Feedback plc (FDBK.L) Earnings Call Transcript & Summary

Good afternoon, ladies and gentlemen, and welcome to the Feedback plc investor presentation. [Operator Instructions] The company may not be in a position to answer every question it receives during the meeting itself. However, the company can review all questions submitted today and will publish their responses where it's appropriate to do so on the Investor Meet Company platform. Before we begin, as usual, we would like to submit the following poll. And if you could give that your kind attention, I'm sure the company would be most grateful. And I would now like to hand you over to the executive management team from Feedback plc. Tom, good afternoon, sir.

Thanks very much, and welcome, everyone. Thank you all for joining us today. It's nice to have the opportunity to be in front of you again and to actually go through some of the work that we're doing both during the period, but also in the background now and to insofar as we're able to give a view as to what we think may be coming down the line. We'll use the format of this presentation first, and then we'll start to pick up questions after we've reached the end of it. You'll hear first from myself and then also from Anesh, our CFO. So for those of you who don't know me, I'm Dr. Tom Oakley. I'm the Chief Executive of Feedback Medical. I'm a radiologist by clinical background, but have been in medical technology for many years and with Feedback now for just over six years.

Thanks, Tom. Good afternoon, everyone. I'm Anesh Patel. I think hopefully, most of the callers on this call will know where I am. I've been with Feedback now for 4.5 years. And by way of background, I'm a chartered accountant, having trained at E&Y, and I've held various roles across investment banking industry, most recently in the health care and life sciences sector.

Thanks, Anesh. So diving straight into it. Firstly, some of the highlights in the period just to showcase some of the amazing things that were achieved, particularly around the NHS during this period. So we were able to actually initially get the GBP 495,000 contract award from Queen Victoria Hospital positioning Bleepa essentially as a digital infrastructure to allow them to run these connected pathways between the GP, the diagnostic setting of their community diagnostic center and then the specialist teams at Queen Victoria. We have been increasingly positioning Bleepa as an infrastructure tool for connecting across provider systems. For those of us that have been with the company for some time, you'll remember that initially, we positioned Bleepa as a collaboration platform within a hospital ecosystem and then increasingly started to think about how we could extend that reach into both the community, but then also across into primary care and diagnostics. And that led us to this cross-provider piece that, again, was funded in the period with Queen Victoria Hospital. And that's really allowed us to essentially use Bleepa to hold a patient outside of the hospital environment, but also outside of the primary care environment and to then completely redesign the care pathway for the patient. We'll give a bit more detail subsequently, but the impact data that this has generated has been astounding, a 92% reduction in hospital appointments and a 63% reduction in wait times. And for those, again, who have been following the company, this was actually picked up in Wes Streeting, the Secretary States and the Department of Health's press release from about three weeks ago, where they actually referenced Queen Victoria Hospital and our program there as a showcase of what they see as the future of diagnostics and elective recovery, which is quite a good indication of the impact that we're having and the fact that the conversations that we're having centrally are beginning to pick up that sort of traction. During the period, we were also awarded some further funding for pathways, pathway pilots at Northern Care Alliance and also in Buckinghamshire, Oxfordshire & Berkshire ICP. And this was to look to see whether we could actually deliver the pathways that we had delivered at QVH, but in other care settings. And that was initially just funded as a one-off payment from NHS England to essentially test whether we could do that. We'll provide some further clarity on that as we come through the presentation. We've been building up our sort of conversational base, both during the period and now, looking at how we can target the more regional care bodies, so integrated care boards and of course, then the central national team. And that was on a backdrop of changes in the landscape where trust were just not empowered to deal with the sort of cross-provider collaborative piece, and that was increasingly part of the portfolio of integrated care boards. And so we have been building up our sort of stakeholder engagement, both with the ICPs and with the national team. During the period, we also signed an MOU with one of the U.K.'s largest provider of primary care services. We have not and are still not able to use their name, but there has been some progress on the back of that. And again, I'll provide an update of that in a few slides' time. Also during the period, we were nominated and then successfully awarded the HSJ Partnership Award as being essentially the best collaborator around clinical service redesign. And this is again a reflection of the work we've been doing at Queen Victoria Hospital and recognition of the fact that the transformation we've delivered has had an astounding impact on the care delivery provided by that organization and ultimately, eventually on to the wait list within that area. We've also been focusing getting the technology ready for how we might scale it. In the event that the NHS does really get its arms around this and take it forward, we need to be prepared to scale. And part of that has been an investment in us being able to integrate with core NHS systems. So there are a couple of systems that the NHS provides from itself to all of the GP practices and all of the hospitals across the country. And so we have gone through essentially an integration program with the national systems so that we can utilize those within Bleepa. So specifically, the e-referral service or also known as ERS. This is how GPs refer in to hospitals for outpatient services. It was essential that we would be able to take a stream of that within Bleepa if we are going to position this as a potentially national or at-scale solution. And then also for feeding information back into the GP setting through an interface called GP Connect and MESH which is a vast improvement on the alternative, which is essentially e-mailing information back to the GP. And so this is a relatively evolving infrastructure that the NHS is developing, and we are one of the first partners to have actually successfully integrated for GP Connect and MESH into the primary care system. And that allows us to offer us a sort of closed-loop interface where we can receive a referral, process a patient and pass the information back to the GP. And because it's a national infrastructure, we can do that essentially with any GP practice across the U.K., which is an astounding step forward in terms of scale because it means we can do primary care almost immediately. So then our focus is purely on the hospital partners as we go region by region. And lastly, just to mention, we've also looked at how we could broaden some of the feature set within Bleepa to better meet the needs of frontline clinicians. And we formed a collaboration with Vertex In Healthcare, which is a South African-based medical software company to bring in some of their product suite within Bleepa, including an image viewer called MedDream, which is really designed for radiology use. The image viewer within Bleepa is designed for frontline clinicians. It shows you a very simple view of the patient. The MedDream viewer allows you to reformat the image and create 3D views. that allow you to actually more accurately diagnose and also to plan for surgery. So it is a much more complex than the one we provide within Bleepa, and we are able to offer that as an additional component to Bleepa that they can purchase as an additional license package where they want to use Bleepa for direct radiology reporting or for more complex surgical and procedural work. So that's a summary of what was delivered in the year. If I move forward now to the financial slides, and Anesh, I'll let you talk please through.

Thanks, Tom. So these are the key financials for the 12 months ended 31st of May 2025. So revenue was reported as GBP 0.89 million, and that was down 25% on the prior year because -- mostly because the prior year included some nonrecurring revenue, and mostly the CDC pilots of GBP 300,000, and there were some one-off software development fees charged to our partner, Image Engineering in the U.S. of around GBP 64,000. This drop was offset by QVH, Queen Victoria Hospital, converting to a full contract at a higher contract value of GBP 495,000, which had a positive GBP 40,000 impact on revenue. And also, we had inflationary increases on our existing clients. And Bleepa contributed 90% of that revenue figure there. Sales in 2025 were also GBP 0.89 million. Sales is different to revenue. It's non-IFRS. It's the total value of customer contracts that are billed in the year as opposed to revenue, which is subject to adjustments depending on timing of when the contract was signed. So we typically bill for the full annual contract value upfront and recognize the revenue monthly across the life of the customer contract. Most of the sales, the GBP 0.89 million, they came from renewals from long-standing Bleepa customers who have a track record of renewing each year with inflationary uplifts. And this is mainly the Northern Care Alliance, also called NCA in the deck and in our reports, the Royal Berk Hospital, RBH and Queen Victoria Hospital, QVH as well as two smaller NHS Trusts who still use our legacy product, Cadran PACS, and they've renewed over the last five or six years, which again just highlights the customer lifetime value with the NHS once you're in. Obviously, there is a lengthy sales cycle process to get there ahead of that. But once you are in it is what we found is it is very sticky. In terms of EBITDA loss, we reported GBP 3.06 million in EBITDA loss, which was 12% higher than the prior year, and that's driven by the fall in revenue, some modest increase in staff costs driven by headcount expansion and cost-of-living salary increases as well as noncash charges being higher, and this was mostly share-based payments, which included a one-off accelerated charge of around GBP 70,000 on share options, which were surrendered in the year. And again, that was noncash. These negative items, I suppose, were offset by lower spend on discretionary marketing activities and other costs, particularly in H1 as we took steps to really reduce the cash burn ahead of visibility on the fundraise, which completed successfully at the end of November, and that raised GBP 6.1 million gross or GBP 5.6 million net. And with the fundraise, we being successful and raising the GBP 5.6 million in November, we've ended 2025 with GBP 5.95 million of cash as of the 31st of May. Backing the fund raise out, so adjusting for the financing cash flows, the prefinancing cash flow net was GBP 3.54 million in 2025, and that equates to an average monthly net burn rate of around GBP 295,000 per month, which is broadly similar to the burn rate as at H1. Since the year-end, as we've discussed and highlighted in the final results RNS, given the ongoing organizational changes and the challenges with the NHS leading to a delay in contracting, we have taken steps -- further steps to reduce our costs post period, primarily reducing our software development team, which is outsourced and pausing activities in India until we've got better visibility of commercial contracts. And this is likely a temporary measure and also identifying future cost savings. And altogether, we have confidence that our runway extends to early calendar year 2027, even in a downside scenario, which assumes that only the existing customers renew and that we don't get any further additional new customers. So taking these steps, it gives the company more time to develop the opportunities that we're progressing and that we'll talk to in this deck with sufficient cash through to early 2027. Tom, that probably leads on to the next slide, we talk about the opportunities.

Yes. Perfect. So I think it's probably worth at that point also just saying, I think, it's clear for all both inside and outside the company that the NHS has been going through some changes and some difficulties of late which has slowed decision-making capability. And from our company's perspective, we have seen that as a lengthening sales cycle, which has been very frustrating because the opportunities that we are nurturing are taking quite some time to actually complete. That said, I think that in the background, we are making good progress on them. And so as Anesh has mentioned, we have taken steps now to actually reduce our burn rate so that we can wait out those decisions as part of the NHS funding cycle. And again, we'll give a bit of flavor to that in a few slides' time. But I think it is worth speaking about that now, just to say that we are proactively managing that and are aware of it, but we do believe that we have a pretty exciting opportunity ahead, and therefore, it is worth us waiting that out. And so we will come to those, hopefully, in a few slides' time. I wanted to spend a bit of time just really clarifying the value proposition of what we are delivering into the NHS and why it's important and why we think that is going to create a market opportunity for us. The way that health care is delivered in the U.K. hasn't really changed since the 1940s. You will go to see a GP who then refers you to a specialist who then arranges some tests and then sees you with the results. That is not a model that scales and it's quite an expensive model to deliver. What we have enabled with Bleepa is by lifting the patient out of the care environment, we've allowed the NHS to think differently about how they would deliver that service. And what we have observed and what the NHS partners that we have been working with have observed is that in the traditional model, the initial outpatient appointment very rarely changes the tests that are requested. And so actually, it makes sense if you just went straight to the tests. So you present to your GP with certain symptoms, you therefore get a particular bundle of tests. And then a specialist can come in and they can review those test results and 9x out of 10, they can actually make a management decision for you without needing to see you. And as a result of that, we have moved from the traditional 1940s model to what we would then call a diagnostic-first asynchronous model, where the asynchronous is actually about how a clinician remotely comes in and reviews those results. And asynchronous working can be just one specialist or it can be multiple specialists, which is an added advantage of this approach because sometimes you're referred to a particular specialty and it turns out it's actually a different specialty that needs to see you with a Bleepa model that additional specialty can just be brought in and you can have a dynamic discussion and asynchronous discussion around your information. And that allows you to be definitively managed in one go rather than having to be referred back to the GP and re-referred to another specialist. So this is a really streamlined and optimized clinical journey. And it aligns to a number of key areas of U.K. government policy, for those who follow the NHS and the sort of press releases coming out around it, you will have heard Wes Streeting, the Secretary of State talking about a leftward shift. So we start to deliver more care in the community outside of the hospital. You will have heard also of this move towards prevention away from treatment and this move from analog into digital. And Bleepa essentially underpins each three of those big shifts. You will also have heard Keir Starmer saying that amongst his six priority missions is the eradication of the NHS wait list. And that is essentially what the NHS calls its elective recovery program. And that is the core program in which we are now focusing as a business. And that is primarily because that is the only area of the NHS that is getting considerable attention and spend at this current environment because it is the government's #1 priority for health care. So our focus is very much into that space. We've mentioned also that we have done some work on the product to improve the integrations into the NHS' own ecosystem to make it both more native and scalable. And we have also embarked on a series of partnerships, which we'll go into more detail in a minute. But particularly that partnership with the primary care provider is very strategic because it has allowed us to also bring into Bleepa a live view of the GP record, which means that when a consultant logs into the patient on Bleepa, not only are they seeing all of the diagnostic tests that they would need to see, but they can actually see all of the additional clinical information that your GP holds on you, which means they can make a much more informed and much more comprehensive decision about your care than they would otherwise have been able to. And I think that is the real secret as to why we are able to avoid 92% of hospital appointments is because what would have been facilitated via a sort of history, a medical history and a clinical discussion is actually accessible to them via the GP record. And so all of these changes together position us to scale into the NHS opportunity around elective recovery once we can get the NHS ecosystem locked in around it and deciding to move forward. So I asked for this slide to be put in because I wanted to give a bit more granularity about what it is we are working on at the minute, what we consider to be the sort of key streams of the business, where those key streams are and what we think the next steps look like and have a fairly honest discussion about some of the challenges that we have faced and some of which we have overcome and some of which we're still overcoming. So, again, for those who have been following the NHS, you will be aware that the Secretary of State decided to fold NHS England into the Department of Health and therefore, achieve a 50% staff reduction in NHS England and that, that 50% extension of cutting extended into the ICBs. So all of the central and regional decision-making capability has essentially been cut in half. That is an ongoing process because that restructuring has not actually been funded and therefore, those redundancies that were planned have not been able to take place in a majority of settings, which means that there are a lot of people in the NHS who are uncertain about whether they have a job or not, which has had an impact on decision-making. So we looked at this and we took the view that although we were having very good conversations at a number of ICBs, for regional health bodies, actually, the opportunity to really move something forward in the time frames that we need to as a business and actually the country needs to on behalf of patients was to actually get a centralized decision around Bleepa with central cut-through that would allow it to be scaled at pace and to essentially be centrally purchased and then rolled out to the system. So we -- although we continue our ICB-focused conversations, we have spent a lot of time and resource actually engaging directly with Central NHS England, Department of Health and the Office of the Secretary of State. As part of that process earlier in the year, we published all of our outcome data from Queen Victoria Hospital, which fundamentally addresses that elective recovery problem. So the reduction in hospital appointments, 92%, reduction in wait times by 63% and also the fact that you can -- by working asynchronously, see about 5x the number of patients that you would have done in the same time. So it means that the NHS workforce can see more patients with the time available. All of those are key triggers for the national team, and it opened up a dialogue with them. And so that dialogue is ongoing. We -- and I think we've indicated previously, we were asked to participate and submit a business case as part of the spending review, which happened earlier in the year, and that is for a national -- potential national program for Bleepa. That is still working its way through the spending review process. The capital allocations coming off the back of that have not been confirmed, and we still think it will be a couple of months before those are confirmed. In the event that the business case submission was successful, we then have to work out with the national team whether they do then want to move forward with the national program for Bleepa, what that would look like, how that might be procured, what sort of commercial arrangement that would then require. But the spending review money outlines the funding available for the next three years and will come into force from April of next year with the new NHS financial year. So we're looking at a decision somewhere in that sort of time frame. So between now and the end of March, by which point we would then have to implement a program if it was to occur. So I can't say more than we are having regular dialogue and exchange and that we're working very closely with the national team. I think I can also indicate that in the post period, the national team have provided further funding for our program at QVH so that it could renew and also expand to other pathways to help build the evidence base around the possibilities and capabilities of Bleepa. So it's not just one pathway in one location, it's actually multiple pathways with the potential option to extend that to other hospitals within Sussex. So the indications are as good as they can be. And I think there's a lot of work done on that in the background that I think the market is unaware of. So unfortunately, there's no reportable news flow, which is why there hasn't been much we can say on it. But those conversations are progressing, and it is a very real opportunity that we are pursuing. For those who also follow the company, you will have seen that we have started to expand into the neighborhood health care model. So, again, picking up one of Wes Streeting's key themes around the left shift of care into the community. They are -- the NHS is trying to redesign services around the patient outside of the hospital so that individuals in the community will receive enhanced mental health, social care support, community-based nursing to try to better manage their disease and health care needs in the community so that they don't attend hospital. And this is being badged as neighborhood health delivery, and you will see lots of this in the press. So knowing that this was coming, we worked closely with a consulting firm called PPL, Private Public Limited, who are a sort of private public partnership that work very closely with senior Department of Health figures and were awarded a contract to develop the first simulation of neighborhood delivery in London. And working with PPL, they selected Bleepa as a platform for which to run this simulation. And the simulation ran over the course of two days. We've delivered about 27 different citizen scenarios of various different types from mental health through to physical complaints just to see how the neighborhood model should actually be delivered and the sort of underpinning technology that will be required to deliver it. And Bleepa, of course, being in that position has now become a front runner in the sort of infrastructure for neighborhood delivery. And I think it's worth saying, and it's a point we keep reiterating to the NHS that Bleepa really is a digital glue that sticks the system together. If you take it for one use case, you should be using it in others. So if the NHS takes Bleepa as an infrastructure for elective care, they should also be using it for neighborhood delivery. And if they take it for neighborhood delivery, they should also be using it for elective care. So we are trying to get the NHS to think a bit more holistically around the sort of infrastructure it now needs to invest in. And one thing is absolutely clear, you cannot deliver effective models of care outside of hospital if you do not have both good quality access to clinical information and also good quality access to colleagues which are the two things that Bleepa really delivers, a common view of the patient's clinical information and a dedicated collaboration environment where stakeholders can come together around the patient. So our view, and I'm believing the NHS' view will be that Bleepa should be a core infrastructure for unlocking its future vision around care models. I mentioned in the previous slide that we have signed in the period an MOU with one of the U.K.'s leading primary care solutions partners. This particular partner has gone through a significant organizational restructuring since we announced the MOU, which meant that the progress on that has not been as fast as we wanted it to be. However, I am pleased to say that they are very much back at the table, and we are looking about ways of taking a shared opportunity through to market around elective recovery. And in the background, while we were going through that reorganization, we were able to integrate the Bleepa suite into their product suite to allow us to do things like bring the GP record into the Bleepa view so that clinicians can use it as part of case management. And we will update the market as things progress on that. And we have already got a series of potential customers interested in that combined proposition. As Anesh mentioned in his overview of the financial reports, we have taken the decision to pause activities in India. We were very close to a series of paid pilots, but we didn't yet have visibility around where those would progress into formative contracts. And given the relative weighting of the NHS opportunity versus the opportunity in India, we felt that we had to contain our cash to focus on the NHS opportunity. We've left those opportunities in India in a way that we could reactivate them subsequently if we have an improved cash position or in the event that the NHS opportunity takes off and then we are able to then revisit those. So those have not been closed. There just paused. And I think we remain optimistic that there is a great opportunity for Bleepa in that environment and in that market when we have the cash to actively pursue it. And finally, again, because we wanted to take a wider view as to where we could see potential opportunity for Bleepa. We were invited out on a couple of trade missions to North America, particularly one out to Canada, where we had the opportunity to just go and explore that at a very high level with stakeholders on the ground. Canada looks like a very interesting potential market for us in that it is closely aligned to the sort of U.K. private -- U.K. public sector. So it has an NHS-like model and is much closer to what we do here in the U.K. than the United States of America, for example. And so it just gave us an opportunity to begin to scope that. We aren't actively pursuing any opportunity in cancer at the minute beyond a couple of cursory conversations that have followed that, that mission. But it remains a potential future opportunity for us to explore. And I think it was good that we had the opportunity to go to do that. I wanted to spend a little bit of time just giving a bit of the broader context for those who are not close followers of the NHS and those who are not close followers of our company. So forgive me for those who are aware and who do follow the company closely. Feedback operates within the context of the NHS being our primary domestic customer. The vast majority of health care is delivered by the NHS, and that is under the direct control of the government. Increasingly now as the government have abolished NHS England, giving them direct oversight and control through the Department of Health. This is positive for us at Feedback because it means that because we are so closely aligned with the government initiatives, we stand to receive most of that focus around both funding and decision-making. That said, it has, of course, created quite a lot of complexity in the market, which we are having to navigate at the minute. But the key initiatives that we are aligned to are the reforming elective care plan, which is this general realization and recognition by the NHS that actually they can't just keep doing more of the same. They cannot just keep throwing money at the system and expecting a different outcome. They must look at new models of care, new mechanisms of delivery. And actually, the one that we have illustrated on Bleepa is definitely the frontrunner of new approaches and the one that has delivered the biggest potential impact and therefore, hopefully, the one that they are going to get behind and follow. The Darzi report, which was actually one of the earlier reports that was done by the new administration that essentially said that the NHS is broken. And again, that the current model needs to change, that there needs to be increased focus on neighborhood delivery and out-of-hospital delivery, which again is fulfilled by Bleepa. And then more recently, the announcement of a 10-year plan for England, which reiterates Wes Streeting's priorities around analog to digital hospital community and sickness to prevention and that sort of neighborhood focus. But also key within the 10-year plan was a call for a single patient record and also increased focus on the NHS app. And arguably, the infrastructure that Bleepa provides, provides that single patient record and provides that single patient view as an underlying infrastructure for multiple types of care delivery. And so this background is helpful for us because it helps to sell it into the national infrastructure. And this is quite a nice visual just to show you what I've already outlined that the traditional model is this gray line, so GP refers, you go to an outpatient appointment, then you have diagnostic testing. There is an in-person discussion by your specialist teams, they then see you in a follow-up appointment and then the decision is made for you versus the Bleepa path where essentially you go straight through bypass the first outpatient appointment, go straight to diagnostic investigation and you have a virtual discussion rather than all of the in-person elements and get straight to the decision. So time to decision is much, much shorter because we've cut out the long meandering clinical pathway. I won't dwell on this slide. This is really just to show that even by ICS, we have a large opportunity. If you take the national picture, we have a considerable opportunity here both to drive revenue but also impact for the NHS. And therefore, given the decision-making capability within ICS has been reduced of late, our focus into the national team to drive a sort of cut-through agenda, I think, is definitely the right strategy. We've already touched upon the simulation that we delivered, but I wanted to include it in this deck so that after this presentation, you will have the opportunity to review this. The formal report of the neighborhood simulation was released yesterday by PPL. It's quite long, but it is well worth a read because it lays out the key requirement around the digital infrastructure to enable a shared view and also comms. And of course, that is being provided by Bleepa, and it's the only platform that's being used in this context to date, which gives us a very good lead in the market in that area. And lastly, just a couple of our commercial partnerships that we have been working on. We've touched upon the primary care provider, and that has made a resurgence. We've touched on Vertex and the ability for us to provide bolt-on offerings to Bleepa, particularly where Bleepa needs to be used for medical image display and for surgical planning. And then also potential partnerships with large cloud vendors such as AWS, who have provided some background opportunity for us in India and are now increasingly interested in the opportunity that we represent in the U.K. Clearly, the more patient volumes that we drive through Bleepa, the greater the use of cloud technology and therefore, the interest of our organizations are quite aligned. And in the event that we do get an at-scale opportunity with the NHS, we have already started conversations with delivery partners like Moorhouse Consulting so that they can come in and help to scale the proposition, support with implementation and support with the clinical change management that goes in alongside the technology. I will stop here at the company and product overview. I think we've already covered that mostly in the slides. And I'm very keen that we get an opportunity to answer your questions. So, bring me questions. Thanks.

Absolutely. Tom, if I may just jump back in there. Thank you very much indeed for your presentation this afternoon. [Operator Instructions] But just while the team take a few moments to review those questions have been submitted already, I just like to remind you that a recording of this presentation, along with a copy of the slides and the published Q&A can all be accessed via your investor dashboards. Guys, as you can see that we've received a number of questions throughout your presentation this afternoon. And thank you to all of those on the call for taking the time to submit their questions. But guys, at this point, if I may just hand back to you just to read out those questions and give your responses where it's appropriate to do so. And if I pick up from you at the end, that would be great. Thank you.

Yes. Perfect. Okay. Well, we'll just run through. So first question, what has been the outcome of Feedback's participation in neighborhood health service simulation and will be an integral part of this service? Yes. Okay. So I covered it slightly in the presentation. So we've done the first simulation. The report came out yesterday. It has stimulated conversations with central NHS stakeholders. The neighborhood program is still in the early stages. They have essentially delegated 42 locations or what the NHS is calling places that will then deliver a neighborhood model, and that's kind of the first wave. Those 42 places are just appointing their executive leadership. There will be a single responsible officer for each of those localities. And then they will be working with various consulting firms to define their model and proposition of which PPL probably is the front runner, and we expect them to get the vast majority of those consulting roles, which then allows us to position Bleepa into them. So I suspect what would you see coming forward from this? I suspect that there may be more simulations in the 42 different sites. So I would expect, hopefully, future announcements around us doing further simulations. I suspect the real contract revenue from this opportunity is still a little way out. The NHS has not allocated funding to this as of yet. And I doubt it will until the new financial year, which will start in April. So our focus at the minute is really about positioning Bleepa into those 42 places and doing that in collaboration with PPL, who we partnered with in the simulation. So it is a big opportunity, but it is one that I think is further out, and we are just taking a slightly longer strategic view of that. Will there be any commercial developments from Feedback's collaboration agreement with a provider of primary care solutions as announced a year ago? Yes, we think that there will be. We -- as I mentioned, they have gone through a reorganization, which has definitely delayed the sort of commercial progress we were hoping for. We've done a lot of technical product integration in the background so that we -- our product suites are aligned. And we are now talking about go-to-market strategy with them, and we already have some early customer engagement opportunities. So I think we will see movement on that, and I'm hoping that, that will be relatively soon. So, yes, that has now picked up again. How is the CDC pathway pilot at the Northern Care Alliance NHS Foundation Trust site in Oldham progressing? And is this likely to lead to a CDC contract? Yes. So, we mentioned during the presentation that NHS England had funded a series of pathway pilots and that, that had happened at the Northern Care Alliance and then also at Amersham and BOB ICS. This was always one-off funding. We thought at the time it would lead into either renewal of NHS England funding or into a direct contract. The reality is that the individual trust in question don't have the budget to take on a contract for this. And the NHS England national team have taken the view that they would rather have a central conversation rather than continue to keep funding these individual programs with the exception of QVH, where they have renewed funding for us because they want to see one site where multiple pathways are able to be implemented, and that is the most established and advanced one. So I don't think we will see individual contracts at those sites, but they have helped to form part of the business case assessment that has gone into the central national team. So I hope that makes sense. So we are hoping that this will lead to a large contract rather than local contracts. Has any revenue been generated from the collaboration with Vertex? Not to date. However, we are in discussions with the team at Vertex about potentially integrating our software the other way. So rather than us taking on some of their product suite into Bleepa, where actually we can also embed Bleepa into some of their product suite so that they can sell us into their markets, both in South Africa and also in the Middle East. So we are hopeful that, that will lead to some revenue given that they already have existing customers that they think they can sell this into. And next question. Could you give an update, please, on the pilots in Amersham CDC and BOB ICS work? I think we've covered those off. So the pilots were implemented. They have not renewed because the local trusts haven't got the budget to fund them and the national team is taking a more central view as opposed to renewing locality-based deployment, which is probably an encouraging thing in the grand scheme of things. How are the pilots progressing in India? And when will they convert to commercial contracts? So I think we covered this in the presentation. we have paused those pilot opportunities because we didn't have visibility around how they would convert to long-term contracts. And therefore, they were still relatively speculative. And in the absence of that opportunity, near-term opportunity in India, we took the view to conserve cash and focus on the NHS opportunity in front of us. And therefore, we have paused those. They are left at a stage where we could reactivate them. And we do believe that there is still a very good opportunity for Bleepa in that market, but it's going to take longer and more cash than we originally thought it would. And so at this point, it makes sense to pause those. Okay. Your technology clearly makes a difference. You have case studies that prove the value. You have clinical and political support for wider adoption. So why is it such a struggle to gain that wider adoption? Yes. That's a question from Frank. It's a good question. The answer is it is a complicated sales cycle with multiple stakeholders. The system is set up in such a way that it's designed to say no. So you have to win the hearts and minds of every stakeholder in that decision chain. Otherwise, a single dissenting voice can stop it from landing. So it's not as simple as having one individual make a decision that's typically somewhere in the order of around 30 to 40 stakeholders in a decision like this. And it is a complex sale. And as you go up the tree into the central NHS, the number of touch points and stakeholders get larger. And so we have to navigate that. And we are navigating that in the context where now most of the people we're talking to have job uncertainty. And I think it's understandable, but that sometimes leads to slower decisions. That said, the NHS are going to have to make some decisions about this within that sort of time frame that we outlined because the spending review money that is being processed currently will land in the system from April, and that will define the spend opportunity for the next three years for the NHS. And it won't flip anyone's attention that, of course, that's linked into a political cycle as well, which will culminate in another general election and Labor will want to be able to illustrate impact on elective recovery, and my honest opinion, and I know this may sound biased, but my honest opinion is the only way that the NHS is going to improve its elective position is by changing the care model. And to do that, it will require an underlying digital infrastructure to do that, and Bleepa is the only tool that will allow them to adopt that straight to diagnostic asynchronous approach across multiple pathways and multiple geographies, certainly in the time frame that they are looking to achieve this. And therefore, if they are serious about elective recovery, they really do need to make the decision about whether they're going to take our technology or not, and they will not achieve it without it. I hope that answers your question. Michael, beyond NHS contracts, are there plans to pursue international opportunities to private sector health care markets to accelerate revenue growth? Yes. So I think we've outlined this again in the presentation. We -- given the cash constraints of the business, we have to rationalize which opportunities we pursue and where we try to spend the money. Again, we've taken the decision in India to pause that for exactly that reason. We have gone out to Canada to scope that market at a high level. We have previously historically gone out to Middle East as part of Arab Health. So we have looked at international markets to try to gauge our product market fit. We have scope to market entry into most of those markets. And we have plans for most of those markets should we be in a position where we have the cash to activate them. We are waiting out the NHS decision. And as Anesh outlined right at the beginning, we are conserving cash to buy the time to allow us to reach those decision points towards the end of this year, beginning of next year and to still have the cash reserves to then activate those opportunities and get into the NHS growth trajectory. But yes, we are definitely looking at international opportunities and have scoped these. We just haven't activated cash spend on them yet. Michael, again, what competitive advantages does feedback have in terms of digital infrastructure versus other health care providers targeting NHS contracts? Yes, it's a really good question. So, essentially, who's the competition. So there are competitors to Bleepa that do bits of what we do. So there are other providers out there that have chat-based products. There are other competitors out there that do imaging. There are other competitors that do data and analysis, and there are other competitors that do integration. But there's no one entity that has really pulled that together into a single product offering nor anyone who has then deployed that into that pathway transformation and redesign in the way that we have. So the things that give us a competitive advantage here are, firstly, that the essential components of Bleepa are quite defensible. So things that we do uniquely in the market are that image-based annotation in the context of chat, which is essential for running asynchronous conversations. It's not enough just to be able to see an image and read a report. If you're having a dynamic exchange that's going to replace an in-person exchange, you need to be able to highlight things in an image and then link it to a question and then link that question to a response. And that is proprietary technology. That is also something that makes Bleepa a medical device. And to our knowledge, we remain the only collaboration and comms platform for asynchronous delivery that's certified as a medical device for image display. And that is quite a high barrier to entry. But then there's also all the other work that we've done in this year around that interfacing between the primary care systems. So, again, that asynchronous platform that is plugged in natively to every GP practice in the country, that is something that is unique to us. We also have within our product suite, this dashboard capability that allows us to track patients as they go through care journeys. And again, the way that we have designed that dashboard allows you to go from a dashboard view directly to patient level insights, and that again is unique. To be able to give a regional and national team a view of where any patient is at any time across any care pathway is a unique proposition to Bleepa. And so these are -- these in combination just add to that competitive advantage, and that's why we are confident in that position. But if you look online, you will see other companies that are making claims around this space. You will see other companies that are -- that do have functionality in some of those verticals, but no one has stitched that together. And without that stitching together, you don't have a comprehensive platform. You don't have something that can scale to deliver the impact. And most importantly of all, we're the only company that has demonstrated a 92% reduction in outpatient appointments and a 63% reduction in wait times as a result of implementing our technology and servicing the clinical redesign on top of it. And so that is quite a high barrier for someone to come in and do it. Okay. Next question. The results mentioned that enhanced competitor analysis has been conducted during this period. Has the competitive landscape changed significantly? I mean, we've essentially just covered that. Interestingly, the landscape hasn't really changed. And in fact, if anything, has changed slightly in our favor. I mean, as we've alluded to, this is a very difficult trading environment and a lot of medical technology companies have struggled during this period. And the closest competitor that we had actually, unfortunately, went into administration during this period. And although we had a good technology, it wasn't that close to B, but it was the next closest thing. And in fact, we have seen a plethora of companies that have gone that way. The reason we don't think it will go that way is, one, because we have such a good cash position; and two, because we really are in the crosshairs of the NHS central discussion and tying to every single core value proposition that the government and the national body are asking for. And of course, the only company that has that sort of evidence base around it. So, yes, so the competitive landscape hasn't changed other than the fact that some of our potential competitors have actually fallen away. Okay.

Do you like to take the next couple of questions, Tom...

Yes, give me a break.

It's a question from Liam. No company ever uses the whole runway. When do you plan to raise new funds in what form? So we have no plans to raise funds at this moment in time. The runway to early 2027 is based on a downside scenario. I should probably just emphasize that. So this assumes that only existing customers renew and we manage costs on that basis to extend the runway. We're working to more optimistic scenarios, and we've talked a lot about what's been going on at the national level and with individual ICBs. And we are hoping still once this period of uncertainty with the NHS diminishes to land contracts. So we don't have any plans to raise funds yet. We are planning for the downside, but that takes us through to early 2027 in terms of cash. There's no immediate plans to raise funds. And hopefully, that answers Paul G's question, which is with current cash burn and new contracts, when will another placing be necessary? I think hopefully, that has just been answered. The next question from Liam, have you terminated Rohit Singh's contract? So, Rohit is the resident Indian director of the Indian entity. And we've reduced the contract, but we need to retain resident directorship services from a local resident Indian person, and we've retained Rohit for that. And we'll take an ongoing view on what happens with India, but we've cut cost to the volume to the bare minimal in India.

I think we could probably say, yes, Rohit is no longer an employee, but has become just essentially a resident director on a standing basis while the company has paused. And then if we reactivate, we will take a view.

Exactly. Do you want to take the next question, Tom on...?

I would also just say, I think, Rohit, actually has done a relatively good job at nurturing some of those opportunities. I think there is a view that India is faster, but actually, it's really not. It's still a complex ecosystem. The decision-making process is different to the NHS. Decisions in the NHS are done by committee, as we've outlined. Decisions in India are usually taken by an individual who's senior in an organization, but getting to that stakeholder is often very challenging and very involved and takes quite a lot of time. And people underneath that decision-maker just will not make those decisions. So it has taken a long time to get to those decision-makers, hence, why we're only just at the point of piloting, but we've taken the view that those opportunities are still too far out and that's why we're pausing. I'm sorry, what was the next one?

Lanarkshire.

Lanarkshire. How do Trust continue to use WhatsApp? So I think this is in relation to the ICO's ruling against NHS Lanarkshire and their use of WhatsApp. So for those who are not aware of this, NHS Lanarkshire had a series of patient data leaks as a result of the use of WhatsApp by their clinical teams. It led to the ICO giving them a rep remand, but they stopped short of finding them. And I think that probably is the answer to your question, Liam, because they didn't go so far as to find the organization, it was more of a slap on the wrist rather than an actual point blank order to stop using it. And the NHS at the minute, given its huge range of priorities and areas of focus, has deprioritized that data governance piece because it is more involved in settling staff pay disputes, trying to drive elective recovery and trying to ensure that services are ready for winter. But I agree with you as a member of the public and as a patient and a doctor I'm not happy with the ongoing use of WhatsApp, and I think that should have been taken more strongly than it was. And of course, without that mandate to come off WhatsApp, that does reduce the mandate for adopting platforms like Bleepa within a hospital. Hence, why we are still focused on that inter-hospital bit where actually the infrastructure unlocks transformation. So we're trying to pursue a carrot rather than a stick at. Did you, in hindsight, ramp up the business too soon given all the inefficiency in the NHS you would have been aware of? Hindsight is a very difficult thing on this. The things that have set us back and delayed decision-making couldn't really have been anticipated in advance. We could never have anticipated that Wes Streeting going to abolish NHS England and wipe out half of the staff base of ICSs. We also couldn't have called the general election that led to the election of labor government, which for those who are following the company, you will remember, we had just unlocked a brand-new funding mechanism that would have led to a national rollout of paper called ERF. And then within a month or so of that, they called the general election, new government, that program completely collapsed and our opportunity disappeared. So we've had a number of forced starts where we've got all the way right to the top and then the top has changed, and that has set us back. And I think it would be fair to say that the extent of the NHS financial challenge and operational challenge has been worsened by the staff strikes, which again weren't anticipated. In fact, a lot of the staff settlements were paid for out of digital pots of money, hundreds of millions of pounds have been diverted away from digital spend to meet those increased staff salaries, which leaves digital initiatives such as ourselves somewhat sidelined, unfortunately. But, yes, if we know and what we know now, I think we still had to spend the money that we spent to prove the proposition. We still had to develop the platform to its current level of capability in order to fulfill the opportunity for a national deployment. But, yes, it is unfortunate that those events have occurred and they have definitely delayed and slowed our opportunity. Luckily, we are capitalized well enough to wait that out. The critical decision has to have occurred by early of next year, in which case, we will take a view depending on what the NHS decides to do.

I think we're just about to get timed out.

Okay. We've got one -- time for one last question, I think two. So what happened to the military opportunity? That's Liam. Essentially, the procurement we were waiting for has still not happened. So the military was running a program called Project Cortisone, and that was about developing the digital infrastructure for the armed forces. That was due to have come out 18 months ago, and it has not. And until it does, there isn't an opportunity for us to procure for the opportunity. So we're still watching and waiting at the moment that, that is published, then we will definitely be looking to participate because we have such a good value proposition into that space, particularly our ability to push information from remote sites and to connect the care team around the patients. So, yes, we maintain the view that that's a really interesting market opportunity for us. But because it is confined to procurement, we don't have the opportunity to bid for it until that procurement comes up the trash. And I think we've probably run out of time there, but we can pick up the other questions.

Yes.

Absolutely. Tom, if I may just jump back in there. Thank you very much indeed for addressing all of those questions that came in from investors this afternoon. And we will, of course, give you back all of the questions as well as any further ones if they come through as well after the presentation just for you to review. But, Tom, perhaps before really now just looking to redirect those on the call to provide you their feedback, which I know is particularly important to yourself and the company. If I could please just ask you for a few closing comments just to wrap up with, that would be great.

Yes. Thank you. So, I think, I'd like to be clear that we, as a company, share your frustrations at the lack of pace of contracts, it has been a very difficult and frustrating trading environment with the NHS in certainly for the last two and a bit years. We have had a number of opportunities that have not gone our way. That said, we have never had a better value proposition, a better integration piece around the product. We've never been more ready to scale than we are now. And I can safely say we have also never had that level of senior national engagement that we do at this current time. So we remain confident that we have an incredible opportunity here in the U.K. We have taken steps to conserve our cash so that we can wait out that opportunity and to allow it to mature that opportunity needs to mature ahead of the end of the NHS financial year, which is March. And so we will know within that sort of time frame, whether the NHS is going to move on Bleepa or not. And so we will continue to wait that out. We will continue to work in the background. We will continue to look at other opportunities to diversify outside of the NHS while we wait. But given the cash constraints of the company, we do have to follow our instincts and lean into this NHS opportunity, which is what we have done because it remains the most viable route to market in the event that it is successful. So, please keep watching this space. Please bear with us. We are in a bit of a holding pattern at the minute, but we are continuing to progress in the background, and we will not let this opportunity slip away from us.

Perfect. That's great, Tom. Thank you once again for updating investors this afternoon. Could I please ask investors not to close this session as you'll now be automatically redirected for the opportunity to provide your feedback in order that the management team can better understand your views and expectations. This will only take a few moments to complete, but I'm sure it will be greatly valued by the company. On behalf of the management team of Feedback plc, we would like to thank you for attending today's presentation. That now concludes today's session. So, good afternoon to you all.

Thank you.