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Interview: Norman Niven

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Norman Niven on disrupting the system and shaping the future of health tech

How did you become a CEO and start your successful career?

I developed a pharmacy from scratch where I had to conjure up new ideas to get business coming to me. I was the first to have a delivery van in the UK and to collect prescriptions from people at home, usually, elderly people, bring them back to dispense them. We also worked very closely on measuring, managing and monitoring repeat prescriptions.”

It was interesting to see the negative reaction from other pharmacists in the area about us offering these new services. They felt that the collection from older people’s homes, in particular, was outrageous. We started to work closely with care homes which led me to develop Nomads. This was the first medication management system and it grew so rapidly that I had to sell the pharmacy. I became the CEO of surgichem and we were acquired by Bupa after we became a leader with over 70 per cent of market share.

My advice to any young pharmacist is to not go near the traditional way of doing things. You have to look for opportunities that you alone can provide. If you have to go in to talk to a care home then provide something different – otherwise, why would they change?

When you went to Bupa, that was your first time within the health care sector where you were working below someone. How did that change your perspective?

It changed my perspective massively as I had never worked for a large company. I wasn’t too happy to be running my old company for 18 months and looked to leave at that stage but I stayed. I was parachuted into healthcare recruitment where I was put in charge of a business making 60 million pounds a year but it wasn’t turning a profit. I brought the eight businesses together under one new banner and we made over 70 million with 5 million profit. 

My time with Bupa was extremely useful because I worked within a highly organised environment and worked closely with a group of hospitals and care homes. I was desperate to go into my own business again because I couldn’t really make the impact I wanted to as there were too many levels to go through to get permission and everything had to be done the Bupa way which is tiring. So I left to set up another business developing the medication system that allowed liquids to be put together by pharmacists. 

It’s a liquid monitoring dosing system called Biodose which was very successful and we were acquired by Quantum Pharmaceutical in 2013. We had been on the market for less than 18 months before they invested over a million in the business. I got involved in assistive technology where we set up another new company called Protelhealth and developed a website called, Tell Me Now to sell this technology. There was suddenly an influx of new products with brilliant designs on the market which was a very exciting time but the following year, everything stopped. We were seeing products where the inventors hadn’t bothered to do their homework on whether the product would succeed.”

I was approached by Liverpool City Council because they had a major problem with the shortage of carers and those who were working on medications were worried about liability issues. We were asked to set up a new service to ease the shortage so the staff would be redeployed into understaffed areas. I came up with a new system called Paman which is remotely operated medication system for monitoring people administering drugs at home. It uses fully qualified pharmacy technicians and pharmacists to observe the hub.

What was the point if no one is going to bother checking if people are taking their medicine?

We remove the carers from having to visit people at home by taking over that role. In doing so, we saved one council 350,000 pounds per annum for every 100 people and another saved over half a million pounds in one year. It dramatically reduces errors, improves safety and has a massive impact on drug wastage. 

The biggest barrier to NHS entry with a new product is vested interests as someone will come along and realise the product being introduced may take their job. When we started with our system, we had a variety of people who would say to service users, you don’t want to be using that thing so let’s unplug it or put it in the bin. That’s hundreds of pounds worth of equipment just because they are not going to manage it because they realised it may be better than them.”

That’s the biggest problem every aspiring developer has as you’ll never know about this or see it as it’s done very quietly. The solution is what I call innovation proving centres so instead of selling your product to the NHS, you would sell it a centre instead. They do a proving role on the product to ensure it works where they mark it out of 100 and anything above 90 means that everyone is satisfied it works.”

Do you think we could see something like those innovation centres or are we still years away from that?

The biggest problem we have as a nation is that we lag behind other counties. In Europe, the most innovative country within the health care market is France as they have been innovating very rapidly. If you look at the UK, we have a plethora of apps and if it isn’t one then it isn’t taken seriously. The really exciting tech is not the gloriously designed stuff that looks good but the tech that delivers a service.

People talk about the digitalisation of health, yet people in positions in authority are unsure how to define it. We are using it as a sort of throwaway where there is a lot of talk and nothing else. The difference with France or Scandinavia is they look at everything made in their country and they adopt it. 

In the UK, there isn’t this nationalistic acceptance where we buy British and give it a chance. In France, Germany and the Netherlands, they don’t develop a lot but what they do develop, they bring to market very quickly but over here, it takes months.

Have you gotten used to immediate pushback or was there ever a doubt in your mind to take a step back?

The irony is, every single pushback I ever had made me ten times more determined to get it in. All of our competitors would always try to get rid of us by any means they could but that made us intensely determined to succeed. 

The biggest killer of businesses is complacency. If you are building a business and everything is going swimmingly, then that is when you die because there is nothing to challenge you. However good you are, you can still develop and if you don’t, someone is going to come up from behind you and leapfrog you because they thought of something you couldn’t be bothered thinking about.

Where do you see the future health tech going and what does that look like for SMEs?

It’s hard to be disruptive when you get negativity or pushback unless you are a seasoned entrepreneur or obsessed. If you want to define an entrepreneur, it’s someone who is an obsessive gambler but instead of roulette, they have a desire inside to bring new products to market. They gamble money and time because they are not in the business to make money. During the business builder, it’s about being the first and peer acceptance that you are smart and have the best product. That’s the only thing that drives you and if you don’t have that drive, you will fail.

Healthcare is not moving as fast as people like to make out because it’s stopped at every turn. The future is not necessarily about technology but it’s about how it can deliver services and without the two coming together then you have nothing.

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