesta Impact Investments supports a new educational platform

Nesta Impact Investments recently completed a £1 million investment into MEL Science, a London-based science educational platform. Manish Miglani from the Investments team, explains the added value of this acquisition and how it will help Nesta close the attainment gap.

Investing in scalable solutions to tackle the world’s biggest challenges 

The ongoing Covid-19 pandemic and vaccination rollout has shown us yet again the power of science to help solve some of the biggest challenges. And yet many schools continue to see a reduction of interest and attainment of pupils in science subjects, especially in disadvantaged groups. 

So we’re delighted to share that Nesta Impact Investments has completed a £1 million investment into MEL Science, an exciting new platform that brings science to life through educational kits that combine hands-on experiments with interactive VR simulations and live lessons for use at home, in afterschool clubs and at school. This is our first investment since Nesta published its new strategy earlier this month, featuring its fairer start mission.

The attainment gap is high in science for pupils from disadvantaged backgrounds and in disadvantaged schools. Our due diligence reinforced that this leads to both lower science take-up and lower attainment, and key reasons have been lack of resources. There is also evidence of gender imbalances in STEM education. 

Therefore, there is a real need for a product like MEL Science to make science more accessible and engaging, specifically in secondary schools, and increase weaker pupil interest in science, all at a cost aligned with budget-stretched schools.

There is existing evidence from the results of New Jersey Institute of Technology (NJIT)’s research into how MEL VR Science Simulations improve learning outcomes which suggests that integration of such tech into the school curricula could be a viable solution to improve pupil engagement and outcomes in STEM education.

Nesta’s investment follows on from  a recent round of funding that the company raised in late 2020 from international investors such as Mubadala Investment Company, Channel 4 Ventures and other entities from Europe and China.

Vassili Philippov, Founder and CEO of MEL Science commented: “MEL Science is on a journey to build a new class of science education platform. One of our areas for growth is to deepen our educational impact. We want kids who use our products to be more curious and seek to solve problems. We want our kids to think like a scientist, to do better in exams, to study science at university and maybe even become scientists in future. We know society needs more scientific literacy for mankind to have a sustainable future. We are delighted Nesta is joining us on this journey. We hope Nesta’s support can help MEL Science deepen its impact with schools, after-school clubs and other institutions around the world.”  

This investment complements our investment backing last year for Empiribox, which is helping primary science education in the UK through its lesson plans, assessments, equipment and termly CPD. Empiribox has also launched an introductory free blended learning platform to assist schools continue their science education through lockdown.

This is the Year that Was – Nesta Impact Investment Team


Our investment strategy is designed to back companies aligned with Nesta’s broader strategic goals, one of our methods of scaling innovation and impact. A quick recap on Investment at Nesta – we have been investing in early stage tech businesses across Nesta’s history, scaling innovation and impact since 2012. We were one of the first “profit with purpose” investors in the UK. We look to support businesses where there is strong alignment between commercial success and social or environmental impact. 


As we embarked on this new year, we saw countless comments and reflections on the unprecedented challenges we all faced across the globe in 2020. There is no doubt 2020 was not a year any of us would choose to revisit, but in the face of hardship and uncertainty, we have been inspired by the innovation, creativity and resourcefulness we have seen both in our existing investment portfolio and in the founders we have met more virtually than physically across the year. 


Here’s a walk through the year of the Investments Team at Nesta:


Four days after the first national lockdown started in late March 2020, we led a £1.5m investment round in Q Doctor. Founded by Dr Chris Whittle (a doctor from the NHS’s CEP) who wanted to make a change to the way people access healthcare, QDoctor provides remote video consultation technology mainly for NHS GPs and also specialist and urgent care services. This has been a key digital service in 2020 to enable the NHS to continue caring for patients while they remain in their own homes, as reflected in patient signup numbers having grown by a factor of 5. In 2021, QDoctor is now running key Covid vaccine booking systems in England and we are looking forward to a rapid rollout. 


At the end of March, we led a $10M total investment round, of which Nesta invested $1.3M, in BibliU, a digital platform providing digital textbooks and data analytics to universities and colleges. A recent survey found that 65% of higher ed students skip buying print textbooks due to cost. BibliU helps to make textbooks more affordable by working with publishers to provide the content students need via its digital Learning Enablement platform.  Reflecting themes in Nesta’s Fairer Start Mission, BibliU’s Universal Learning model enables institutions to give all students first day access to their books. We have seen a surge in UK and US universities signing up to the platform and BibliU’s revenue has more than tripled since our investment, with more than 125K users.


In mid April, Nesta invested £750k in science education company Empiribox alongside another £750k of new capital from existing investors Downing Ventures, to support the company in improving the teaching of primary school science (KS1 and KS2). Empiribox offers science experiment kits  as well as teacher training and pupil assessment. This makes it possible for non-Science trained primary school teachers (>70% in the UK) to gain knowledge and the confidence to teach science to their pupils. During the year, our investment was used to develop and launch a new online platform, “Empiribox@home ” which has helped more than 3000 schools enable pupils to continue their science education via remote learning during lockdown.


Job matching and recruitment service platform for those at the start of their career, GetMyFirstJob, saw enhanced support from Nesta this year, both in terms of a follow on investment in April and close collaboration with Nesta’s Sustainable Future Mission team, FutureFit and IGL. Given the prospect of escalating unemployment (particularly for those aged 16-24), services such as GetMyFirstJob are crucial to help young people find the right jobs or training opportunities. We helped to establish a multi-disciplinary team across Nesta to partner with GetMyFirstJob and improve the way they use their data and have more impact. As the UK shifts its focus toward a green recovery, it’s vital more people are skilled and able to get green jobs and move into the green sector. Colleagues from across Nesta have collaborated to test and trial engagement between young job seekers and “green jobs” advertised by major companies such as Hitachi Rail and WSP Global. 


One of our legacy technology venture investments, Skimlinks, was sold to a retail marketing platform in May, delivering Nesta almost 3x our investment value. Skimlinks’ technology automatically monetizes product links in commerce-related content, a tool to automate affiliate marketing. The company serves major publishing houses and content generators. This is an investment we have held since Nesta invested in purely commercial technology startups back in 2009 and demonstrates the need for patient capital in scaling up innovation.


In July, Nesta invested £750K alongside Hoxton Ventures, in Skin Analytics, which has developed an AI diagnostic tool to detect skin cancer. The technology can identify skin cancers, to the same level as a dermatologist and, as a consequence, will reduce the burden on primary care and GPs who are typically first port of call for skin concerns. With the NHS overwhelmed by Covid, cancer diagnoses are being delayed. Tools like Skin Analytics can efficiently clear the backload of cases, identify  those patients who are at real risk and get them access to specialist care quickly. Quick diagnoses can have a significant impact on reducing mortality from skin cancer. 


Third Space Learning (TSL) provides maths tutoring online, particularly targeting disadvantaged children who are falling behind. The company had grown to serve c.20K children about two thirds of whom were on free school meals. During 2020, TSL bid  in the open competition to deliver the National Tutoring Programme (NTP) and is now supporting a rapidly growing cohort of schools and students.  Nesta has continued to support TSL this year, providing follow-on investment  in October to support its rapid growth. TSL has performed impressively during the year and over time, reaching nearly 70,000 pupils with 1-1 maths tuition since 2013 and demonstrating continued potential for growth and impact.


Arbor Education is a Schools Management Information Systems SAAS platform developed to help schools more effectively use data. There is strong evidence that schools making better use of data in decision making deliver more effective educational outcomes. Arbor has continued through the year as the most successful challenger to the legacy monopoly platform Capita SIMS. In December, Nesta supported Arbor in its merger with  The Key, the UK’s leading provider of governance support services for schools, bringing access to 16,000 school leaders and governors. The deal marks an exciting development for Arbor and helps consolidate The Key as a major force in the UK education services market.  


Over the Christmas break we finalised a follow on investment in ProFinda,  a product that uses advanced data analytics for skills matching. It has a broad range of applications and is used by the big consultancies for internal knowledge management, recruitment and staffing, and learning and development. It is a crucial piece of infrastructure for embedding Diversity and Inclusion inside large organisations, by making internal staffing decisions on a much more transparent basis and facilitating best practice, such as blind search. Nesta will be using Profinda ourselves, to make the amazing range of skills and knowledge across the organisation more accessible, and enable more cross team exchange. 


Oomph was set up in 2011 to provide exercise classes and other activities in care homes. Nesta first invested in 2013 to support the growth of the business and again in 2016 to expand into taking care home residents out on day trips. As Covid took hold, the care home industry has been battered on all fronts and the future looked pretty bleak for all players in the elderly care sector. However, demonstrating  agility, resilience and creativity the company acted early and decisively to reinvent Oomph’s business model. It has now launched Oomph On Demand, a range of online classes for care home residents and training for care home workers which have been received enthusiastically by the care home sector and set Oomph on a more positive footing into 2021.


During the year we have actively supported our legacy technology ventures portfolio with follow-on funding to Symetrica , a market leading civil defence company, eoSemi, assisting energy efficiency in electronic devices by developing next generation frequency control devices for integrated circuits and Smart Surgical Appliances, developing a next generation surgical imaging system to minimise risk in and increase the scope for minimally invasive surgery which in turn should improve clinical outcomes and reduce NHS workload. We have seen the rapidly climbing value of a key remaining asset, Featurespace, which works at the forefront of application of AI to reduce financial fraud, ranked as one of the UK’s fastest growing tech companies. 


We have seen creative and resourceful responses to the Covid crisis in our mission-related fund investments, such as the Pay It Forward campaign run by Crowdfunder enabling >£100m of donations to help organisations rebuild and recover, Big Issue Invest’s role in delivering the Resilience and Recovery Loan fund providing financial support packages for social sector organisations and Bethnal Green Ventures re-orienting their Tech for Good accelerator to help startups that will build back better post pandemic. 


What a year 2020 was! But despite the bleak backdrop we have been energised by the companies we work with and their relentless focus on growth and impact. We have started 2021 with enthusiasm and optimism to see further growth and creativity in the portfolio and to continue to support the inspiring innovators who deliver both social/environmental impact and commercial success. 


Nesta supports Female Founders Office Hours to improve access to funding and support

Lisa Barclay, Investment Director
I am going to be participating in my third Female Founders Office Hours in a couple of weeks and wanted to share the concept. Playfair Capital and Tech Nation have done a tremendous job in pulling together dozens of VC investors over the past year and connecting hundreds of female founders to them. The main aim of the events are to address some systemic failures – a lack of funding and support for female founders in tech and barriers to accessing investors, particularly outside of London.
During Female Founders Office Hours, each founder is matched with 4 investors with whom they have 1-1 sessions to pitch their startup, ask for advice, or use in whichever way is going to be most helpful to them. As an investor, it is inspirational to meet each founder, hear their story and support them. In the UK, for every £1 of VC capital, less than 1p goes to all female founding teams and 10p goes to mixed gender founding teams.  These are woeful stats which need to change and all credit to Playfair Capital and Tech Nation for bringing together the industry to collaborate in driving change. You can read the blog introducing Nesta Impact Investments as well as some of the other VCs who will be taking part in the November Female Founders Office Hours. Look out for future events and if you are a female founder please do sign up on the Playfair Capital website.

Why Nesta is investing in ed-tech for higher education

Nesta Impact Investments recently led the £7million Series A investment round to support the growth of edtech company, BibliU.  Nesta invested £1million alongside other investors, Guinness Asset Management, Oxford Sciences Innovation and several family offices managed by Stonehage Fleming

Investment in edtech across Europe has grown fast over the past five years and passed the $1bn mark last year. Nesta has been a prominent edtech investor in the venture market, building a portfolio of ten companies across the sector. We see the transformative impact that technology can bring for students, educators and education managers, in enabling more effective learning, improving access to high quality education, reducing teacher workload and providing data-driven decision making tools. 

BibliU is a great example of this. It is a digital learning platform used by universities and higher education institutions to provide students with online access to learning materials. The platform gives educators, academics and university libraries detailed information about content usage patterns and learner engagement that helps them better assess the needs of students. BibliU already has partnerships with over 2000 educational publishers worldwide and offers incredibly comprehensive content coverage. 

We were drawn to support BibliU for several reasons. At its core, BibliU is playing a leading role in the digital transformation of higher education and seeks to support inclusive access to educational content. BibliU offers all students more cost effective access to their course materials and in formats that are inclusive and accessible. There are further environmental benefits of a reduction in print textbooks. 

Closing the access gap

The cost of print textbooks has skyrocketed in recent years. Since 1977, in the UK, textbooks have increased in price at four times the rate of inflation, over 1000%.   87% of students think it is too expensive to buy new textbooks. This leaves more disadvantaged students with poor quality materials such as second hand books that are out of date, or sometimes without course materials at all. In turn, this leaves students worrying they will not achieve the grades they are capable of, simply because they lack access to learning content. In one study, 94% of students who had foregone buying textbooks because of the cost, were concerned that doing so would hurt their grades. During COVID-19, this issue is heightened as social distancing means further lack of access. Ensuring students continue to learn is crucial, particularly for those from disadvantaged backgrounds with no alternatives. 

BibliU provides a solution to this affordability gap. UK universities who sign up to BibliU offer it at zero cost to their students providing equal access to course materials for all. But beyond affordability, the digital format also improves access for students with learning needs such as large text or audio formats. BibliU’s technology offers inclusive access in a personalised way that helps students break down content into components and allows students to be more efficient in searching for definitions, explanations, and figures. BibliU helps students accelerate their learning and enables their teachers and professors to better support them. 

Why investing now matters more than ever

Under current circumstances, the digital technology provided by BibliU also provides a much-needed lifeline for universities adapting to remote learning. There is huge variation across the university sector in terms of tech-readiness. Some universities are at the forefront in applying technology to their learning methodologies, whereas, until recently, many others are still delivering degree education in the same way they have done for decades with face-to-face lectures, classes and tutorials. BibliU is playing a key role in the current Covid-19 crisis, helping universities to shift swiftly to digital learning as students face staying at home for the summer term. Nesta’s investment is supporting BibliU to continue to offer free access to their content during the lockdown, which has seen uptake quadruple. 

Educational content is a $65bn market which dwarfs even music and movies. BibliU has ambitions to reach 60% of the higher education students in the UK and US – 13 million students. The opportunity to deliver innovation at scale is there.  

A Nesta investee, Emerge Education, introduced us to BibliU and we are delighted to build on their early investment and look to scale innovation in higher education through BibliU. It reflects our commitment to the strand of Nesta’s education strategy which seeks to promote a smarter education system to empower learners, teachers and learning institutions to make more effective use of technology and data. Our investment in BibliU sits within Nesta’s broader portfolio of edtech activity which spans schools, higher education and workplace learning and we look to share the insights and experience we draw from this. 

Nesta Impact Investments is excited to be further building on our work in the edtech sector and supporting the BibliU team to transform access to learning in higher education.

The Doctor Will Video Call You Now

Nesta Impact Investments recently led a £1.5 million investment into Q doctor, a platform that allows video consultations between patients and their healthcare providers. Below, Manish Miglani explains why now more than ever these digital technologies are helping the NHS to keep seeing patients across the UK. 

Due to COVID-19, video calling or conferencing has become an essential part of our day to day lives. Many healthcare providers have also had to shift to remote working, seeing more patients across video calls or via the telephone. 

Historically, the NHS has struggled with digitisation, however, COVID-19 has brought with it the need to rapidly digitise like no one could’ve imagined. The recent fast track approval of 11 online video tools as part of the emergency framework (Dynamic Purchase framework) alongside the GP IT Futures framework exemplifies this well. As the chair of the Royal College of GPs Martin Marshall noted to the Times, it has taken “two and a bit weeks to achieve more than we have achieved in 20 years” in adopting new technology into the healthcare system. 

Investing in tech that works

That’s why it comes at an opportune time that Nesta Impact Investments has led a £1.5 million investment into Q doctor, a platform that enables those in the NHS ecosystem to deliver health services directly to patients via video consultation. Q doctor is rapidly expanding at pace to meet the demand caused by COVID-19 and is currently available to 25 million patients across the UK. The platform not only enables patients to continue to have access to their healthcare professionals but it also allows workers to stay safe at home, delivering consultations without needing to be physically in a GP practice. 

When we were evaluating investing in Q doctor last year, we were struck by the impact they were already having across care pathways including specialist and outpatient care, such as enabling Lewisham and Greenwich NHS Trust (LGT) to offer specialist cardiology consultations through video. They had managed to put into practice what the NHS Long Term Plan set out a few years ago – using technology to make it easier for patients to access healthcare and reducing long wait times. Furthermore, unlike many other virtual healthcare platforms that work to replace healthcare infrastructure, Q doctor works alongside existing NHS systems so that patients can stick with their doctor who knows their healthcare needs and also benefit from video consultations. 

Q doctor’s work for COVID-19 and beyond

Our investment is already helping support Q doctor in their response to COVID-19. As the platform is now NHS Digital and NHS England approved and centrally funded, NHS services can now access the platform for free. This has allowed Q doctor to help clinicians securely access their clinical system without any additional hardware and in working with one of the largest providers of NHS urgent care services to support setup of London’s first COVID-19 isolation centre at Heathrow airport. The largest urgent care providers nationally are now working over the Q doctor platform to deliver care to care homes, hospitals and patients in their own homes. It is heartening to see the platform help deliver the softer emotional aspect too, with isolated patients in hospitals and care homes being able to use it to speak to their families and loved ones.

Beyond the current health crisis, we believe Q doctor’s platform will make a truly positive difference for clinicians and patients alike, influencing healthcare in the long term whether it’s improving access to healthcare or simply freeing up clinician time to be used more effectively for those who need it the most. In having to innovate during a time of crisis, this may just be the push the NHS and wider care system needed to fully embrace digital technologies. 


The story of my life

What does a good board pack look like?

Over the next couple of months I will post a couple of blogs about corporate governance with some thoughts on roles, compositions and effective processes at boards.  As a big Simon Sinek fan, I would normally kick things off at the top level thinking about purpose, but in this case I’m going to break the rule. I’m going to start by diving into a detail, what I think a good board pack looks like.  I’m doing this partly because of an immediate need to cover this elsewhere and secondly because it’s probably an easier topic to nail down!

Having said that, the Why, What How runs deep so let’s start with purpose, at least at a micro level, the purpose of the board pack.  

Why do we prepare board packs – which I think are frequently seen by executive managers in investee companies as an unnecessary burden, distraction and cost of receiving capital?  Interestingly, as a side note, in my experience there is a high correlation between deep embracing of board data and company performance in the long run and the way founders and managers respond to board process and reporting is an indicator to me of their capability and quality.  

Fundamentally I believe that a board pack has one purpose with a few direct and indirect outcomes.  The purpose is to enable all board participants to be deeply informed about the critical performance matters in the company in an efficient, consistent and comprehensive way.  The outcomes of achieving a high level of knowledge from having creat board reporting are:

  1. Significantly more efficient board meetings where it is possible to project forwards and problem solve rather than play catch up on what has already happened and therefore can’t be changed. 
  2. Better decision making through comprehensive background data.  Making choices with partial information is always less effective.  Gaps can be temporal meaning trends are not easy to spot, or thematic meaning it is not possible to reflect on interconnections (for example platform performance and customer service, or sales and marketing).
  3. Increased confidence by non-executive board members in the executive likely leading to greater trust and executive freedom.
  4. Increased implicit responsibility of board members to engage.  It’s easy for me not to spend time preparing for board meetings where there is little support to help me, conversely I feel embarrassed and guilty if I have not respected the effort that a team has put into creation of a great board pack.
  5. The creation of a ready made data room to support fund raising or corporate M&A and accelerated confidence and trust building of incoming stakeholders.
  6. Improved organisational culture resulting from transparency, consistency and discipline that is required to have good board reporting in place.  

When a management team weighs up the cost benefit analysis of taking time to prepare high quality board packs, as they must given the limited resources in any start up, they should reflect on all these matters.  The decision may still be that resources are better deployed elsewhere but that should be a comprehensive and intentional decision rather than a passive choice resulting from failing to consider the implications.  

So what does a good board pack look like?  Well first of all a negative response – it doesn’t need to be long, although it might be.  It does not look the same for every company, the depth of contents will vary by company depending on scope of activities, maturity and availability of data.  It does needs to be pragmatic and be designed to meet the needs of and the capability of the company and team. 

What is important is:

  1. Consistency – the pack should pretty much look and feel the same month to month allowing both rapid familiarity helping readers consume data more efficiently, but also lead to easy comparison month to month to help identify trends and patterns.  
  2. Data richness and efficiency.  Subjective views are important and relevant, but backing them up with data leads to more effective analysis and decisions.  Easy visualisation (graphs help) makes this better. However the data needs to be relevant and focussed. There is a pareto of data significance that you should take into account when designing a pack that depends on deep understanding of how your business functions to identify.  What your workers eat for lunch will be irrelevant for most organisations, but for a PT instructor business it might be one of the most critical factors in success. Work out what matters and find ways to measure and report it.  
  3. Comparability – how is performance compared to plan, prior periods and maybe some other relevant benchmark like competitor performance.
  4. Timeliness – if you can’t get a pack to me 10 working days after period end you’re doing something wrong.  
  5. Comprehensiveness.  Your pack should cover all of the following areas.  The amount to report in each category will vary significantly company to company but it is unlikely that every one of the following matters is not relevant to an extent that warrants at least minimal commentary: 
    1. Your market place – insight into customers and competitors
    2. Product/service delivery performance – including both internal (platform downtime) and external (NPS) metrics 
    3. Product/service development plans and delivery – new products, product enhancements, product improvements, remedial fixes.
    4. Marketing – how well are you getting your message out
    5. Sales – what does your pipeline and process performance look like
    6. Customer service performance
    7. Staff – performance, wellbeing, capability gaps and recruitment, issues
    8. Operational resources, space, kit.
    9. Financial resources and performance
    10. Compliance matters, have you done the stuff you should and has anything happened that shouldn’t have from a legal, cultural, safety, environmental, financial (etc.) perspective
    11. Board performance, at least a rolling action list plus minutes – did you record and do the things that you said you would do in past meetings.  

Every pack will look and feel different, and board members will appreciate brevity as long as it is efficient rather than resulting from lack of completeness.  The data you include should be stuff that the leadership team in a business are thinking about all the time, so it should not be difficult to pull together if you have capable people, strong processes and good discipline.  Creating good board reports should be a beneficial exercise for executives as well as non-executives.  

On reflection I now realise that I need to do a huge amount of work on my own board process to meet the standards I’m expecting of my investee companies, but at least that means you know I am speaking from a position of empathy at how hard this stuff is!