Episode 8: Andrew Cannon

Andrew Cannon, CEO of UK-based teleradiology and telepathology services provider Medica Group, chats with Candesic. In an engaging and wide-ranging discussion, he explores the evolving diagnostics landscape, sharing his thoughts on:

• How the NHS and independent sector can work together to tackle diagnostic backlogs at scale
• The opportunities and challenges of operating as a private equity-backed business
• How AI is transforming radiology, from emergency reporting to scan triage and allocation
• The future of remote diagnostics, managed imaging services and telemedicine expansion
• Why international markets and adjacent diagnostic services represent important growth opportunities
• The biggest opportunities – and risks – facing diagnostic providers over the next decade

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Transcript

SPEAKER_01 0:04

Hello and welcome to Candetic in Conversation, a podcast series exploring the big innovations, opportunities, and challenges in health and social care, life sciences and medtech. Today, Candetic is in conversation with Andrew Cannon, who is the CEO of Medica. Andrew, welcome to the podcast. Thank you very much for having me, David. Pleasure to see you again. For the one or two people watching this who don't know, tell us about Medica. Tell us about your journey to becoming CEO.

SPEAKER_00 0:35

Well, Medica Group consists of four divisions really: the UK, Ireland, the US, and our Educate Continuing Professional Development Business. We're the largest telediology provider in the UK. That means we report more scans than anybody else. We work with about 60% of the NHS. So the chances are if one was to be admitted and have an urgent overnight scan for a suspected stroke or something like that, it would probably be read or interpreted by one of our radiologists. We're the largest teleradiology provider in Ireland, and in Ireland we do a mix of uh remote, so teleradiology reporting, but also managed services. So actually on the ground in terms of gaining the images, so uh radiographers, rad technicians or assistants, sonographers, X-ray technicians, and so on. In the US, we have a small but perfectly formed ICRO business, that's a clinical research trials business. So it does reads for the likes of AstraZeneca in large-scale clinical trials, and then finally we have our educate CPD business that supports radiologists, pathologists, doctors, and medics around the world in their ongoing professional development. Fantastic. And talk to us about ownership. So uh a couple of years ago, no, three years ago actually, goodness me, um, Medica was a listed business, PLC. It was taken private by IK Partners, IK Partners, large uh private equity firm, uh originated in uh Scandinavia. And I joined the business about a year after that. So I've been with Medica just over two and a bit years. I'm an accountant by training, boo, his. Um, but I have worked in health and social care for about 25 years now.

SPEAKER_01 2:23

So let's touch on that. I mean, there's there's BUPA, there's that's Voyage Care, isn't it? So uh you've had a long time in the industry. Um, tell us about your experiences that led up to where you are now.

SPEAKER_00 2:33

Um yes, okay. I mean, uh I was an accountant for for a long time and at BUPA um really got interested in in running the operations. So that's the call center, the claims function. Um, and we began whilst there to do some really interesting things. Um open referrals, which is essentially navigating, actively navigating people around the healthcare system and getting a better outcome for a lower cost, which is sort of the holy grail of healthcare. Um, not without controversy at the time, um, but incredibly rewarding. I'm gonna jump in and say why. Um because um healthcare uh and medicine can often take a while to adopt evidence-based or best practice. I'm choosing my words a little bit carefully, and so essentially, if you were being reductive, um, you could say, well, why is somebody in a call centre or an administrative role overruling a GP in terms of the next medical professional that some somebody should see? And the answer is because uh GPs, as the gatekeepers of a lot of services, can't be expected to be across everything and know absolutely everything. You see this a lot with people who have conditions and they become, you know, really, really well educated on their own condition, much more so often than than than GPs, who are you know having to manage absolutely everything and are under incredible pressure. Um and so we would intervene in the pathway if we felt there was a better way, not about cost, but about quality, about getting people quicker access to the right treatment paths.

SPEAKER_01 4:15

All of which also benefits costs, of course.

SPEAKER_00 4:17

Absolutely, yes, absolutely. So if you can shorten treatment paths, if you can get people to see the right person first time, so an electrophysiologist instead of a general cardiologist where that might be the case.

SPEAKER_01 4:27

The argument is it's win-win.

SPEAKER_00 4:29

Absolutely, yeah, absolutely. So um that was really, really interesting. We ran the call center and the operations along the sort of Toyota Toyota production system methodology. So lean, other people would call it, um was incredibly successful, very, very rewarding for the organization and for me personally. Um, as a result of that, bits kept getting glued onto my role. So I then began to run the occupational health business, the wellness business, the health assessment business. At no point did you say now I've got enough to do. They kept piling more things onto you. Yeah, but it became it became more and more interesting because it became like a virtual health system, really.

SPEAKER_01 5:09

So um and from there, from boopa to voyage care?

SPEAKER_00 5:12

And then in Booper, I I I ran the elderly care uh division in the UK. Yeah. Um two and a half years as the as the managing director there, and then joined Voyage Care. So VoyageCare, the largest provider of care and support for people with uh learning disability in the UK. Um it I need to caveat this because I'm no longer the CEO, but it was about 600 locations, 12 and a half thousand people. I was there for about eight and a half years. You were there until it sold, basically. Correct, yeah. And there for a couple of years after.

SPEAKER_01 5:40

Just quickly, I mean you came in after the Take Private in 23. Correct. Would you have preferred, do you have a preference? Are there pros and cons to having a listed company under your belt or or being private? You can be more agile and there's less reporting, I guess, when you're a private company.

SPEAKER_00 5:57

It's a good question. I mean, I've worked in a more junior capacity for listed organizations in the past. Um I've never led a listed organization. I mean, when I did um an MBA, which is a long time ago, more than 30 years ago, one of the big things about being listed was easy access to capital. Um I think I think the growth of infrastructure investors and P funds and all these sorts of things, I think the access to capital for good businesses that want to be able to raise it is there irrespective of whether you're listed or not. So I think that that advantage or that barrier has largely disappeared. I think the absence or the requirement not to have to do quarterly reporting and the short cycles that people think about is an advantage.

SPEAKER_01 6:46

Yeah, and if you've got a let's call it a robust build-in-by-mandate from your PE back here, which uh I dare say, I don't know whether you would, but I dare say you have currently got, then um the differences are perhaps not so great, and the freedom is is significant.

SPEAKER_00 7:02

Yeah, I mean it it's one of the things, that freedom, the the the freedom to act. I've been very fortunate in my career in that the the investors that I've worked with, uh Partners Group, Duke Street, Renhouse, IK have all had really high quality people, uh people who are really bright, who are able to add value through their experience in operations. Do you do you welcome a hands-on investor? Yeah, absolutely. Absolutely. I think one of the challenges in one of the challenges in healthcare is knowing the limits of your technical expertise, and it's something that I think sometimes people struggle with. And so absolutely, I am not afraid to ask for help and get support. I actively would welcome help.

SPEAKER_01 7:52

Provide provided the people supporting you know what they're talking about.

SPEAKER_00 7:54

Well, the yeah, and this is it, you know, the range of people that they're able to support us with, invariably they do. And I think so. For me, that freedom of action with that support is incredibly powerful. And for me, it has been moving from a large global corporate like Booper for me personally. I got a huge amount from Booper. I learned a lot. I can tell by the way I talk about that navigating people on the healthcare system.

SPEAKER_01 8:17

Yeah, you sound almost wistful when you're talking about previous research. Oh, yeah.

SPEAKER_00 8:22

I'm not wistful. I really enjoyed my time. Yeah, rewarding. It was rewarding, it was rewarding, and I was there for 10 years. I stayed for a long time. Sure.

SPEAKER_01 8:29

Let's let's look at the market. There are what's the current figure? 7.4, 7.2, is it now, million people in the NHS, patient backlog, waiting list? The government clearly needs private business. It is making no secret of the fact that it is pivoting towards, it says it is pivoting towards using private more. How are you experiencing that? Is the change real? How is it manifesting itself? How are you finding the market? And how are you balancing the demand with the other side of it, which would be things like strict clinical governance and you know, if the demand is there, but there's a balance to be struck about how you approach the work, I guess?

SPEAKER_00 9:11

Yeah. That's a really good question. I think one of the re one of the things that attracted me to this sector was that I think I got really curious about systems thinking and systems design when I was at Booper, and I was very uh fortunate to to be guided by some mentors and some people who were deeply experienced in designing systems, not technical systems, but processes and flows and things like that. And if you think about a situation where you have uh growing demand and where you have scarce capacity, um having scarce capacity in discrete local units, let's call them hospitals or trusts, um, that can't cope with that demand or can't predict the nature of that demand and the shape of it, is a really, really ineffective and inefficient system design. Much better to aggregate scarce capacity and be able therefore to cope with variations in demand if you're looking for specialist reporting from neuroradiology or pediatric radiology. So, one of the things that I think is structurally interesting about this sector, set aside AI and where we are and set aside tech, is it's a better system and a solution design, I think, to some of the challenges that exist. It also allows you to get really curious on data and insight. So, one of the areas that we are growing in very, very rapidly is sharing that data and insight with local hospitals, local trusts, where because of the we're corralling scanning and reporting in a way that they're not able to, we can see things in the performance of their system, the way patients flow through hospitals and move through it that they can't see themselves.

SPEAKER_01 10:56

I have a question on on routing and AI and the extent to which you can do that, but I'll I'll hold that for a second.

SPEAKER_00 11:04

So so just to finish so just to finish there, if I may. Um so um so I think it's a so I think it's an inherently better structural design. Everything we do begins with clinical quality. So if you kind of track back through my career, whether that's at Booper or Voyage Care most recently, everything was connected to purpose, these are values-led organizations that are grounded in high-quality services that has to come first. So, you know, the first thing that we do is to secure really high-quality clinical capacity. That's the first thing. Um, and then in terms of being able to meet that growing demand, and what are we seeing in the market? We're seeing growing demand for our services. Um, the whole of the market is seeing growth in this area. Um, I think people are hoping still that tech and AI is going to solve it or close the gap. There aren't enough radiologists or pathologists, an area we're expanding into being trained. Um, and I think we see some of the entirely understandably short-termism on budgets and and thinking that you see kind of cycles from year to year, and people thinking in purely cash terms. And so we'll see high levels of activity to clear a backlog and then it'll fall and then it'll fall away, which is not ideal in terms of great outcomes for patients, I would say.

SPEAKER_01 12:38

Well, are you uh are you a long-term solution and an inherent part of the future, or are you a government reaction to saying let's throw this at them, let's clear the backlog, and then we can we can try and fix the system?

SPEAKER_00 12:48

Yeah, of course I would say I would say the former, and I think you know, we're gonna come on to talk about AI and tech. You know, we are able to invest in tech and AI in in a way that the NHS simply can't because it doesn't have the the capital available, it doesn't have the license to I talked about freedom to act, it doesn't have the license to fail that that we that we have. So we can explore investing in clinical tools, assessing the clinical efficacy, and if they don't work, I was gonna say if it goes wrong, if it doesn't work or it's a dead end, that's okay. We've learned and we iterate and we improve our understanding of how to assess tools and their efficacy. I'm a lifelong supporter of the NHS. People in the NHS don't have that luxury, whether that's in terms of capital or time, or often that that kind of that that goodwill to be able to explore dead ends and come to a conclusion.

SPEAKER_01 13:47

And do you find that the public's attitude towards private business assisting working with the NHS is changing? That's a really good that's a really good question. I think if you need a scan, do you do you care whose logo is on the side of the on the side of the the equipment and uh who what badge the nurse is wearing?

SPEAKER_00 14:06

No, I I I don't I don't think you do. And I think I think you know one of the things one of the things that I I think we I think we struggle with in the UK is the NHS rightly is held in enormously high standing as a as a key achievement of the kind of post-Second World War consensus and the Labour government that brought it in and is seen as one of our crowning achievements. 2012 Olympic Games and all that. Absolutely get that. But if you're in pain or you're suffering, or you need access to treatment, which almost always begins with a diagnosis and increasingly begins with you know a scan or a pathology test, I don't think at an individual level you care who delivers that, you know. Particularly if it's free at the point of use and NHS funded. Absolutely, absolutely 100%. And I think you know, I talked about um the aggregation of scarce capacity being a more effective solution.

SPEAKER_01 15:10

Let's turn now and look at a deal or two. Wanted to talk about Axon diagnostics, MITIS Health, um, clinical desktop technology. Yes. Tell us about tell us about that and why that deal or deals were particularly attractive.

SPEAKER_00 15:26

Yeah, so we we uh acquired Axon earlier this year. We thought the Axon um we thought Rahul and the Axon team had done a really great job. They built something really um uh interesting, incredible in a relatively short space of time. Give us the one-line cell as to what they do. Um they're also in teleradiology, but the mice system is something that we didn't have previously, and from a tech point of view for us, is uh could potentially be very powerful for some of our clients. How's that? Was that one sentence?

SPEAKER_01 15:58

Uh it was, but explain what it does as well.

SPEAKER_00 16:01

Okay. Um, so essentially the mice system is how you link and interact with with clients. So the way that uh Medica grew really was direct access to uh hospital systems, the RIS or the PAC. So we are signing in to the RIS, the Radiology Information System. So we would sign in directly. Um that has a number of advantages. It's really cheap, it's really quick, it's really easy to get people up and running. Um, the disadvantages are that it means that local IT teams have to maintain access and um create new passwords for people, ensure they've been taken through, remote repositories have been taken through any kind of system or software updates. So there's kind of pros and cons to that.

SPEAKER_01 16:46

What you want is some kind of standardized reporting system, presumably.

SPEAKER_00 16:49

Yeah, that would be great. However, when you're dealing with you know 60% of the NHS, um hospitals and trusts have their own ways of doing things.

SPEAKER_01 16:58

It's not they're all using their own systems. Yeah.

SPEAKER_00 17:01

Helpful. Yeah. Um MITIS is a bridge is MITIS is a bridge to that and can potentially be a bridge to that for individual clients.

SPEAKER_01 17:08

And to the solution, yeah.

SPEAKER_00 17:10

There you go. Um, so we thought they'd built something really interesting. We thought the tech could potentially be very exciting. Um, it was an organization that shared our values in terms of being focused on patient outcomes, uh, making a difference in people's lives. Um, and so yeah, um, coming together earlier this year, and we're working on integrating the two parts of the business together, and it's going really, really well.

SPEAKER_01 17:33

And just broadening the discussion, we've seen significant consolidation in the UK in this market. How do you feel about uh cross-border expansion? How do you feel about adjacent telemedicine verticals? How do you feel about things like digital pathology? Um, what, if anything, can you say about looking in your crystal ball for the next two, three, four years without giving away any secrets? Yep. Uh, what's interesting, what's hot and what's not? Um digital pathology is hot.

SPEAKER_00 18:00

Yeah. Uh to use your expression, Dave.

SPEAKER_01 18:03

Yeah, not chosen at RAM.

SPEAKER_00 18:05

Digital pathology is hot, uh, high demand. Um, it doesn't, it shares some of the features of teleradiology. So you've got ever-growing demand, scarce capacity, not enough pathologists being trained or coming through, so you've got a structural shortfall that's only going to grow. Um, another area where the consolidation of scarce capacity and the aggregation of it elsewhere or remotely can enable you to get better patient outcomes for a lower cost. So that's exactly the same as teleradiology. The things that are different, um, so we think it's very, very exciting, and we're growing very rapidly in that space. We've invested in a lab in uh Runcorn, um, and we're signing new clients up all the time. So that's I'm very happy with that bit of the world. Um, the bits that are different, you don't get the urgent acute overnight sub-15 minutes kind of turnaround, so that's different, and it's also very demanding in terms of bandwidth compute power, even more demanding than radiology. But that's a very exciting area. So it's an area that we are expanding in organically, and when you've got a robust buy and build mandate, as you called it, David, um, you're always interested in expanding inorganically as well and looking at what's out there.

SPEAKER_01 19:29

Yeah. Uh anything else of interest or other geographies perhaps?

SPEAKER_00 19:33

Um so we recently acquired an ultrasound business in Ireland, uh, the ultrasound suite. Um, our Irish business is going great, guns. Um, women's health, massively underserved in Ireland. Um, and so these are physical clinics, physical locations where you can get uh dating scans, it's it's sonographer led. It's you're doing something different in Ireland, aren't you?

SPEAKER_01 19:58

To to elsewhere, because you're kind of doing you're doing more of the pathway, aren't you?

SPEAKER_00 20:01

Yeah, that's right. So we've got as I say, we've got managed services, we've got people on the on the ground, and this is something. So when I was in um elderly care and when I was in land disability care, I would always go and work for at least a week every year as a carer. Um not industrial tourism, it wasn't marketing, it was a genuine and sincere aim to get closer to where the work gets done and to get curious about the barriers that exist, which of them are systemic barriers, which of them are individual to that particular service or location. Um and incredibly rewarding. So at Voyage, I would do all the things that a carer would do. So I'd bathe people or feed them or toilet them or whatever need to do. Um, it's something that I can't repeat in the UK because I'm not a radiologist, but I was able to repeat it, I've repeated it a few times in Ireland. So I've worked as a route assistant essentially.

SPEAKER_01 20:52

I want to come on to talking about AI because because we have to. Um, how is it shaping the future of the company? I know that we've got uh Carpal to talk about Cure with a QU, of course, uh, and nice hawk potentially. So tell me about how AI is playing into what you were doing with various parts of the business. Okay. Uh gosh. I could fill that I could fill the rest of the session with it.

SPEAKER_00 21:18

I mean, AI occupies a lot of my thinking, a lot of the thinking of the senior team. Um AI is already beginning to have an impact. So I think we're I think with any with any technology, if you look at the path of technology that usually takes longer to adopt and to come to fruition and then has a much bigger, bigger impact, an even bigger impact than people imagined. Um radiology as a sector is one where there are large databases and exam library of image, so you think this is going to be perfect for AI.

SPEAKER_01 21:52

AI is spectacularly good at looking at shades of grey and telling you what it's looking at and its ability to perceive those shades. And patterns far exceeds the the the human eye, obviously. Not necessarily the experience yet.

SPEAKER_00 22:05

Yeah. Um and so the temptation is, I think, to to hypothesise that AI is going to kind of uh get rid of the requirement for radiologists, it's going to close that gap entirely, that the structural gap that exists. And you know, we're beyond the sort of phony war stage of it. It's already beginning to have an impact. What we see today is this is a very nascent space. Lots of people are developing clinic individual clinical tools, and the individual is quite important because this is a little problematic at the moment. So people are developing a CT chest or a CT head tool. The ability of those tools to find incidental findings is negligible, which is problematic when you're looking at an outcome for a whole per for a whole person. And I think there's also a temptation that people think, well, AI is just a kind of a switch and it's on or off. But actually, AI and AI tools require a huge amount of clinical governance, a huge amount of adjusting and assessing sensitivities. If you keep getting lots of false negatives, radiologists or reporters are going to begin to ignore the tool.

SPEAKER_01 23:15

There is, using that definition, there is or there will be a point where the AI has learnt enough. So at some point, presumably in the future, we will have AI fully dictating the triage and routing of every single diagnostic image. There is a future in which that must be possible if it continues to develop. And what can you see a future where the large players have got automated command centres and they are effectively doing the scan allocation?

SPEAKER_00 23:43

I think allocation of scans is allocation of scans are a really interesting one. So AI tools typically take three discrete forms at the moment. And in the future, as you suggest, David, they this is likely to merge. So the three discrete forms are clinic pure clinical tools. Is there an intracranial hemorrhage? Is there a bleed on the brain or not? Yes or no? Workflow, where am I sending this? And then you've got sort of generative large language model. I've pre I being the AI, I have pre-populated the report for you. Do you agree? Are you going to sign this off, David? Um workflow, which you did articulated there, this allocation, um is currently much more problematic than you think it would be. And you know, we're looking at different geographies for potential acquisitions, and so we're very curious about the way AI and teleradiology operates in different geographies.

SPEAKER_01 24:42

And the way in which it's legislated, presumably.

SPEAKER_00 24:44

Absolutely, yeah. Uh because you because it's not just singular countries, so particularly in sort of federated states like Germany, it varies from state to state in Germany. Bavaria is different to Schleswig-Holstein.

SPEAKER_01 24:54

Interesting that you've got knowledge of the Bavarian uh anything that anything we can take from that no, not necessarily absolutely nothing at all.

SPEAKER_00 25:01

Um and um what you see in the US is the uh AI tools and the ability of providers in the US to allocate accurately, which is important. This is not a kind of a dull business thing, maybe it is maybe other people find it as dull, but getting the uh scan to the right radiologist as quickly as possible in the case of a suspected stroke or whatever is is existentially important. One of the features you see in the United States is because there's a payer, really accurate labeling and nomenclature and data structures. You don't see that in the NHS, and as a result, our ability today to flow work around the system automatically is much more limited than you. Where's the fix? Pardon? How do you fix that? You build a tool that can recognize that this is a head and therefore needs a neuroradiologist or needs a general radiologist or that this is easier said than done, though. Post-market surveillance of AI tools, this is another thing where you've got individual AI businesses building, tech businesses building these tools. The work involved around clinical governance, the wrapper, the post-market surveillance, the tuning of these tools is always going to be required and needs an organization with mature clinical governance and expertise to be able to deliver that, I would suggest. Um, and that's probably not consistent with how tech businesses would see themselves today, but I think it's absolutely what we're gonna see over the next few years.

SPEAKER_01 26:42

Speaking of the next few years, yes. How are you going to measure your success? Are you looking at patient volumes, eBit DA, returning the company to public markets? Um, what does good look like for you?

SPEAKER_00 26:54

Um that's a good question. I I mean, not returning it to public markets, but uh the purpose of Medica Group is to improve people's lives through excellence in diagnostics and research. So good for me, I'm always grounded in purpose.

SPEAKER_01 27:10

Good for me is about delivering that purpose and improving on time and on budget while making sure that enough money is being generated, of course, as well.

SPEAKER_00 27:19

And doing it at a bigger scale and doing it and making a difference to healthcare systems worldwide. So one of the things that our scale brings us. So we do two and a half to three million reports per annum. One of the benefits that that scale brings is the ability to write white papers, do clinical research, develop AI tools, improve data and insight and patient flows. So for me, what would it look like? We'd have greater scale geographically, in terms of volumes, we'd be having a even more positive impact on healthcare systems worldwide. So that's what good would look like for me.

SPEAKER_01 28:00

And where is the biggest opportunity, or what are you most excited about?

SPEAKER_00 28:05

Ooh. I I think it would have to be data and I think it would have to be data and insight in the short term and AI in the medium term, if that's not if I've not, if I'm allowed to have two answers, David. Um specifically, what would you like to see it doing that it's not doing now, or or how would you like to see it developing? So data and insight is a really interesting one. So we can today tell hospitals and trusts how they can improve their patient flow and the performance of their hospital.

SPEAKER_01 28:35

And can you take the data that you've garnered from your international forays and feed it back into the NHS and learn things and and share that information?

SPEAKER_00 28:46

Yes, in a limited way. Uh of more interest is the fact that we can see the performance of individual hospitals and trusts and national performance or regional performance. And you know what good looks like. So it well, yes, so so we can help today hospitals and trusts perform better whether that's around following their own protocols, whether they're being too conservative or not conservative enough, whether they've got a problem with their labs on a Thursday.

SPEAKER_01 29:14

Are they happy to hear that advice?

SPEAKER_00 29:16

Well i that's a really good question. That's a really good question.

SPEAKER_01 29:20

Because you can get pushback sometimes from large organizations that think they know the best way to do things and have been doing it that way for decades.

SPEAKER_00 29:29

One of Yeah, it's a it's a really good question. One of the challenges in that has been who do you who do you give that information to, who do you share that insight with, right? Because there isn't typically anybody in a hospital who's in charge of flow. People kind of implicitly know, well, if I can reduce bed days and I can get people moving through the system faster, that's a good thing. Capital letters. Um, but there isn't anybody who's tasked with individually doing it. So who do I give that insight to? How do we get traction? I'm really pleased to say we've got some uh some partners now who are um beginning to receive that information and are sharing with us their own information, patient arrival times, um, allowing us to form a much broader picture of hospital and emergency department performance. So in the short term, I'm really excited about the difference that that can make, not just for medical clients, but for the broader health system.

SPEAKER_01 30:31

We talked about opportunity. I was going to talk about challenge. I mean, you may have just answered that question, but the biggest challenge that you can see over the next three to five years?

SPEAKER_00 30:39

Um biggest challenge. I mean I think I think the NHS is has been for such a long time in a position where it's struggling financially, where it's having to make suboptimal decisions that it knows are suboptimal, but the kind of best of a series of bad choices. I can't see any way in which that's not likely to continue.

SPEAKER_01 31:07

Um they could take a chunk of the funding and put it into social care.

SPEAKER_00 31:10

They could take a chunk of the funding and put it into social care. I think I think that's likely to remain the case. That that sort of structural financial challenge is likely to remain the case. Um I think um one of the challenges around dealing with the NHS is that sort of fragmentation that I spoke about. The siloing. Absolutely, and um the fact that people, organizations require different solutions, and I suppose there is a real risk that the system through AI and through tech fragments yet further and isn't consistent in the way it approaches clinical governance, post-market surveillance of AI tools, its adoption of it. And um whilst I think that would have the benefit of potentially local improvements, I think as a whole you would see a worsening as a result of that.

SPEAKER_01 32:05

Which brings us to a recurring theme of of this conversation, which is that a more holistic approach is often the solution that we don't currently have.

SPEAKER_00 32:14

Yeah, absolutely, absolutely. I think it's a huge opportunity, I think it's a huge opportunity. Um yeah, I think it's a huge I think it's a huge opportunity, not just for kind of the UK PLC and funds and budgets and the NHS as an organization, but for individual patient outcomes. There are people waiting today a scandalously long time. There are there are people in waiting lists today who have cancer or diseases that could be treated, who are missing out on the opportunity to begin that pathway, begin to come into their treatment through a whole variety of reasons. And it's not through kind of trying or best intentions, but through lack of funding or capacity or resource or time or space or whatever people are on that list, and I think that's I think that's a tragedy.

SPEAKER_01 33:10

Got half an eye on the on the clock there. Final question, perhaps. Where do you personally hope to be in three, five? I'll push it, I'll push it a little bit, ten years. Ten years?

SPEAKER_00 33:22

Yeah. I'm old. I'm old, David DC, so in ten years I hope to be. No, you know what? In ten years my my big motivation is to do is to make a difference, is to make a difference. That's like really corny, I've got loads of people say that. My that's why over the last sort of 25-30 years I've done roles which have a direct impact on people, have the potential to change people's lives, not in an abstract way, you know, a ball bearing manufacturer or a pie factory, but in a direct, meaningful, lasting, significant way.

SPEAKER_01 34:03

You'd like to reflect on a job well done.

SPEAKER_00 34:06

Yeah, and I'd like to I'd like to do things, I'd like to make a difference, and I'd like to do it in a in a way which is which it which is inclusive and meaningful and takes people with me and is intellectually stimulating. So to continue to do that would be I've been very, very lucky. I'd like to continue to be that lucky, I guess.

SPEAKER_01 34:27

Andrew Cannon, thank you for your time today. Oh, thank you, David. And thank you to everyone who listened all the way to the end of this podcast. My name is David Farbrother, and I am director of content and communication at Candesic. We are a London based consultancy. Feel free to link in with me or drop me an email. I'd love to hear from you, and new podcasts in this series are available regularly on YouTube, Amazon Music, Apple Podcasts, and Spotify.