The past 12 months have laid bare a growing disconnect in the UK healthtech landscape: while the sector itself continues to expand, many promising innovations are still struggling to scale within the NHS. According to recent data, the UK now has over 465 active healthtech startups, up from just 107 a decade ago, and raised a record £795 million in 2024 alone. In early 2025, the sector saw one of its strongest ever quarters, with nearly £1.4 billion in investment.

Yet despite this growth, a persistent and critical gap remains: a system that struggles to adopt, integrate, and scale the innovation it says it needs.

The Sector is Growing, But So Is the Friction

This is not a story of collapse. Far more healthtech startups are launching than shutting down. In fact, 168 UK healthtech companies have exited successfully through acquisition or IPO, compared to just 61 that have ceased trading. The pipeline is strong, the investor interest remains high, and the technology is increasingly sophisticated.

So why does it still feel so difficult?

Because scaling inside the NHS remains one of the most difficult challenges healthtech companies face.

What’s Holding Innovation Back?

1. The Integration Gap

The biggest barrier isn't lack of innovation. It's lack of integration. While pilots are abundant, 80% of NHS AI projects never scale beyond a single site. There is no clearly defined national route for proven solutions to move from pilot to procurement to practice. Most startups simply don't have the time, capital, or energy to navigate 42 procurement processes.

2. Procurement Remains Complex and Costly

Healthtech companies face significant hurdles trying to sell into the NHS. From unrealistic pricing expectations to compliance-heavy tenders, many startups end up walking away from opportunities that should have been win-wins. Over one-third of healthtech suppliers have avoided NHS tenders altogether, and a quarter have withdrawn products due to commercial unsustainability.

3. Evidence Without Adoption

We’re seeing an increase in clinical validation, real-world testing, and robust trials. But even when startups generate the right evidence, they often hit a wall when trying to scale. The NHS rewards pilots, but rarely commits to rollout. That inconsistency makes long-term business planning next to impossible.

4. System-Level Restructuring

The past two years of NHS restructuring, from the formalisation of ICSs to the reorganisation of central bodies, have created both uncertainty and delay. Decision-making responsibilities are shifting. Procurement pipelines have slowed. Some innovation programmes have been paused or merged. All of this has added friction just when clarity and momentum are most needed.

This Affects Everyone

At Acumentice, we work at the intersection of NHS operational delivery and digital innovation. And from what we’ve seen, this isn’t just a theoretical issue.

We’ve personally known companies with exceptional products, strong clinical backing, and real-world NHS impact, forced to shut down because they couldn’t achieve scale. Not because they weren’t good enough. But because the system made it too difficult to survive.

This is affecting more and more SMEs and startups trying to serve the NHS. And it’s a missed opportunity for patient care, workforce productivity, and operational performance.

What Needs to Change

To move from promise to impact, we need to:

• Reform Procurement: Prioritise value over lowest cost, especially for high-impact innovations. Introduce flexible routes for smaller suppliers.
• Create Clearer Pathways to Scale: National frameworks should support successful pilots to move into broader deployment without needing to start from scratch in every ICS. Health Innovation Networks help - but not enough.
• Provide Bridge Capital: Ensure stability between early-stage grant funding and full-scale adoption. Temporary pauses in schemes like SBRI create real risk.
• Build a Culture of Readiness: NHS organisations need time, tools and headroom to take on innovation, especially under current operational pressures.
• Stabilise Innovation Infrastructure: System change should not come at the cost of progress. We need a more joined-up national approach to healthtech adoption that doesn't get lost in transition.

Conclusion

The UK healthtech sector is not in decline, it's growing. But that growth means little if innovation can't reach the people and services who need it most.

Unless we tackle the systemic barriers that make NHS scale-up so hard, we’ll continue to lose not just companies, but real improvements to patient care.

If you're a healthcare leader or innovator grappling with these challenges, we’d love to hear from you. Acumentice is always open to collaborating with NHS organisations, ICSs and digital health partners to build scalable, sustainable solutions.

‍Let’s turn innovation into impact.

‍