Feedback plc (FDBK) Earnings Call Transcript & Summary

Good afternoon, and welcome to the Feedback plc investor presentation. [Operator Instructions] Before we begin, I'd like to submit the following poll. I'd now like to hand you over to Mark Fletcher. Good afternoon, sir.

Thank you, Charlie, and good afternoon. And before we get into our presentation, I'm delighted that we've been joined, as always, by the CEO, Dr. Tom Oakley, but we have a new face for investors today, and the RNS has just gone out today, welcoming our brilliant new CFO to the team. Emma Oswick is joining us for the first time. And so Emma, would you just like to say hello and introduce yourself?

Hello, everyone. I'm Emma. I'm delighted to have joined Feedback as the new CFO. And thank you very much for that intro, Mark, very warm introduction. I'm a PwC qualified chartered accountant. I've worked with a number of different sized businesses, including a list of businesses before. But my main focus is, I'm a commercial CFO with a background in growing technology-led subscription-based businesses. So I'm, as I say, very excited to join the Feedback team and to join you all today and lovely to meet you. Looking forward to speaking to you.

Thank you very much, Emma. We were going to go through the presentation now, and we will start with the finances, and then we're going to move on to the operational highlights, and then we will do the questions, which I will try and gather together. So we will start with the finances and back to you, Emma.

Thanks, Mark. Essentially, we have been -- there's not much -- there's no additional contracts to report in the first half. We've been focusing on keeping the existing business stable and conserving cash while still working very carefully on our existing client base. I'm happy to say that all of the U.K. clients renewed and we are seeing increasing adoption from them. EBITDA, we remain loss-making. We still have a loss-making position. So we have an EBITDA loss of GBP 1.6 million versus GBP 1.4 million for the first half of last year. And cash flow, although it does look worse this year, it's partly affected by a client moving to 6 monthly renewals rather than annual. So actually, that would be reasonably flat with that adjustment. Overall, we are still in a -- we still have a solid cash flow position. We have enough cash runway out to mid-2027 with some proactive cash flow management. So we -- those are the financial highlights, and I'm happy to take any questions on that later. But I'll hand back to you, Mark.

Thank you. Well, Dr. Tom Oakley or, Tom to me, is going to take us through our operational highlights and some other slides as well that will set the picture for where we've been in this period and where we are now. Tom?

Thanks, Mark, and thank you all for joining us today. It's nice to be able to be back in front of you again to go through both the positive episodes from the period, but also to give you a flavor of where we're going now and what we think is coming just around the corner. To start with the operational highlights from the period. One of the things that I really wanted to pull out quite early on is that we have a relatively large-scale opportunity ahead of us, but it's something that we've been working on for over a year now. So back in the spring of last year, we were actually approached through a conversation with the central executive team at NHS England to actually put in a business case for Bleepa and what it would actually cost to take Bleepa to potentially a national scale for the NHS. And this was submitted as part of the Spring Spending Review, and that is still working its way through the various NHS tiers of management. And so we are still waiting for that decision. I'll come to it in a little bit of time that essentially, that decision process is going to be linked to the NHS financial year. And therefore, that should conclude by the 31st of March of this year. So we're not far away from knowing the outcome for this. That business case is based on Bleepa's ability to impact and drive improvements in elective care performance. We are all aware of the waitlist that are affecting the NHS. One of the things that we have really been able to demonstrate with Bleepa is our ability to see patients faster and more effectively. Our focus is always being on getting that decision for the patient faster by using diagnostics upfront and pathways. And it's that potential that has generated this national interest. The second thing that we've achieved during the period is really to get ourselves ready to then deliver the scale that will be required for such a contract. So we focused from a development perspective on our integrations into some of the core NHS infrastructure. So this involved an integration of something called eRS, which is the electronic referral service. This is how GPs are able to refer into secondary care for those elective cases. So this allows Bleepa to essentially receive those referrals as they're generated from the GP and then to open a case, open a pathway that we can then run. Other systems such as the patient demographic service allows us to check that it's the right patient, which, of course, is vitally important. And this is a core system, again, run by the central NHS. And then GP Connect, which allows us to push information dynamically back into the GP. What this means in combination is that Bleepa now is ready to roll across any primary care setting in the U.K. So it greatly reduces our implementation burden in terms of getting to scale. And that was a key achievement during the period. We also have started to expand the number of pathways that we are delivering on Bleepa. We have the established breathlessness pathway, which has been our flagship pilot for many years now, but we've been at pains to show that this can go across multiple clinical settings. This isn't just a one pathway tool. This is a core infrastructure that allows you to completely redesign care delivery across multiple specialty areas. And so I'm pleased to say that actually, we had gone live in the period with our second pathway, which is a nonsite-specific pathway. And this is actually a cancer pathway or suspected cancer pathway. And this is for patients who are sat in front of a GP with nonspecific abdominal pain, and they go forward for a series of diagnostic investigations, including some cross-sectional imaging like CT scans that allow us to pick up what could be hidden cancers. And it's a great use case not just to show the breadth of capability of Bleepa, but also to show that we can deliver in very high-stakes clinical settings. Nobody wants to miss cancer. It's a crucial importance that we get those diagnostics early, and we get those decisions for patients early. And so we're already beginning to see some very positive data coming out of that NSS pathway. And as we'll come to later in the presentation, this isn't the last pathway. We have a series of pathways that are being rolled on to Bleepa with some going live even this week. So I'll come to that in a bit more detail in a minute. But important to note that we are demonstrating the breadth of capability and that we are applicable to multiple clinical areas. We also, during the period, alluded to a number of commercial and strategic partnerships that we were building out. This is in recognition of the fact that if we are going to scale based on a national or even regional opportunity, we will need support to be able to do that. There are various options for how we can do that. One, of course, would be to expand our core team, but that may not be the most effective route to doing that. And so we've looked at a range of options with a range of different partners. That includes both from a technical perspective, talking to our cloud partners and then also linked to that deployment partners who they work with and can support our engagement with. And then beyond just the technical implementation partners, the sort of commercial partners who could help us to sell and position this into the NHS. And we announced our partnership with the at-scale primary care partner who has a national footprint who allows us both to roll the product, but also to speak to GPs up and down the country about some of the offerings that we are developing. And lastly, but I think very importantly, we were also selected to deliver 2 national neighborhood simulations. So the neighborhood health model is one of the driving priorities of the NHS in the upcoming 10-year period. It's all about shifting care out of acute providers into the community. Now one of the core things to be able to do that is to be able to have a common view of the patient across all the different services that need to work together. If you're going to deliver care in the community, you need to be able to align all of those community services around the patient. So Bleepa not only gives you that common view of the patient, but we also allow different stakeholders to come together to collaborate. And in a clinical context, that might be different specialties, but in a community neighborhood context, that could be social care, mental health, even local authority. And so we were able to demonstrate that you could, through a digital infrastructure like Bleepa, very quickly and effectively move into that neighborhood model. And we'll speak a little bit more about that in one of the coming slides. So I just wanted to pause briefly and remind everyone of the value proposition beneath our product and what it is that Bleepa really unlocks in the NHS. I'm sure that everyone on this call will have at some time, had some interaction with the health care service, and many of you may have gone through an elective care journey. So you will know firsthand how convoluted and time-consuming it is. So the traditional care model essentially involves your GP referring you to a specialist. And in the traditional model, you would go to see that specialist usually in person. And then that specialist will arrange some tests for you. And then once those tests are completed, you will then go back and see them for the results. And in the event that it turns out that, that was the wrong specialty, you will be referred back to your GP and re-referred and you may end up repeating the whole process. It's a model that hasn't changed since the 1940s. It's a model that doesn't scale, and it's a model that is very expensive and arguably doesn't deliver the best care for the patient because of all of the unnecessary appointments that you have to have before you get a decision. So what we have been able to unlock with Bleepa is the ability to think about the whole pathway differently. So what you are able to do is to actually say, broadly speaking, if you present with these symptoms, you're going to need these tests. They're going to be done regardless of you having an appointment. So why don't we just go straight ahead in all of those investigations. Once those tests are completed, we will actually then present those completely remotely to a team of specialists who can review that, decide whether you need more testing or whether actually they can reach a decision without testing or in a rare occasion that they might actually need to see you. And as a result of that, we've been able to show that you can both shorten that pathway from time of referral to time to decision, but also that actually in about 90% of cases, you can make those decisions for the patient based on that diagnostic information and the information that we bring through from primary care and that you can do that without ever needing to see the patient. So what does that actually mean for the NHS as a whole? Well, given that the NHS needs to see more patients and it needs to see more patients quickly, it is in desperate need of a productivity boost. Being able to redesign these pathways and redesign the way in which we deliver specialist opinions to patients is a fundamental principle of how we're going to drive change for the NHS. What we've been able to demonstrate certainly in terms of breathlessness pathway on Bleepa in Sussex is that we can complete these pathways on average 63% faster than the standard that the NHS is aiming for and failing to hit, which is the 18-week target. So we're going faster than the NHS is even able to deliver at the minute. We are hitting a target and going faster than the target. We're also able to avoid about 90% of those traditional appointments and manage the entire case completely remotely. And what this has led to is a conversation with the system about, could we redesign some of the financial tariffs for activity that would reflect the lower cost of delivering this remote model? And if we were to renegotiate a lower tariff, could we then drive enough activity that we would have actually end up in a position where we were doing more patients but within the same financial envelope? And what we've actually been able to model with the system is that if they were to agree a new tariff rate for what we would call a synchronous delivery, which is the Bleepa approach, they would be able to see about 30% more patients for the same NHS budget. Now bearing in mind that the national target is around a 2% productivity improvement, the fact that we could deliver a 30% productivity improvement within the same budget is frankly astounding. And I think why we are generating such interest for the product and the approach. So what does this mean for us now and what's coming around the corner? So as I mentioned right at the beginning of the presentation, we have attracted quite a lot of central attention for what we have been doing in the NHS in Sussex, particularly. We have submitted that business case. It has gone through a spending review process and is currently working its way through the system. And we are waiting for an outcome from that, which could result in an at-scale opportunity for us as a company. That could be as large as a full national contract. It could be on a more regional or ICB basis. We don't know yet, but we are strongly expecting for that to be a positive outcome. That said, we can't guarantee anything, and we don't have a confirmed answer from the center yet despite multiple conversations and this being a very live dialogue. So we are all watching this space with a great anticipation. And as soon as we have a firm outcome, of course, we'll be communicating that to the market. But we are in a very strong position given what we can deliver for the system and the impact that we can deliver for patients. Separately to that more central opportunity, we've also been building our sales pipeline of opportunities directly with the integrated care boards. So the integrated care boards are essentially responsible for localities of care. There were 42 of them, and they're now being consolidated into 26. That is supported by the fact that new money is coming online from April at the start of the next NHS financial year, which is also part of that spending review package, and contains different pots of funding, including a GBP 10 billion pot for tech adoption for the next 3-year period. That means that there is new money coming online to support these conversations with the individual ICBs, all of whom who are tasked with driving elective recovery for their populations, all of whom need to do more activity within that same financial package for activity and all of whom recognize broadly speaking, the need for change. So this is finally a captive audience with money coming online in April, and that is a group for us to engage with. We have struggled over the last 12 months to engage with this audience largely because, as you'll see in point 3 here, the NHS has been going through a restructuring for the last 12 months. I mentioned that there were 42 ICBs and that they're consolidating into 26. This is also being in parallel to NHS England being absorbed into the Department of Health, which has meant that essentially a 50% headcount reduction across both the national and the regional teams, which means until recently, people haven't known whether they were going to have a job or not. And a lot of the stakeholders we have been engaging with were either leaving or soon to leave potentially. So now we're in a position where that consolidation should be completed soon. And therefore, we are confident that the people who are in post will remain in post. So now we know who we can actually go and sell to and engage to, whereas until this point, we've not had that clarity. So I think we're at a unique moment where we now have an actual stable customer who has clear priorities and who has money coming online from April, which is a really good environment for us to go and sell to. And I'll show you in the next slide, that is not something we have had actually for quite some time. And that's why I think we have a real opportunity ahead of us now. Again, the partnerships that we have been developing during the period to get us ready for scale, either for national opportunity or for those ICB-based opportunities are progressing at pace. We are not able to fully disclose at this time the nature of those partnerships, but they are both around the tech focus supported by cloud vendors and consulting firms, but then also around that go-to-market strategy with the large at-scale primary care providers. And lastly, a note on Neighborhood Health. As I've said, Bleepa was the underpinning infrastructure for both of the national simulations for Neighborhood Health. Neighborhood Health as a program, though, I think, has still got quite a way to go. We don't yet know what the funding allocation is going to be to support Neighborhood Health. And as we know from the NHS, if there's not money there to do it, the program won't move forward. We suspect that monies will be coming online later in this upcoming financial year. But I suspect that, that means that the Neighborhood opportunity, though something that would be right in our crosshairs is something that is still a little bit further out, but definitely something we are pursuing and actively in conversations with up and down the country. So I just wanted to finish with a bit of context and scene setting for the NHS, why we feel confident that we have a really good opportunity coming through and also to show you again the turbulence that we have been dealing with to date. So since labor came into power, they did a year-long program where essentially they tried to understand the problems that we're facing in the NHS and then to come up with a strategy paper called the 10-year plan to outline what they wanted to deliver over the next 10-year period. Those 2 processes, the pause and the strategy have now concluded, and it is now transferring into action. And we are at that action and implementation junction now. So spending review money, which will outline what the NHS has to spend for the next 3 years, that lands in the system in April. The merger of NHS England and the Department of Health, although going on in the background, should complete within the next year. And the mergers of the ICBs should be complete going into this upcoming financial year. So as of April, we should have a much more stable environment with fresh new monies coming in to drive those decisions. So the landscape is good. And of course, in the background, we have our own potential national opportunity, which has also gone through the spending review process, and we may get a decision in and around end of March, beginning of April around that sort of opportunity. So things are generally stabilizing after what has been a long and sustained period of turbulence. And our product and our proposition is very well aligned to the direction of travel, elective recovery, waitlist reduction remains the driving priority for the NHS. And I think that there is no product out there that has a better proposition for delivering that change. We have demonstrated to the NHS that fundamentally using this technology, they can completely redesign the service model to a version that is faster, that is better for patients and is actually more cost effective. Those productivity changes are absolutely what the system needs going forward. So the concluding point is we are still slightly waiting for a decision. The decision is coming relatively soon. And based on that, we believe our positioning couldn't be better. But it's not a done thing until the money is in the bank. So we are still waiting. So at that point, I'll pause and we can go back to questions.

Thank you very much, Tom. You can also have a glass of water at this moment in time, if you want. But thank you very much to those of you who have submitted questions already. Two or three of the questions were relatively similar and touch on the points that you were just on there, Tom. There was a question around what traction you're getting with the NHS and creating sort of new commercial partnerships? There was a question around what positive trends you're seeing? Or are you seeing positive trends within the market? And a similar related question is what would be the plan B if the national opportunity doesn't appear. So do you want to take those together?

Yes. Yes, you might have to remind me if I forget any of it. But yes, essentially, for the last 18 months, we've been having lots of conversations at both regional and national level. There's been a huge amount of interest in the work that we've done, including national coverage, the programming QVH was mentioned in official Department of Health briefings and press releases. So at every level of the system, there is an awareness, a, of what we're doing and also the impact that this could really drive. The difficulty has been that because of the consolidation of the ICBs and because of the difficult financial position that the NHS has been without this new spending review money coming online, we haven't been able to turn those -- that interest into decisions and therefore, decisions into contracts. So essentially, we have been bottling up this repressed demand for Bleepa, and I'm hoping that, that will all get uncaught in April as that new money and stability comes back into the system. So we're confident in that sort of pipeline. Hopefully, the last slide probably covered the wider landscape questions. But again, if you want more information on that, just ask in the chat and we can revisit it. And in fact, I think Mark on the call might be quite useful given your expertise in this space. Does that answer the questions, Mark, or I missed?

Did you cover the Plan B?

Plan B. Yes. No, good. So we are optimistic that Plan A will happen. The Plan A may have a variety of flavors. Plan A may involve us licensing Bleepa into the center, which would be a single contract. It may be a framework whereby actually we then have to still sell this to ICBs. Either of those scenarios, of course, will be a wonderful move forward for the company and a great recognition of what we -- of the value proposition. But they're very different in terms of what we would need to do, how we would need to scale and going forward. But of course, they're not guaranteed. And in the event that neither of those happen, the default position is to then continue to sell directly to ICBs. ICBs will be the right customers. They are the strategic commissioners of the system. They will be able to also take the system forward on the basis that it has value proposition between providers. So rather than selling this to individual NHS trusts, it's better to sell this at a regional level where they can see the benefits across a broader population. And because of that new strategic commissioning role that ICBs have, they're definitely the right target customer for us. So the proposition is, sell to ICBs. Now we've been nurturing a deep pipeline of ICB interest for some time, as I've just mentioned. ICBs are very aware of the proposition. They're very aware of the fact that new money is coming in, and they will be also trying to prioritize what products, what approaches, what programs they're going to take forward as that new money comes online. So we're very much focused on driving those conversations in parallel.

We've had a couple of questions in regards to Neighborhood Health. So one of them is sort of what opportunities with partners and trust, what developments have there been in relation to Neighborhood Health. And then the other one was in relation to the simulations. And is there any possibility of that leading to an adoption at an adaption at a -- sorry, adoption at a national scale. So did you want to answer those together, Tom?

Yes. Well, I think by its very nature, Neighborhood Commissioning will never be done at a national scale. It will be done on a locality basis based on the new place-based locations that have been agreed, of which there are a number up and down the country. I think as we alluded to in the last slide, although the value proposition of Bleepa into Neighborhood as a core enabler is absolutely clear, and I think largely well appreciated up and down the country as a result of the simulations, it's still uncertain where and when the money will be coming into the system to pay for neighborhoods. So I still think that Neighborhood contracts will be some way off even though the value proposition is there. So what we're seeing at the minute is that we are having a lot of conversations with the new Neighborhood teams up and down the country. Everyone is recognizing that actually it may be a good idea to invest in digital infrastructure rather than say, bricks and mortar. I think the natural instinct for the system is to go and build new centers, and there has been a lot of press coverage about building Neighborhood centers. But actually, what we found from the simulation was that the participants found it much more useful to collaborate through a digital channel than they did through physical colocation. And actually, if the lessons from simulations are taken forward, digital would be prioritized rather than bricks and mortar building. And so I think at the minute, the crux of our commercial opportunity rests on us putting that digital infrastructure piece front and center, which I think is being done very successfully at the minute. But as I say, I think Neighborhood is still further out. Right now, the driving focus for the NHS is around elective recovery. That's where our core value proposition really sits, and that's where our evidence base sits. And I think that forms the basis of both the national and ICB conversations that we're having.

I had a couple of questions in regards to the integrations, which I think from memory was point 2 on your operational highlights. There was a question around what is -- what competitive advantage does Bleepa have in terms of the infrastructure versus other health tech providers. And a similar question was what other companies have these integrations? So I think those two sit quite nicely together.

Yes. They're both very good questions. So what the integrations allow us to do is to essentially interface directly into primary care, but on a fully national basis rather than having to integrate each GP practice. So you can list a service through the Bleepa platform, and it can be made available to any GP in any location. That allows us to receive referrals from that GP practice, but then also to push the information back into that GP practice. So you could, in theory, actually scale pathways on a national basis just on that coupling into primary care. You don't necessarily have to interface locally into each of the hospitals in order to drive these pathways. And there is a discussion at the minute about whether the Bleepa infrastructure also needs to integrate into electronic patient records or whether it can be done as a stand-alone proposition. And this is more of a digital and governance concern than it is a clinical consideration. And there are pros and cons of both. The argument for that is that those NHS trusts also want to hold a copy of the information. The downside of that scenario is that, one, it will take a lot longer to implement and it will slow the ability for us to scale these pathways nationally. But also a lot of the way that the EPR contracts are structured for hospitals, they get charged every time a patient lands in those environments. And therefore, if we can actually hold the patient on Bleepa as a separate infrastructure for delivering elective care, we can actually reduce the license charges for those EPR installations for each of the hospitals. So it allows the system as a whole to actually manage the patient very effectively without needing that bespoke interface into each of those environments. And in terms of the other providers that have these integrations, yes, there are other providers that have those interfaces. But typically, their offerings are very narrow in terms of either clinical specialty area or services. So we know that there are dermatology providers, for example, that will run dermatology pathways that involve photos. They may also have some of those interfaces. But what they're not able to do is to bring together the whole view of the patient in the way that Bleepa can. So what Bleepa is doing is providing a pathway-agnostic infrastructure that you can use to deliver multiple services on rather than just a very narrow and bespoke view. And that goes back to our core value proposition that Bleepa is both a diagnostic -- a medical device for display of diagnostic information, which is very important because if you're going to be displaying diagnostic information to clinical stakeholders, you've got to be able to do it at the right quality to make those decisions. We are, to our knowledge, still the only collaboration platform that is certified as a medical device for image display as part of those diagnostic pathways. And therefore, our value proposition remains unique. I think this question in many ways, overlaps some questions we've had before around are we different to our competitors who are our competitors? And the answer is the same as it has always been. There are competitors that do bits of what we do. So there are competitors that do chat. There are competitors that do diagnostics and there are competitors that do data analysis. but no one who has put that together end-to-end as a whole neat and defined value proposition and within a medical device wrapper. So there isn't anyone else that can hold that entirety of the patient between primary and secondary care and enable this full end-to-end pathway across multiple specialty areas and within the context of that being a medical device. So we are unique in having those integrations, but we are unique in how we're using those integrations to open up a national infrastructure opportunity. And that's the thing that really defines our proposition.

Thank you. We are -- we've got some finance questions around the sort of level of cash that the company holds at the moment, what we see as the possible burn rate over the next 12 months? And also, do we anticipate any additional funding being needed. So Emma, did you want to answer those?

Yes. At the moment, at the close of November, we had GBP 3.82 million in cash left. We believe that with proactive cash flow management, we can -- our cash runway will -- we have sufficient cash runway to mid-2027. The requirement to fundraise really depends on the structure and the timing of the contracts that we close. If they are a normal SaaS type structure with a year's subscription upfront and some implementation costs, then that means we -- the requirement to fund raise will -- there may not be any at all. It should be self-funding. But if these are -- if it's the slower scenario of rolling out in a framework and having to sell individually to each ICB, that may require some fundraising. But at the moment, until we see the contractual structure and we know where we stand, it's hard to say exactly how -- give any numbers around that.

We've had some questions about opportunities from the past. India, there was -- we've been asked for an update on what's happening with India, but I will come to that in a second because we've been asked about Cortisone, the opportunity with the Army and the CBS contract around horses. I don't know if any of those -- I don't think any of those opportunities are still live, Tom, but did you want to say anything on those?

No, none of those are still live. It was a strategic decision to not pursue those because obviously, we have finite cash, and we have in this country, certainly a very large and dominant primary customer, which is the NHS. And it's worth also saying that although we've also looked at private health care provision in this country, that also has a core dependency on NHS because a lot of private hospitals in the U.K., their core business is actually running in NHS work. And so while we've had the uncertainty of NHS contracts and cash flow, a lot of the private providers have similarly have that uncertainty and also not being prepared to make decisions to move forward. And I think you'll see increasing pressure actually on the private providers as the NHS tries to reduce its dependency on private provision. So slightly convoluted way of saying, no, those opportunities have fallen away. We focused strategically on the NHS because -- we believe that's our largest and most realistic route to commercial success. And therefore, we've had to be disciplined about that and focus very much on that.

Did you want to add anything on India as well? Or does that fall under the same category?

It falls under the same category. We've paused in India. So we haven't fully withdrawn. We definitely feel we have a strong value proposition to that market. But what we found when we went into India is that actually the decision-making process, although different, isn't that much faster than it is in the NHS. So here in the U.K., a lot of decisions are made by committee, and it takes a long time to move through those various committees. In India, the decisions typically are taken more by an individual, but actually getting to that individual is a much more convoluted process, and you have to go through multiple tiers in order to do it. And so the conclusion was that to do India properly, we would have to properly resource that, and that wasn't something we could do at this current commercial juncture. So we have parked it for the time being and to be revisited in the future as and when the opportunity presents itself.

And just to round off the sort of this series of questions, we've been asked our sort of customer retention rate and also why the QVH contract shifted to 6 months. So just clear those off.

Yes. So our retention rate is pretty astounding. I mean, basically, all of our customers have renewed and they've renewed for multiple years. And the reason for that is, as we've always said, typically speaking, NHS contracts have a very long lifetime value. The time it takes to actually acquire the customer and the cost of acquiring a customer is quite large. But once they are a customer, they tend to renew for multiple years, and therefore, the total lifetime value is high. And I think that, that is also a testament to the quality of our product, the value proposition that we have created and the fact that they do see recurring value and therefore, are renewing despite very difficult and tight financial environments in the NHS at the minute. So they continue to renew the contracts with us. Was there a second part to the question on that, Mark?

Now you're testing me and I was just planning my next question. So...

Sorry.

Before I come back.

I feel like there was a bit of that question I've not caught.

It was customer retention rate was in there -- I can't spot what the second part was, and I think there was. I will make sure that, that's covered. The next question was going to be around proving -- are there challenges within the NHS around being a small business and having to prove this or not being able to prove this at scale until it's sort of rolled out. Is this a particular challenge within the NHS? We've had sort of 2 questions along those lines.

Yes. I don't think that is particularly about being a small company. I think there is always a credibility question over any company trying to do something in the public sector. And that relates both to the credibility of the offer, so what is the evidence base and then what is the confidence in your ability to take that forward. And I think this is partly why we've put so much focus into those partnership conversations with both cloud vendors and consulting firms is to give some credibility to the NHS that we have some big names behind us. And in the event we are successful in getting a contract, we will be able to move at pace and at scale with these partners to implement. And I do genuinely believe that, that has given us the credibility for those conversations. There is also a slight dichotomy here in that you actually need those small companies to drive that sort of innovation. We know that SMEs like ourselves are much more dynamic, much more innovative and therefore, the potential impact of their solutions are much greater typically than larger companies. And it's worth also saying that the NHS recognizes that and has a commitment to doing business with SMEs. And it is part of their procurement drives and their state of political aims is to increase the engagement with SMEs and also to see the NHS as a driver of economic growth for the U.K., which means that they are also preferencing working with U.K. businesses. So actually, as a U.K. SME, we should be relatively well positioned for NHS procurement, you would hope on that backdrop.

I have been politely reminded of what the part 2 of the previous question was, which is in regards to QVH transferring to a 6-month contract and what impact that has had.

Yes. So QVH is actually being funded from various budgetary pots held by the National diagnostics team. So every extension to that contract has been based on the availability of capital from the central team. And it happened at the last renewal, they essentially had 6-month availability of different pots, and that's what driven it. So that's the primary reason. And hence, why we're now at this junction where the national team have run this pilot for so long. The question -- the inevitable question is, so when does this become an actual contract at scale? And that is the junction that we're now at.

Could I add the financial impact of that? Essentially, that has taken our sales down. You'll notice that sales are GBP 0.31 million versus GBP 0.59 million the previous year, and that's mostly because the QVH contract has gone from annual to 6 monthly. And that's -- so that will reverse in the second half. I'm glad to say that they renewed again after this date. And that means that the second half, you would see that effect reverse. It's also impacted our cash. I mentioned it in passing at the beginning to say that our cash flow was GBP 2.1 million negative versus GBP 1.73 million and a large proportion of that is due to the fact that we only received 6 months rather than the full year's revenue in the first half of 2026 compared to the first half of 2025. So I hope that helps clarify that.

There's a couple of questions remaining. One, I think, Tom, you've probably covered already, but it was how far into the sort of NHS financial year do you think it will be before a decision is made. But I feel like you've covered that already. Is there anything you want to add?

Well, as it stands at the minute, the decision needs to be made before the end of this financial year of the NHS, which is, of course, the 31st of March. So if we want to be implementing as of 1st of April, we need to get our skates on. And when I say we, I mean us collectively with the NHS. So it's -- yes, I don't think that this -- I don't think this is something that's going to spill over into next year with an open-ended running rate. This is a decision that needs to happen relatively soon.

And then there's a question around for investors who like to keep an eye out on news related to Bleepa, which government departments and which sort of teams should they be looking at for information news and opportunities?

Well, centrally speaking, the news will be coming out of both NHS England and the Department of Health. I mean, I mentioned earlier, we've actually already been covered off in one of the Department of Health's press releases from last year. So it will be those sorts of announcements. I suspect most people probably don't have a subscription to the health service journal, but actually that's where a lot of trade release gets issued. So you may see coverage there. And then if it's taken positive enough, so as we're all hoping, you may even see it in more mainstream media outlets. So I don't think you'll have to go looking and also as and when we get good news, we will be pushing it out as well. So you should see it on your RNS feeds as well.

The final question that I had at the time I took my last notes was are there -- has there been any progress in relation to Canada? I know that you did a visit out there last year, Tom, but I don't think there's any live opportunity at this moment.

Yes. No, we did. We were invited out on a trade mission to Canada. And I think we looked at the opportunity there. Again, similar to India, there's a great fit for what we do. I think there's a huge potential in that market, but there's a potential you have to invest in. And right now, we don't have the cash to make that investment. I think it was an important thing to go in scope that opportunity and to actually go in person and kick the tires on it. And I came away very intrigued because I think that there is a strong proposition there. But it's not one we can open right now, not until we land this core contract here in the U.K., stabilize our position and then we're on a good footing for growth. It would be a distraction to do it at this point.

Fantastic. Well, thank you very much. And Tom, I'm going to ask you for some closing remarks, please.

Thanks, Mark. Yes, I think to conclude, we have put a lot of work into getting to this current juncture. And I appreciate that from a shareholders' perspective, it must feel very frustrating because you probably haven't seen any news coming through because we haven't been able to announce new contracts. However, what we have been doing is very strategically and methodically working in the background of the Center of the NHS to drive this value proposition through multiple layers of stakeholders to get it to a point where actually they would get behind us, ask for business cases to be submitted, push that through spending review. And we're almost at the final hurdle now of what has been an 18-month or longer race. And we hope for a successful outcome. I'm optimistic for a successful outcome, but we won't know until we get that directive from the center, but we're not far away. And I just want to thank the shareholders and investors for sticking with us during this time. It has been turbulent. It has been difficult. And it's been very frustrating for us as a company not being able to communicate the full breadth of the activity that we are doing on behalf of your investments. And I'm hoping that all of that work will soon bear fruit.

Thank you very much. Well, thank you, Dr. Tom Oakley, the CEO. Thank you to Emma Oswick for your first appearance as CFO. And at this moment in time, I hand back to Charlie.

Thank you. Once again, could I please ask investors not to close this session as you'll now be automatically redirected to provide your feedback, which will help the company better understand your views and expectations. On behalf of the management team of Feedback plc, we would like to thank you for attending today's presentation, and good afternoon to you all.