Helping the NHS deliver actual outcomes AND generating revenue for your organisation
This pivot from Software As A Service to Software With A Service is starting to gain more attention both UK and stateside and not just from a healthcare perspective. Every second article keeps telling me how SAAS is dead and will be completely replaced by AI. I suspect we are a little way from that BUT for those of you who are selling into the NHS I do think exploring Software With A Service offers a previously untapped opportunity.
The opportunity sits on both sides of the table. The NHS is beyond stretched (corridor care job adverts last week are the latest horror) and is looking for actual outcomes to be delivered when it is procuring services.
Often the challenge with SAAS investments is that they aren't actually used and in some cases are never implemented and leveraged. The uptake and adoption has been a massive problem forever and a day and is getting worse. If SAAS providers can provide even a basic ‘bronze’ service that supports the implementation of these services and accessing benefits there is a massive value add both sides – one an actual benefit from the investment and two revenue for the SAAS provide via a different pot of funding.
Over the last 12 months we have supported two businesses selling into the NHS and I wanted to share the stories behind their success in taking this approach.
Lets open up by saying that there is no doubt that the NHS knows what needs to be done, and there's some great tools out there designed to help in so many ways. SaaS is often a really cost effective way to procure these solutions. But the age old NHS problem has been exacerbated recently, they simply haven't got the time or expertise, so great tools end up on the shelf. This is made worse now with the huge budget constraints and short-falls, so potentially great products that didn't get used will not get renewed, and new innovative products will get ignored because of the past experiences with "shelf-ware" purchases.
So how can we help the NHS get the most out of these products? If only there was a way for the product experts to bring their experience to make these implementations a success and deliver real outcomes for the NHS!
SARD: a race to the bottom!
When we were engaged by SARD, they were candid that it was already a race to the bottom regarding the licence costs trusts were able to pay; rates had been £250 ahead (a decade before) and were now sitting at about £10 a head! An incredible decline. The lack of staff to make use of these services was further frustrating the investment and we worked with SARD to understand the outcomes that trusts were looking to achieve and to pivot away from just providing software to delivering these actual outcomes and implementing service for them and making the data and therefore the answers available. It is important to share that we did this with sustainability in mind within the trusts, ensuring that they were getting real value for money and actual outcomes.
Internally for SARD, this meant quite the change as a new operating model was needed, new roles to be hired and acceptance and understanding within the business that they were moving towards a technology powered consultancy. In addition to internal changes there was a need to signal to the market this shift and to pivot from selling software to ‘proper’ services. I’m so proud of the SARD team rising to the challenge; its a hell of an undertaking when you are 13 years into running your business a certain way BUT the proof is in the pudding and as they closed out 2024 with their largest revenue year to date – in a market where plenty of other competitors were being acquired and consolidation was at play. They have a pipeline of clients progressing outcomes during 2025 and are adding massive value to the trusts they are delivering for – a key component of this
e18 going above and beyond
My second example is intelligent automation consultancy e18 Innovation (e18) who are leading the market around RPA adoption across the NHS. An NHS E agenda in 2020 drove an’ ask’ to implement RPA to help reduce costs and improve clinical pathways, often those that were struggling with integration to EPR systems.
e18 engaged us as strategic advisors at the beginning of The Grafters journey, we immediately saw a unique opportunity. Unlike typical SaaS providers, e18 was consistently going above and beyond – investing heavily in pre-sales and delivering services that far surpassed what their competitors were offering.
Our first step was to help e18 recognise the significant value they were already providing. We worked with their team to categorise and group the service layers they offered, building a clear cost model to accurately assess the true cost of delivery.
With central funding for NHS business cases being withdrawn and funding needing to shift to local levels, e18 faced a rapidly evolving landscape. Many trusts were struggling with stretched resources and lacked the capability to implement solutions effectively. To address this, we guided e18 in developing a number of service offerings. By leveraging the experience, RPA processes, and playbooks they had already built across the NHS, we helped them shape a service model that directly responded to the capability gaps within trusts. This not only ensured consistency in outcomes but also relieved the implementation burden for their NHS clients.
We focused on creating a commercial model that enabled e18 to retain its commitment to exceptional client delivery while operating as a sustainable and scalable business. The result was a series of service offerings that were outcomes-focused, financially accessible to NHS trusts, and strategically positioned to unlock long-term value for both e18 and their clients.
Over the past two years, this approach has allowed e18 to significantly expand its footprint in the NHS, positioning itself as a Software with a Service leader in the automation space. Their ability to combine technology with structured, managed services has proven to be a game-changer for NHS trusts, enabling them to maximise the value of their automation investments.
This shift to tiered service levels has significantly enhanced client satisfaction, fostered long-term partnerships through contract extensions, and enabled e18 to expand their team with additional expertise to strengthen their broader operating model. By incorporating value-added services such as workshops, masterclasses, and webinars, e18 has firmly established itself as the leading independent RPA consultancy in the UK for the NHS, trusted to deliver impactful and sustainable automation solutions. These operating model changes for e18 have ensured an additional £1m in company valuation over the last 12 months alone.
If you are working in healthcare, selling into the NHS and wanting to add tangible outcomes to your clients and increase your revenue drop me a line to discuss further.