Feedback (LSE:FDBK) — Results and Company Update

0:00 Good afternoon and welcome to the FEEDBACK PLC Investor Presentation. Throughout today's recorded presentation, investors will be in listen only mode. Questions are encouraged to be submitted at any time via the Q and A tab situated on the right hand corner of your screen. Simply type in your questions and press set. 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, doctor 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 is joining us for the first time. And so, Emma, would you just like to say hello and introduce yourself?

0:48 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. A very warm introduction. I'm a p d PLC 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. Lovely to meet you. Looking forward to speaking to you. Thank you very much, Emma. We were gonna go through the presentation now, and we will start with the finances, and then we're gonna move on to the operational highlights.

1:38 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. Mhmm. Thanks, Mark. Essentially, we have been focused there's not much there's 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 UK clients renewed, and we are seeing increasing adoption from them. EBITDA, we remain loss making. We still have loss making position. So we have an EBITDA loss of 1,600,000 versus GBP 1,400,000 for the first half of last year.

2:27 And cash flow, although it does look worse this year, it's partly affected by a client moving to six monthly renewals rather than annual. So actually, that would be reasonably flat with that adjustment. Overall, we are we are still in a we still have a a solid cash flow position. We have enough cash runway out to mid twenty twenty seven with some proactive cash flow management. So we I I those are the financial highlights, and I'm I'm happy to take any questions on that later. But I'll hand back to you, Mark. Thank you. Well, doctor Tom O'Clay or Tom to me is gonna 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?

3:19 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. So 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 BLEEPR and what it would actually cost to take BLEEPR to potentially a national scale for the NHS.

4:11 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, but essentially that decision process is going to be linked to the NHS financial year, and therefore that should conclude by the thirty first of March of this year. So, we're not far away from knowing the outcome for this. That business case is based on Bleepers ability to impact and drive improvements in elective care performance. We are all aware of the wait lists that are affecting the NHS. One of the things that we have really been able to demonstrate with bleeper is our ability to see patients faster and more effectively.

4:59 Our focus has always been on getting that decision for the patient faster by using diagnostics upfront in 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 would 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 to 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.

5:51 Other systems such as the patient demographic service allows us just 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 BLEEPR now is ready to roll across any primary care setting in The UK. 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 BLEEPR. 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.

6:46 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 non site 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 non specific abdominal pain. They go forwards 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 BLEEPR, but also to show that we can deliver in very high stakes clinical settings.

7:38 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 were being rolled onto BLEEPR, 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. So we've looked at a range of options with a range of different partners.

8:43 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 that could help us to sell and position this into NHS. And we announced our partnership with the AtScale 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're developing. And lastly, but I think very importantly, we were also selected to deliver two national neighbourhood simulations.

9:32 So the neighbourhood health model is one of the driving priorities of the NHS in the upcoming ten 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, BLEEPR 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 neighbourhood context that could be social care, mental health, even local authority.

10:19 And so we were able to demonstrate that you could, through a digital infrastructure like Blipper, very quickly and effectively move into that neighbourhood 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 BLEEPR really unlocks in the NHS. I'm sure that everyone on this call will have at some time had some interaction with the healthcare 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 a traditional model you would go to see that specialist, usually in person, and then that specialist will arrange some tests for you.

11:18 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 BLEEPR 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.

12:07 They're going to be done regardless of you having an appointment. So, why don't we just go straight ahead and order 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 times of decision, but also that in about ninety percent 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.

13:08 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 a breathlessness pathway on BLEEPR 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 eighteen week target. So we're going faster than the NHS is even able to deliver at the minute. We're 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.

13:54 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 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 asynchronous delivery, which is the bleeper 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.

14:56 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 the 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.

15:42 That said, we can't guarantee anything and we don't have a confirmed answer from the centre yet despite multiple conversations and this being a very live dialogue. So we're 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.

16:35 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 10,000,000,000 pot for tech adoption for the next three year period. That means that there is new money coming online to support these conversations with the individual ICBs, all of whom are 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 recognise, 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.

17:26 We have struggled over the last twelve months to engage with this audience largely because as you'll see in point three here, the NHS has been going through a restructuring for the last twelve months. I mentioned that there were 42 ICBs and 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 meant until recently people haven't known whether they were going to have a job or not. And a lot of the stakeholders we had 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're 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.

18:25 So I think we were 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.

19:15 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, BLEEPR was the underpinning infrastructure for both of the national simulations for neighbourhood health. Neighbourhood health as a programme 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 neighbourhood health and as we know from the NHS if there's not money there to do it the programme won't move forwards. 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.

20:13 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 Labour came into power, they did a year long programme where essentially they tried to understand the problems that were facing the NHS and then to come up with a strategy paper called the ten year plan to outline what they wanted to deliver over the next ten year period. Those two processes, the pause and the strategy, have now concluded and it is now transferring into action.

21:01 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 three 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.

21:56 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, weightless 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 VNHS 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 forwards. So the concluding point is, we are still slightly waiting for a decision. The decision is coming relatively soon.

22:49 And based on that, we believe our positioning couldn't be better. But it's not a done thing until the money's 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.

23:35 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 if I forget any of it. But yes. Essentially, for the last eighteen 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. There's including national coverage, the program in QVH was mentioned in official Department of Health briefings and press releases.

24:22 So at every level of the system there is an awareness of 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 that interest into decisions and therefore decisions into contracts. So essentially, have been bottling up this repressed demand for BLEEPR, and I'm hoping that that will all get uncorked in April as that new money and stability comes back into the system. So we're confident in that sort of pipeline.

25:11 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'll we we can revisit it. And in fact, having Mark on the call might be quite useful given your expertise in this in this space. Does that answer the questions, Mark? Or have I missed? Did you get covered the plan b? Oh, plan b. Yes. No. Good. So we are optimistic that plan a will happen. Plan A may have a variety of flavours. Plan A may involve us licensing Bleepa into the centre, which would be a single contract.

25:59 It may be a framework whereby actually we then have to still sell this to ICBs. Either of those scenarios of course would be a wonderful move forwards for the company and a great recognition 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 forwards. But of course they're not guaranteed in any 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 forwards on the basis that it has a value proposition between providers.

26:46 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 default position 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 prioritise what products, what approaches, what programs they're going to take forwards 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.

27:39 So one of them is sort of what opportunities with partners and trusts, 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 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 neighbourhood as a core enabler is absolutely clear and I think largely well appreciated up and down the country as a result of simulations, it's still uncertain where and when the money will be coming into the system to pay for neighborhoods.

28:44 So I still think the 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're having a lot of conversations with the new neighbourhood teams up and down the country. Everyone's recognising 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 centres and there has been a lot of press coverage about building neighbourhood centres. 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 the simulations are taken forwards, digital would be prioritised rather than bricks and mortar building.

29:37 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. Thank you. I had a couple of questions in regards to the integrations, which I think from memory was point two on your operational highlights. There was a question around what is what competitive advantage does bleep have in terms of the infrastructure versus other health tech providers? And a similar question was what other companies have these integrations?

30:31 So I think those two sit quite nicely together. Yeah. It's 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 a fully national basis, rather than having to integrate at each GP practice. So, you can list a service through the bleeper 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 that coupling into primary care.

31:17 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 bleeper infrastructure also needs to integrate into electronic patient records or whether it can be done as a standalone 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 that a lot of the way that the EPR contracts are structured for hospitals, they get charged every time a patient lands in those environments.

32:06 And therefore, we can actually hold the patient on BLEEPR 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.

32:53 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 BLEEPR can. So what BLEEPR 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 Blipper 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.

33:48 And therefore our value proposition remains unique. I think this question in many ways overlaps with 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.

34:39 So we aren't 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 the the sort of level of cash that the company holds at the moment, what we see as the possible burn rate over the next twelve 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 of November, we have $3,820,000 in cash left.

35:26 We believe that with proactive cash flow management, we can our cash runway will we have sufficient cash runway to mid-twenty twenty seven. The the requirement to fundraise really depends on the structure and the timing of the contracts that we we can we if that we close. If 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 fundraise will that that there may not be any at all. It should be self funding. But if if these are 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.

36:22 But at the moment, until we see the contractual structure and we know where we stand, it's hard to say exactly how give give any numbers around that. Thank you. 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. So we've been asked about cortisone, the opportunity with the army, and the DBS 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. No. None of those are still alive. 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.

37:22 And it's worth also saying that although we've also looked at private healthcare provision in this country, that also has a core dependency on NHS, because a lot of private hospitals in The UK, their core business is actually running NHS work. And so while we've had the uncertainty of NHS contracts and cash flow, a lot of the private providers have similarly had that uncertainty and also not been prepared to make decisions to move forwards. And I think you'll see increasing pressure actually on these 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 focus 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.

38:20 Did you want to add anything on India as well or does that fall under the same category? It falls under the same category. 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 UK 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.

39:14 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 this sort of this series of questions, we've been asked our sort of customer retention rate and also why the QVH contract shifted to six months. So if we could just clear those off. Yep. So our our retention rate is pretty astounding. I mean, 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.

39:59 But once they are a customer, they tend to renew for multiple years, and therefore, the the total lifetime value is is high. And I think that that is also a testament to the quality of our products, 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 their contracts with us. Was there a second part of the question on that, Mark? Now you're testing me, and I'm I was just planning my next question. So let me Sorry. Before I come back. I feel like there was a bit of that question I I've not quite There was customer retention rate was in I can't spot what the second part was, and I think there was. So 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 two questions along those lines.

41:11 Yes. I I don't think that it's 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 we offer. So what is the evidence base? And then what is their confidence in your ability to take that forwards. 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 that 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.

42:03 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 recognises that and has a commitment to doing business with SMEs. And it is part of their procurement drives and their stated political aims is to increase the engagement with SMEs and also to see the NHS as a driver of economic growth for The UK, which means that they are also preferencing working with UK businesses.

42:53 So actually, as a UK SME, we should be relatively well positioned for NHS procurement, you you would hope, on on that backdrop. I have been politely reminded of what the part two of the previous question was, which is in regards to QVH transferring to a six month contract and what impact that has had. Yes. So QVH is actually being funded from various budget reports 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 that at the last renewal they essentially had six month availability of different pots and that's what's 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?

43:56 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 310,000 versus GBP 590,000 the previous year. And that's mostly because the QVH contract has gone from annual to six monthly. And that's so that will reverse in the second half. I'm glad to say that they've renewed again And after this 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 2,100,000 negative versus 1,730,000, and a large proportion of that is due to the fact that we only received six months rather than the full year's revenue in the first half of twenty twenty six compared with the first half of twenty twenty five.

44:58 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 sounds at the minute, the decision needs to be made before the end of this financial year of the NHS, which is, of course, the March 31. So, you know, if we want to be implementing as of April 1, we need to get our skates on. And when I say we, I mean, that us collectively with the NHS. So it's yes. I don't think that this I don't think this is something that's gonna spill over into next year with a open ended running rate, that this is a decision that needs to happen relatively soon.

45:54 And then there's a question around for investors who like to keep an eye out on news related to BLEEPR, 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 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 gets issued. So you may see coverage there.

46:43 And then if it's taken forwards with enough, Gusto, as we were 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 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. Yep. No. We 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.

47:33 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 and 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 UK, stabilize our position, 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.

48:20 Thanks, Mark. Yeah. I think to conclude, we have put a lot of work into getting to this current juncture, and I appreciate this from a shareholder's 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 with the centre 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 is being an eighteen month or longer race.

49:06 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 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. I'm hoping that all of that work will soon bear fruit. Thank you very much. Well, thank you, doctor Tom Oakland, the CEO. Thank you to Emma Ozwicke for your first appearance as CFO. And this at this moment in time, I hand back to Charlie.

49:55 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.