Feedback (LSE:FDBK) — Results and Company Update

0:01 Good afternoon, ladies and gentlemen, and welcome to the FEEDBACK PLC Results Investor Presentation. Throughout this recorded presentation, investors will be in listen only mode. Questions are encouraged and can be submitted at any time using the Q and A tab situated on the right hand corner of your screen. Just simply type in your questions at any time and press send. The company may not be in a position to answer every question received during the call. However, it can review all company, all questions submitted today, and we'll publish those responses where it's appropriate to do so. Before we begin, we'd like to submit the following poll. And if you give that your kind attention, I'm sure the company will be most grateful. I'd now like

0:31 to hand over to CFO, Anish Patel, and Tom Oakley, CEO. Good afternoon. Thanks very much. Hello, everyone. Welcome to this presentation. Hopefully, we will be able to answer as many questions as possible for you and give you the the latest on the company and where we're where we're heading. For those of you who don't know me, I'm doctor Tom Oakley. I'm the chief executive FEEDBACK.

0:55 Anesh, if you just wanna introduce yourself quickly, and then I'll I'll go through. Sure. Thanks, Tom. Good afternoon all. Anish Patel, CFO. As Tom said, great to be here today, and, hopefully, we'll answer as many questions that you have as possible. Fantastic. So I'm just gonna start moving through the slides, and I can see that those are actually moving. So great. So for those of you who are not familiar with us as a as a company, just ever so briefly, FEEDBACK PLC is a specialist in medical technology.

1:26 We really focus on how you can bring good quality diagnostic information to frontline clinicians both within the NHS and more broadly within within health care. And our history is very much within developing software as a medical device. We started out over twenty years ago in the field of medical imaging and very rapidly pivoted about five years ago when I joined as chief executive to address the needs of a wider clinical audience and not just radiologists who are the typical users of medical imaging. We have a couple of very impactful frontline clinical tools, the first of which is Blipper, which is essentially a clinical grade version of WhatsApp. It is the only communication platform available in the market that is certified as a medical device for image display, which gives us quite a unique position in the market.

2:18 And in recent years, we have been able to expand the use of that communication platform to bridge the divide, not just between specialties within a hospital, but to actually look more broadly at how we can bridge the divide between different care settings. So primary care where GPs are based through to hospitals where the the specialists are based. We have a number of growing routes to market, and hopefully, everyone will have seen the announcement this morning about our first it's extending to The UK private health care sector with Medical Imaging Partnership, which we'll to in a little bit. Because we address health care in The UK and also internationally, it's a very substantial market that we're going after.

3:04 Over 10,000,000,000 in total addressable market for for our core products within our our core markets. So definitely a very sizable opportunity. And just to highlight, we maintain a very strong and healthy cash balance closing the period at at 5,400,000, which puts us in a very good position to deliver the impact that we need to through our products. Just to cover off a couple of operational highlights from the period, we have been focused very much on building out the opportunity to go after larger regional contracts and pursue that opportunity to connect to different care providers. And to do that, we have had to improve the product slightly. And during the period, we released version 1.6, which included an ability to track patients across a pathway and to display that as a dashboard to particularly pathway admins and care navigators.

4:02 And what that does is it allows us to give a view of where any patient is at any given time on any given pathway, which is a hugely powerful tool when you're trying to coordinate most multiple care pathways across multiple care settings. We'll cover that off in a little bit more detail when we when we look at the products, in a few slides. We were also very importantly granted our import license for as a medical device into India. For those of you who have been following the company for some time, we we have been looking to engage in the India market for a good eighteen months to two years now. And our original ambition was always to bring BLEEPR to the Indian market because of the parallels in the needs versus the the NHS sites.

4:49 The difficulty we have with BLEEPR is that it is a medical device. And therefore, in order to be able to sell it in India, we have to actually be able to license it in country. And there were only two ways of of doing that. One was to actually set up our own operating subsidiary and import the product to ourselves, which is the the option we elected to take. The second was to actually license it to a wholesaler in country who could then distribute it on our behalf,

5:18 but had the downside that we would have to therefore hand over all of our technical information and therefore expose our IP. And so we felt that was that was a risk that we wouldn't take. So what that did was delay our market entry because we had to establish the operating subsidiary, but then also had to subsequently get the import license for. But during the period, at the end of the last year, we actually got, the import license for, which means we can now sell within India, which is a big step forwards for us. And it tied in very nicely with the appointment of Rohit Singh, who is our in country managing director, who joined us from the UK India Business Council, where he was heavily involved in bringing UK companies into India, helping them to establish and then scale. And so it was a very timely appointment. And in the the months that have happened since, he has already started to create huge impact really elevate the the presence of Bleepa within India.

6:15 And we'll cover that off again in a in a few slides time. Anish, I'll probably hand over to you for this slide. Sure. Thanks. On this slide, we've got the financial KPIs for the six months ended 11/30/2023. Revenue revenue reported as naught £440,000, of which contributed 77%. This is down 24% on the prior period, and that's mostly due to the timing of revenue recognition on the QBH pilot contract, which in the prior period included, a backdated element related to five months, and also legacy product contracts now reaching the end of term, and they comprise about 5% of the current revenue. Looking into h two, we do expect, h two revenue to be stronger than h one, and partly that's due to the NHS England pilot contracts, which we announced in December, and we'll come to a bit more detail on that a bit later.

7:15 The QBH contract extension again, which we announced post period and which takes us through to the end of June at the same rate, and also conversion expected conversion of the pipeline over the coming over the coming months. We also track sales, which we, which is non IFRS revenue representing the total value of customer contracts won in a period, and that was no point four one million pounds. Again, sales were down 33%, reflecting the lower NHS contract wins in the period. And, of course, that filters through into the lower reported revenue. But similar to revenue, we expect h two sales to be stronger than h one. Contributed 73% of that figure, and image engineering license fees, 20%.

8:03 And just as a recap, image engineering license fees is royalties that we collect from legacy CADRampax technology, which we've got licensed to a partner in The US, and we'll give a bit more detail on that in a few slides time. We've stated be before that we will replace the sales metric with annual recurring revenue, and we'll do so in the future once we have a bit more certainty on the 12 monthly renewals of our existing customers, QBH in particular. EBITDA loss increased to 1,670,000. Again, so this is a 37% widening on the previous period, and that's driven by the lower revenue and higher OpEx in the period.

8:49 The reason for the higher operating costs in the current period versus the the prior period is mostly due to higher staff costs arising from headcount expansion, particularly in the sales and BD team, and that includes Rohit, our new MD in India, and also cost of living wage increases. Two other components to the increase, one, being being a portion of outsourced software development costs, which we previously capitalized whilst was being developed and in development phase. A portion of those which we incur from our outsourced r and d partner in Poland, we're now recognizing as operating expense given the majority of bleep. But the total spend with our partner remains consistent.

9:37 Also, consultancy and contractor costs in this period related to business development activities, which were incurred because they will be able to help us generate higher sales in the future. Tom's mentioned the cash position remains strong at £5,370,000, which is sufficient for our current needs, and that represents a net cash outflow in the period in six months of £1,950,000. And that's due to the increase in EBITDA loss as I've just explained and, more favorable working capital movements in the prior period versus the current period in respect of, invoice signings, sorry, invoice issuances and invoice payments from customers.

10:24 Tom, next slide, please. Brilliant. Thanks so much. I think it's worth actually just highlighting as a as a point to to the audience. It's not unexpected for us to recognize most of our revenue in in h two. It's just the way that the NHS typically procures solutions. So the NHS financial year finishes on the March 31, and what we usually see is peak buying activity within the month of March and the month of April because that's where we see end of year budget being spent and the beginning of the subsequent year budget being spent. So so that is often where we recognize most of the opportunities, and we'll we'll again come to that in a in a little bit.

11:11 And just to pull out the sort of highlights in the in the post period and and to give some idea of where we might be going now. We have previously announced that there was a further extension to our pilot at Queen Victoria Hospital. For those of you who are not familiar with this pilot, we have been running The UK's first symptom based care pathway that incorporates a community diagnostic center. And we've been doing that for getting on for two years now with Queen Victoria Hospital. This has been a fantastic pilot site for us in that it has allowed us to generate a lot of clinical evidence, which we have subsequently been able to leverage, for both national and regional conversations and to build the pipeline of opportunity for our CDC offering.

11:59 The extension, although it has delayed the decision around actually awarding the contract for the QVH pilot, it has actually meant that we can maintain that position and be paid for delivering against that site. We anticipate that the procurement is to close relatively soon, hence, the extension only rolling until the June 30 because that will cover any transitional arrangements that may be needed. And, of course, as soon as we hear, we will update the market. Just to remind everyone, the reason for the delay to that procurement was because of some legal contractual issues around the procurement in the first stage, which meant that they had to restart that procurement process, which has taken over nine months to to complete.

12:47 The second thing to highlight is that having generated all this clinical evidence from the QVH pilot, we were actually invited to provide evidence to the all party parliamentary group for diagnostics around the impact of delivering pathways as part of the CDC program. And we'll come to the the outcome data from QVH in a couple of slides. But in essence, what we have created is a very compelling argument that having invested over £10,000,000,000 of capital investment in CDCs, the NHS has yet to recognize much of an impact on that in terms of reducing wait lists. And that is fundamentally because the diagnostic results that are being generated are not being embedded and applied into clinical pathways.

13:35 And the thing that moves patient care forwards are clinical decisions, not diagnostic results. And so the thing that we now have to focus on is getting the diagnostic outputs of the CDC and take them and embed them meaningfully into the clinical pathways so that the clinicians involved can make safe and practical decisions for the patient off those results. And that is fundamentally what we have been demonstrating at Queen Victoria Hospital is the ability to take diagnostic results, put them under the nose of clinicians, prompt them to do something about it, have a collaborative discussion with relative specialists, and come up with a definitive management plan that can go straight back to the GP. The all party parliamentary group report was published last month and is available both on our website, but also on the Royal College websites both of radiology and pathology.

14:30 And you will see that bleep is featured within that, both within the exact summary and within the body of the report. And what it has enabled us to do is to really have meaningful engagement from the national team who were also present at the meeting. And the case we have made to the national team is that you've made this investment in bricks and mortar and in staffing, but you now must make the investment in the digital component that essentially glues that system into the wider health care system. And without that investment, the CDC program will not deliver the impact that it it needs to. As a result of that discussion, and that engagement with the national team, we were successfully awarded £300,000 of funding this year, yeah, in order to undertake two further pilots of the solution.

15:19 One at the CDC site in Amersham and one as a pan regional pilot across Buckinghamshire, Oxfordshire, and Berkshire. And that is early evidence of the fact that the national team are taking this very seriously. And what they want to see is whether we can translate the impact data that we have seen in Queen Victoria Hospital into these new settings. And if we can, that sets the precedence then for wider rollout and adoption. And then hot off the press from this morning, we have finally been put in the position where we are able to announce that one of our partnerships in the private health care space is is with Medical Imaging Partnership.

16:04 And what we have been working on with Medical Imaging Partnership is essentially to see how we can translate the pathway work that we are doing in the NHS side into the private sector space. Medical Imaging Partners are a very innovative supplier of diagnostic services based in the Southeast Of England. They have been trying to develop a range of clinical pathways around prostate screening, gynecological presentations, and and cardiac presentations. And they have been very interested in closely following the work we have been delivering at Queen Victoria Hospital. And the aim of adopting this pilot approach in the private space is firstly to show that you can deliver an accelerated patient journey and therefore better quality of care to the patient within the private space and that you can also strip out a lot of cost associated with that pathway just as we have done in the NHS.

17:01 It also has a secondary impact that you can demonstrate that the private sector can deliver NHS, standard pathways at a lower price point and therefore will make the private sector a more attractive partner for outsourcing a lot of the NHS outpatient work. So there are there are two goals here that we're looking to demonstrate with this pilot. And, again, I'll cover that in a bit more detail in a few slides.

17:30 For those in the audience that are not familiar with our products, I'll just give a very quick overview. So this is Blipper. Blipper is our clinical communication interface. This is essentially an app that can be used on any Internet connected device, be that mobile, desktop, or or tablet. It provides a common view of a patient's clinical data sourced from multiple clinical settings. So both from primary care from where the GP is based and also from multiple hospitals within a region. And around that common view of a patient's clinical data, we have a secure collaboration environment where different clinical stakeholders can come together to review the diagnostics and make management decisions about the patient.

18:18 BLEEPR is the only communication platform available in The UK market that is certified as a medical device for image display. And therefore, the moment that you want to demonstrate something to colleagues using either photos or X-ray radiology images, Bleeper is actually the only application that you should be using. We use BLEEPR and sell BLEEPR both into individual hospitals as a WhatsApp replacement to allow teams to more efficiently refer patients between specialties within that hospital. And in fact, we have demonstrated a 74% reduction in referral time at our Northern Care Alliance site as a result of using Blipper for for exactly that purpose. But BLEEPR is also able to pull together stakeholders from different care settings and can bring in a GP and specialists around that common view so that we can deliver a complete end to end pathway.

19:14 And that, hence, is the the the focus of the work around community diagnostic centers. And then underneath BLEEPR, we have a cloud architecture called CareLocker. Unlike a traditional cloud environment where the data is pooled on mass, CareLocker is more like a bubble bath whereby we have a bubble for every patient that acts as an individualized storage locker for for that patient's data That has the advantage of giving us enhanced security, scalability, and also cost. Because we're able to see which patients are active or inactive in care pathways, we can move patients between different levels of cloud storage. Therefore, patients that are inactive can be stored on glacial cloud, which is extremely cheap, and then bought up to high CPU cloud as required when they enter clinical pathways, and that data needs to be available for review.

20:11 For those of us, that have been following the company for some time, you will also have noticed that we, took CareLocker one stage further, and we actually, in India, enabled patients to access their own CareLocker through a dedicated app, which we called CareLocker, which is essentially a skimmed down version of Blipper that doesn't have a lot of the medical grade image viewing components that you would require for clinical use. But it allows us to give patients access to their own medical data within the care walker. And having looked at this in India and paused that opportunity because of the the the widespread use of WhatsApp for essentially sharing images out in India, We are actually seeing some interest in bringing this, back to The UK given that patients are now increasingly needing access to their medical records so that they can go to different parts of the country to receive care.

21:05 And, of course, one of the main reasons we this is a company is because the data flow in the NHS is not joined up enough to allow that data to be available at other centers. So unless they're using, they won't be able to see what's happened at another hospital. So hence why we're seeing some interest around around this going forwards.

21:27 In terms of the key growth drivers, certainly here within The UK, they will break them down by the the different customer segments. So for for individual trusts that are predominantly using for WhatsApp and pager replacement, the main driver here is around the regulatory issues and problems associated with using WhatsApp for patient communication. So, the British Medical Journal have found that ninety eight percent of doctors are using WhatsApp routinely to discuss patient cases and reach decisions. It's quite understandable why because, actually, it's more effective and more timely for the patient if doctors can collaborate in that way. The problem comes that that data is then stored out of the control of the NHS, and it doesn't link back to the patient's medical record, which means that decisions can be happening in a silo that means that mistakes can then happen with the patient.

22:21 So one of the core drivers around sales to individual trust has always been the rationale for moving clinicians off WhatsApp. And last year, the the regulator for this space, Information Commission's Office, the ICO, actually made a ruling against NHS Lanarkshire and their use of WhatsApp. There was a a 500 breaches of patient data in a year because of the clinical use of WhatsApp at that site. And what this has done is actually sent a message across the NHS reinforcing that all trusts should be getting their clinicians off WhatsApp for all patient related comms. What it hasn't translated to yet is is actual purchases of compliance solutions. It stimulated a lot of inbound inquiries, and we've entered into a lot of discussions with trusts.

23:11 But the financial reality of the NHS currently means that in this financial year, there isn't an allocation to do anything. A lot of trusts have been told they had to make a 30% real term saving in year, which meant that there's no budget left to take on priority projects like this. So what we are planning for instead is that they will be making budget reallocations for the next financial year that could incorporate this element. And therefore, we should be in a position to start making some sales around this post April as we enter the new financial year. In terms of the drivers of the cross provider space, the community diagnostic space, which is our our key target area, And this is fundamentally around all the things that you will be seeing in the national headlines. So patient wait lists, NHS budgetary problems, NHS staffing problems.

24:07 So what BLEEPR allows you to do is cut patient waiting lists whilst reducing costs and without requiring any additional staff. So we fundamentally hit all three of the NHS pain points and have very substantive evidence to prove that we can do this. Evidence that is now being tested by these additional pilots and commissioned by the national team. And then taking it up one level to the national stage, the value that BLEEPR represents to a region grows if you expand it nationally. The ability to bring specialists into any case and have patients investigated in any clinical setting gives complete flexibility to the system to allow them to match capacity and demand.

24:57 You can have a cardiologist in Nottingham reviewing a case in Devon completely securely through BLEEPR. And so for why do we can roll this, the broader the system impact that we can have. And that is the premise of most of the national conversations we are currently having. This is just to illustrate the sort of structure of the NHS and the fact that as you go up the ladder, the size of the organization increases and the number of organizations decrease. So we are always striving to sell to the higher tiers of this pyramid. But the higher you go, the more evidence you need and the more substantial the the barriers are to getting those sales.

25:43 So we typically are focusing around the integrated care systems because they have the commissioning power to take on contracts across multiple trusts and multiple GPs. But we maintain that direct sales approach into individual NHS trusts, again, around that bleep of WhatsApp page replacement. Typically, don't sell directly to GPs, one, of the the just a sheer number and also because the value proposition is really about collaboration. So bringing the GP into wider clinical conversations with other specialists. And so hence, we we focus on those two middle tiers.

26:23 I just wanted to spend a bit of time reviewing our existing customer contracts and some of the evidence that's coming out of those. Our most publicized evidence, of course, being around the CDC space. But we are actually also getting very comprehensive evidence of benefit from within our individual deployments. So we have been deployed at the Northern Care Alliance for many years now. In fact, Northern Care Alliance was the original pilot site for when we first developed the product. And we have had an independent assessment done of impact at the Northern Care Alliance. And what this has demonstrated is essentially a 74% reduction in referral time in between specialties. So a patient going from A and E to respiratory or A and E to cardiology, for example. We have also found that that has translated into, on average, a reduced length of stay of about one and a half days for patients, which in turn translates into quite a substantial cost saving for the organization that scales as they take it across more departments and across more clinical settings.

27:25 To such an extent that actually if they were to roll this across Greater Manchester over the course of five years, we'd be saving them a bit in the order of about 7,700,000. One of the things that I think is also important to highlight is that 88% of staff found that Blipper was very easy to use. This is absolutely critical to the success of the product. BLEEPR is an this is is an additional overlay of existing clinical systems to which we take all the all the information. It has to be easier to use than those individual systems. Otherwise, no clinician would engage with it. And to get that level of satisfaction is almost unheard of within health care IT, which is typically poorly designed from a a a clinician user experience perspective. And this evidence is actually helping us to engage with more inpatient trust, particularly as we pick up that theme around the ICO ruling against WhatsApp and preparing to drive sales in in the next financial year.

28:22 We also have a long term contract now with Hospital in Reading. The use case here is somewhat different and slightly more more focused. Is predominantly used here as a method of securely capturing images of patients that are coming into the hospital, particularly out of hours with wounds, burns, and dermatology lesions, things that need to be identified and captured on admission that are then often followed up as the patient progresses through a care journey. And therefore, BLEEPR is also increasingly being used between the hospital and the community team as the patients move between those two services. Off the back of the ICO ruling against NHS Lanarkshire, we've actually engaged conversations with the trust about expanding the scope of here to try to emulate more of a WhatsApp replacement and to engage more with the communication elements of the application.

29:17 And we will update the market as as and when we expand the use case here within the trust. And it's worth actually saying this before we move on to CDCs, both the Northern Care Alliance and Royal Bartlett Hospital are examples of a growing baseline annual recurring revenue. We we don't currently report ARR externally, but we we do intend to as that base grows. But this is evidence of a strategy that whilst it may take time to acquire customers in the NHS, they are typically very sticky and renew year on year. And therefore, you can reliably use those to build a growing base of annual recurring revenue. And the lifetime value of most NHS customers is therefore quite substantial.

30:03 So the the pain of acquisition is is more than compensated for by the lifetime value and the growing base of recurring revenue that that that follows.

30:11 And so just to spend a little bit of time here. So this is the outcome data from the Queen Victoria Hospital pilot that we have been running. So this is the national flagship around how you use community diagnostic centers to deliver end to end symptom based care pathways. The pathway we've been delivering at Queen Victoria Hospital is a breathlessness pathway. This is fundamentally a patient who's going to their GP experiencing shortness of breath of unknown cause. They are then immediately referred through for diagnostic investigations at the community diagnostic center. Those diagnostic outputs are then reviewed by respiratory consultant, a cardiologist, and an upper airway specialist, someone like an ear, nose, and throat specialist who, between them, cover off all the root causes of breathlessness and can advise definitively on what the management plan for the patient needs to be. In the event that they actually require additional investigations such as a high resolution CT scan, they can actually additionally request that. Can then happen and come back through and be represented to the asynchronous MDT, allowing them to then request additional tests and still come back with a definitive management plan.

31:22 And in summary, what we have demonstrated over the two years that we have been doing this is a 63% reduction in patient wait times compared to the national target. We have also demonstrated an 88% reduction in the requirement for outpatient appointments. And what that translates into is an average of an average saving of £295 per patient that is going through a bleep pathway. The traditional model for referral will see you go to see a GP. They refer you to see a specialist. That specialist then requests the investigations. Those investigations are then reviewed, and they see you back in clinic with the results. If it happens to be your heart and not your lungs, you then get bounced back to the GP who then refers you through to see a cardiologist.

32:15 What we are essentially doing is cutting out that first outpatient appointment and going straight to diagnosis because what we know and what we have learned from this pilot is that in about ninety five percent of cases, the original outpatient appointment doesn't change the requests, the investigations requested. And therefore, there's very little point in having it. You're much better off moving straight to those, diagnostic investigations.

32:38 And then the second step, that secondary review back in the outpatient clinic isn't needed if we can remotely present those diagnostic data to all the specialists required and have them remotely discuss and reach the management plan for the patient. And therefore, we can save in eighty eight percent of cases that second outpatient appointment. And and this is a double hit on efficiency for the system. One, because you now don't need a consultant in an outpatient clinic 88% of the time, and that consultant can then instead be doing operating lists or angio lists or other interventional lists that are actually designed to treat patients rather than diagnose them. So we are both accelerating diagnostic journey and bringing in additional capacity for the therapeutic and interventional side of the NHS.

33:29 So it's a double hit to the waitlist reduction. And that is really the sort of compound value that adopting bleep brings. And hence, the argument we've portrayed to the national team that bleep is the digital glue that brings the CDC program into the elective recovery program and allows you to leverage all of that investment and all of the diagnostic results to drive down patient wait lists.

33:57 So what has that resulted in? Has resulted in some very robust and intense discussions with the national team and then subsequently agreeing to sponsor additional pilots to see how the impact we had at QVH translates into other areas. So under the £300,000 award that we received right at the end of last year, one was a 50 k award to conduct a single pathway deployment at the Amersham CDC. This is another breathlessness pathway, but with a fundamental focus on a test called spirometry. It's an example of how we can translate some like for like services. And then the larger award, the 250,000 award to Buckinghamshire, Oxfordshire, and Berkshire West ICS is actually both to look at the breathlessness pathway coming out of Oxford, but actually to look at how we can deliver services more more broadly at a regional level.

34:58 This is a process called mutual aid, which looks at how you can leverage capacity and demand more flexibly if you have a common solution across the patch. So one of the examples that I I can give you is that there are cohorts of patients in Berkshire who require an ECG. There isn't local capacity to perform an ECG. So these these patients are being sent to Oxford to have the ECG taken, but there isn't capacity to report the ECG from the cardiology teams in Oxford. So that ECG has to come back to the team in Berkshire for, reporting. There currently isn't the infrastructure to do that. However, with BLEEPR, you can do that completely seamlessly. It doesn't matter where that ECG is taken or who it's reported by. It's all a common view of the patient that any stakeholder within that, environment can access.

35:51 And as a result of that, it allows you to send patients to where you've got capacity in the system and, again, help you to bring down that that wait list. So those are the the the two pilot sites that are, currently being evaluated. They are due to run until the March 31. We are slim well, we are somewhat unclear what will happen as the next phase, and there are there are three different options. One is that the pilot is extended. The second is that the pilot converts to a full contract. And the third is that actually we onboard additional clinical pathways as additional pilots within those regions. And we won't know which one of those three we're looking at until probably the end of March as this financial year closes.

36:39 And, of course, we'll update the market once we have clarity on that position.

36:46 And just taking the community diagnostic space as a whole, there are now a 174 CDCs that are either operational or under construction. So this is being over £10,000,000,000 worth of capital expenditure over the last two years in order to develop these sites. If we were to acquire a national contract or to be able to service all of these CDCs, that will actually generate about 96,000,000 of revenue annually for us based on licensing. So it is a substantial market opportunity and an opportunity that we are really uniquely positioned to go after. Again, is the only collaboration platform that has that certification for medical imaging display. And if you are running a diagnostic pathway, the ability to display imaging is, of course, absolutely fundamental.

37:38 And therefore, we we are very confident in our market positioning. And, of course, also, we're sitting on very substantive evidence having run that initial pilot with Hospital for for that length of time.

37:52 I won't linger on this slide. This was really just to illustrate the number of, integrated care systems that we now have in The UK, and to show you their rough distribution. What this as you will see, all of the ICSs are very different sizes. They have very different populations and makeups and also very different health care needs depending on their location. That actually makes it quite difficult to standardize the pricing of as a CDC proposition. So we actually do price on a per patient episode basis. But to give you some sense of the order of magnitude, we would expect a typical CDC contract to be in the order of £450,000 per year in the situation where we are providing the cloud hosting.

38:38 There are some customer sites that are likely to want an on premise hosting whereby we won't be accruing cloud costs. And at that point, the price point is about half roughly of of what we would expect there. This is just to highlight the APPG for diagnostics report. This is available on our on our website. And if you can't find it, please let us know, and we will be more than happy to forward you a a copy of it. It's well worth a read for any investor that really would like to understand this space, what the drivers are, what has been achieved to date. And you will see the bleeper is actually mentioned throughout the the the report both in the executive summary and and subsequently because it is such a key example of the digital gap that now needs to be filled.

39:34 So moving to India. As we illustrated in the post period highlights, the substantive change here has been about the award of the import license for to our operating subsidiary in India and also the appointment of Rohit Singh as our in country managing director. What Rohit has primarily focused on is raising the profile of within the Indian market. You will hopefully have seen for those who follow our our social media, we have started to receive a number of awards for Blipper, and that is largely thanks to Rohit and his network and his ability to get in front of these sorts of organizations. And it has already started to generate a lot of inbound inquiry for.

40:22 The second thing that is really driving the market opportunity here is that India is currently adopting its own equivalent of the GDPR legislation with equivalent fines. So just as we are beginning to see GDPR being a driver for the move away from WhatsApp here in The UK, that is now coming through in India as well. What that actually means for us is that our ideal target customers, the large hospital chains in India who maybe have forty, fifty, a 100 hospitals, and in some cases, almost as large as the NHS themselves, they will be the initial targets for this regulatory and and legislative process. And therefore, they are the ones that are most exposed and also most likely to have the leak. So it means that Rohit is being able to get in right in front of these organizations.

41:14 There's a a bit of a regulatory stick coming down the road. And then we are also able to demonstrate the same benefits and evidence that we've drawn out of the Northern Care Alliance to make a very compelling argument as a carrot that this will also have huge efficiency around your organization and will therefore strip out a lot of cost for you. So we will both make you compliant, we will save you time, and we will save you cost. And that is really beginning to resonate. And I don't anticipate it will be too long before we're able to say that we have a definitive opportunity here. And then, again, as we touched upon earlier, hold off the press today. This is our partnership with Medical Imaging Partners. This is absolutely focused around how we leverage the work we've done at Queen Victoria Hospital around pathways and bring it into the private health care space.

42:07 Insurers are now up against it because of the wait lists in the NHS. Most people with private health care policies are activating those policies, which is somewhat breaking the insurance model. And it means that actually they need a much more efficient means of delivering care and a pathway approach that goes straight to diagnosis and enables multi specialty remote review, cuts out two outpatient appointments, and is proven to save a lot of cost is exactly what they're looking for. And this is the first of many conversations that we've actually been able to announce, and it will be a really useful proof case as a stepping stone transition from the NHS into the private sector and will support the conversations we are having with a number of The UK larger providers and insurers.

42:57 So we will keep the market updated, obviously, as this progresses and as we are able to translate that data across and demonstrate that impact. And I mentioned right at the beginning, the second thing this is about is not just optimizing the private sector pathways and helping them to to strip out costs, but actually demonstrating that they therefore have the capacity to deliver more of the NHS outpatient elective pathways. And therefore, when the when the NHS is out looking to outsource more of that activity, it makes it more attractive to be able to do that in the private space where they know it can be done safely and effectively. Because of this pathway approach, probably at a lower price point. So it will also save the NHS money, but allow them to outsource more more work to the private sector.

43:43 And lastly, just before we we draw to a close and take questions, just to highlight again the the strategy for us to generate revenue for by licensing some of our legacy technology, we have a a long term relationship with a company called Imaging Engineering who licensed CADRAM, which was one of the underlying technologies of and one of the initial products that the company had for the last couple of decades. What CADRAM allows imaging engineering to do is to convert old X-ray machines that run on analog technology to a digital technology that makes them more efficient and allows them to, essentially acquire X rays at a lower radiation dose. And, there are about 2,000 sites across The US that are going to either need to buy new X-ray equipment or upgrade to the digital model. And it is, of course, considerably cheaper to upgrade to digital than it is to buy a new system.

44:42 And therefore, that's the market that imaging engineering are going for. We saw 80,000 of revenue in in this period, which is slightly up actually on on the the prior period. And we suspect that as imaging engineering grow into that opportunity in The US, we will see that revenue at least maintained, if not growing as as they grow into that opportunity. So just finally, in terms of outlook, I think the near term opportunity for us is to really double down on the outputs of the APBG report and the traction that is getting with the national team around CDCs. It won't have escaped anyone's attention that we will at some point have a general election, and the outcome of that general election will really set the tone for the rest of the NHS for the for the next five years. One thing we can guarantee that will be in there is the fact that they will have a huge waitlist reduction program and that that will have to leverage the CDCs.

45:46 And therefore, regardless of what happens with that election, we we are very well positioned. It is also worth saying that this first step into The UK private market does set does give us the ability to demonstrate the advantages and the efficiency and the cost saving in a way that will also make that attractive to other international opportunities, particularly where insurance is the dominant form of payment such as in The United States. So this is a sort of stepping stone again to a much larger international opportunity once we've been able to prove it here. So I will stop presenting there, and then we can move to questions. That's great, Tom and Anish. Thank you very much indeed for updating investors. I'll just bring your cameras up also. Ladies and gentlemen, please do continue to submit your questions using the q and a tab situated on the right hand corner of your screen. That's why Tom and Anish take a few moments to review your questions submitted already. I'd just like to remind you that a recording of this presentation, along with a copy of the slides and the published Q and A, can be accessed via your Investor Meet company dashboard.

46:49 Tom, Anish, you've received quite a few questions throughout your presentation. I know we got just a little bit of time remaining. I'll let you fire through those questions if I may. If I could just ask you to read them out and give you a response, I'll pick up from you at the end. Yeah. Sure. So given the unique properties of bleep, why has it taken so long to be adopted in the NHS, EG, at QVH pilot so far? It's a it's a very good question. The the I think you're right. Has unique position. We have a proven value to the market. It's, I think, no secretly that health care takes a long time to really buy and uptake a product. We are seeing the growing interest. We are seeing the adoption of pilots, and we know that pilots eventually do convert to contract. That seems to be the the cycle.

47:39 We know that most NHS purchasing activity happens around the financial year end, so we're expecting most of that activity to happen in the next couple of months. QVH is is a particularly frustrating example of NHS procurement. There was a legal challenge to the original procurement that meant that the entire procurement collapsed. And then as a result, had to be restarted. And as a result, that took a further nine months to get us to this point. It's unfortunately just the the the way that the NHS does business. But as we as we hopefully have pulled out in this presentation, once you have acquired a customer, they tend to be extremely sticky, and they tend to stick with you for the long term.

48:25 And so it is well worth the effort of going through that that sales process. Anesh, I don't know you wanna add to that or if you've just question. No. I'll I'll move on to the next one. So this one is congratulations on winning the IHW Gold Award in New Delhi. But when will we start to see some sales in India? I think with India, it's it's it's difficult to put an exact date on actual sales, but we're very confident that this will be in the short term. Rohit has built a very deep funnel of opportunities already. He's got the right contacts with the right stakeholders at the right customers. He's a one man band in India, but we do have, active partnership and reseller agreements that we are discussing at the moment, which will enable us to, scale rapidly when that does happen. So I think, like I said, it's it's it's difficult to give a date, but we're confident this will be the short to short to near term.

49:25 Yeah. I I think it's worth saying as well the awards that Rohit has been winning out there, the the judging panel that allocates that award are often our customer groups. So it's it's often senior people in the large hospital chains that are making those awards. So it it has a a a double value in that it actually also makes them very aware of the product, and they get to see all of our brochures and sales collateral as part of the process. So it's a sale opportunity as well as a as just a marketing one. Yeah. And just to add, think it's similar to the NHS in The UK. I think we will probably see customers initially request pilots or be it short term pilots that are paid for and before entering into a contract. But I think that's just the nature of moving into a into a different geography.

50:14 But, yeah, we are we remain confident. There's another question. How many CDCs are you currently in discussions with? So another of the 174 CDCs, I'm with our sales team supplemented by a third party lead generation consultancy support. They've contacted the majority of those in terms of active and and, actually, there's a huge degree of variation in terms of how ready these CVCs are for a technology such as ours that actually just ready to actually start with the with with the actual work. But in terms of active discussions, you know, we don't, of course, publish our sales pipeline, but, you know, we have at least between five and ten active conversations with CDCs underway.

51:03 I think to give you an idea of the scale of that, so when when NHS England brought together a webinar of CDC sites for us to present the report to and and to basically pitch as a solution Of they were able to bring in about 20 CDCs that were interested in in actually pursuing a pathway approach. And of those 20, there were only two that were able to actually take up the pilot offer because of technical capabilities and the stage of their build and everything else, and that was Amersham and and Oxford. Most of the CDCs, though, are due to complete by the end of this financial year. So it should be operational in the summer, which means actually our opportunity to then grow into the space is is So I suspect that we are probably looking at an additional 60 or so CDCs that are coming online within that sort of that sort of period. And, obviously, we are in communication with with all of those.

52:07 There's a question here around oh, then so the military has been listed as a service area on the website for a number of years, yet there does not seem to be any developments in this particular market. This is obvious potential. But have there been any trials by potential customers? Yeah. No. This is a really good point. So I think it doesn't escape anyone's attention that the military would be a fantastic user of the platform. We actually have had conversations with the military. The the way that the military will engage with this is through a formalized procurement route. There is a there was a planned procurement that was due to take place in September of last year, which is being postponed. So we are engaged with it. As soon as that procurement occurs, we will be participating and and and putting in our our bid.

52:55 Interestingly, the military is forming some of Rohit's early conversations in India as well for for all the obvious reasons, the ability to connect up field hospitals with specialist centers. So we will see something in this space. It's just that we're at the mercy of the public. And and that's just before There's another question here. Liam b, have you ramped up too soon? Should you be cutting back now? You know, I think it's what what I would say to that is, you know, there's obviously a lead time in recruiting the technical capabilities that we've recruited over the last eighteen months. And, actually, we are still a relatively small team. You know, there are twenty twenty seven heads, in The UK, but we do run things as efficiently as possible. I think we have to, you know, I suppose what we can't wait for are contracts to come in immediately and then start the recruitment phase because it there is that lead time in in in in especially the r and d, integration, implementation, and technical team. So, no, I think the the answer to that question is no. I don't think we have ramped up, and it's not time to cut, at this moment in time.

54:08 Like I said, we do look for cost efficiencies across the system on an ongoing basis. So I think we're, you know, we're very controlled in terms of our costs. Okay. With an increased focus on digital infrastructure to combat winter pressures and patient backlogs, how does FEEDBACK plan to leverage its technology to capture more opportunities within the NHS and beyond? In short, by selling into the different stakeholders that we presented. So there are differing priorities both nationally and at the ICS regional level. You have to be able to sell comprehensively into each of those stakeholder levels. Although the theme is is always the same, it's always weightless reduction, cost reduction, and workforce.

54:59 So there is a a sort of common approach to that. And and so our our approach is really to sell them to each of those each of those groups. And this question here, do do you feel confident with your ability to scale up based on customer expectations if contracts are won? Yes, we as as as as we kind of alluded to, in parallel, we obviously are planning for success and a lot of success, and we are making sure that we are ready for a potential large scale deployment of if that were the case. And and, obviously, we have no plans to recruit a huge amount of employees. What we would do in that instance is engage the partners we've already been talking to who are essentially consultants who have NHS credentials in terms of implementation, change management, integration.

55:55 That's probably the area that we would require support. The technology itself is very scalable, but it's the implementation that we would require assistance with. And we have relationships with providers who could do that for us if we needed to call on them in in in in that scenario. Yeah. That's quite generic question. Could you expand on your thoughts and plans on new products and partnerships? I think fundamentally, are very focused on deploying into the CDC space here in The UK and then going after the large hospital groups in in India. We will be doing that in partnership as as Anesh said. And if we get the opportunity to scale at PACE, then we will be doing that with partners.

56:42 But in terms of building out new products, we won't be looking at that in the in the near term. There's there's a lot to go after with what we've already got. And I think the opportunity is to really convert and maximize that. Will additional pilots with individual NHS organizations be required for each potential contract, or will the data from the current pilots provide sufficient evidence to roll out on the national level? It's a it's a good question. It's one that we we are often asking ourselves. When we're dealing with individual organizations, I I think that they are probably likely to want a pilot phase in the initial stage. However, as we start dealing with larger regional organizations, they are much more likely to move to contract based on the existing pilot opportunity, particularly where that is part of a more coordinated program. So where the national team are implementing a particular pathway like breathlessness, for example, there will come a point when actually we have proven the preferences pathway. And I I think that point is coming very soon where we will have demonstrated at QVH. We'll have demonstrated that you can translate that to another site.

57:58 And then having done that, the next instinct is go to contract, and that would be something that is pushed out, hopefully, at a regional level with support, hopefully, from the central team. And so I think it is I think we are all planning on the basis that the requirement for pilots will drop off once we reach that critical, evidence point. I'm not like any others. There's a question here. Why not pitch for the whole NHS not at 96,000,000, which is the total addressable market for NHS CDCs, but at 48,000,000 to get your foot in the door. I suppose the question is there, are you are you, you know, pricing yourself out is is the underlying question.

58:49 You know, we've never been turned away from a contract because of our pricing, and we will always be you know, the 96,000,000 comes from an average count contract value of $455,100 k. For smaller CDCs, that would, of course, be lower. We price on a per patient episode basis, and it's very competitive. And as I said, we you know, the contract value could be smaller for for a small CDC, and we'd be would be more than willing to apply discounts if we got our foot in the door. But, yeah, price is not the reason why anyone's turned around, turned away the contract. It's other reasons which we've outlined, including general inertia and procurement challenges, IT department challenges that we've spoken about as well. So we certainly would not price ourselves out of getting a foot in the door. Yeah. I I think if we thought that dropping the price and offering a volume discount of that scale to the national team would would result in movement, we would do it in a heartbeat. The reality is it it it won't.

59:53 This is around multi stakeholder engagement over time, building confidence, building the evidence base, designing and securing compliant routes for procurement and building on it. And it and it takes many, many engagements and many months, but we're we're really getting there. And I think that the you only need to look at the pricing in relation to the impact data to know that we're we're pricing it very, very attractively. So even at the lower tier of our pricing where where we have low volumes, the the average per patient price is in the order of about £6. And yet we are releasing £295 back to the system. And that is you you could strongly argue almost underpriced.

1:00:42 However, we think that is what the NHS will tolerate in pricing. So therefore, that's where we're where we're aiming. But, yeah, we're certainly not overpriced, and and I don't much as I would love to say if we just did an offer like that, it would shift the dial. It it won't. It's not that that's holding holding things. Tom, I might just jump in there because for every one question you answer, you're getting fired with another couple. I know you've touched on some of these things, and and I know you've been going on for over an hour now. So I'm just mindful of both time. But if there's anything there that that that that grabs your attention, feel free to to address it. If not, obviously, I'll provide you all the questions post the meeting, and we can always look at adding additional responses at that point if that would be more suitable. If there are no further questions, then, Tom, if I could just ask you for a couple of closing comments, and I'll redirect investors to give them your feedback.

1:01:31 Yeah. No. Thanks. Okay. I think you're you're right. Let's let's give everyone the time back. We'll we'll come back on the questions where we where we're able to. So I just think just to conclude, firstly, thank you all for your time. I'm hoping that we have conveyed the confidence that we feel as a management team around the opportunities ahead of us. It cannot be understated the the sort of milestone we have achieved by getting money out of the central NHS England team during the current economic and workforce crisis affecting the NHS. That is a clear indication that they are taking this seriously and prioritizing it and that they are recognizing the benefits that we bring. And in the same vein, I don't think it can be understated the significance of us opening up an opportunity in The UK private sector.

1:02:17 I know that we've you you probably all feel that we have spoken about it for a long time, and it has been in the making for a long time, which it is now here. And I think it shows that you can translate the work we've been doing in the NHS to the private sector, and opening up both channels makes this a fully comprehensive offering to the whole of health care, which is what we're we're all trying to deliver. So thank you for your time. Thank you for your investment in the company, and we look forward to announce further news as soon as we are able to. That's great. Tom, Anish, thank you once again for updating investors. Can I please ask investors not to close this session as we'll now automatically redirect you for the opportunity to provide your feedback in order that the company can better understand your views and expectations?

1:03:02 This will only take a few moments to complete, but I'm sure it be greatly valued by the company. On behalf of the management team at FEEDBACK PLC, we'd like to thank you for attending today's presentation, and good afternoon to you all. Thank you. Thank you.