Episode 2 - Start-ups and innovators

22 November 2021

Hosted by Dr Kate Hamblin, University of Sheffield, and Eve Solomon, TEC Services Association.

Technology is fundamental to our everyday lives and is becoming increasingly ‘smart’ through the use of sensors, artificial intelligence (AI) and data collection and processing. There has been an explosion of new developments in the care and technology marketplace, with new devices, software and service models, focused on different consumers within the care ecosystem.

Our Sustainable Care programme research found this marketplace is confusing and hard to navigate for commissioners of adult social care, care providers who are increasingly expected to include technology as part of their ‘offer’, and people who need support and their carers. With growing numbers of start-ups in the sector, there were concerns from purchasers - commissioners, care providers and people who use services - about sustainability and whether these ‘new players’ would be able to provide the same level of customer support as they grow their businesses.

At the same time, our research found start-ups experienced challenges in making their way into the marketplace, with some commissioners of services felt to be risk-averse and allied with large, ‘dependable’ and established - but perhaps less innovative - organisations. Some commissioners were happy to pilot new approaches, but more cautious about investing at scale.

In the recent Sustainable Care and TSA Digital Care Futures podcast, Kate Hamblin (University of Sheffield) and Eve Solomon (TSA) spoke to guests from three very different start-ups, all using technologies to facilitate and support care, to explore some of the challenges and opportunities they had encountered.

Podcast guests

Neil Eastwood

Neil Eastwood, founder and CEO of Care Friends, an employee referral app for social care.

“A start-up like this is like a massive freight train in the station with a mini-engine and you’re screaming the mini-engine as much as you can to get some movement and eventually you start to get movement. Once you get momentum, life gets a lot easier because you can’t be stopped. But trying to get going, that’s the thing.”

Hector Alexander

Hector Alexander is the Co-founder of Yokeru, which provides AI-driven automated voice call systems to care providers, including local authorities.

“It’s much easier if you know from the start this is a long-term game. It doesn’t take a few months - it takes years or more.”

Darren Crombie

Darren Crombie is the CEO and Founder of Bridgit Care which provides a range of products and support aimed at assisting unpaid carers.

“We say to our caring community ‘you’re not alone’ and I think as start-ups we need to remember - ‘you’re not alone’ - we’re part of a collective of people trying to innovate and make a difference.”


The technology and care market is difficult: there is a lot of fragmentation in the care sector, with multiple care providers and local authorities, all with different commissioning arrangements. It’s also increasingly crowded with technology and finding a way into that market is difficult for start-ups.

Funding and sustainability are also challenges. There are opportunities, including national funding programmes, but these often have a significant time-lag between application and award and can bring administrative and financial burdens and ‘cash-flow stress’. The speed of innovation and development in this sector versus the pace of funding opportunities are often at odds.

Scaling-up is also a challenge because start-ups need ‘architecture’ to do this - growth needs the addition of dedicated staff to manage HR, payroll, customer experience, sales etc, which can be very costly.

The care sector is under pressure and focused, in particular during the COVID-19 pandemic, on managing crisis. This makes it harder to gain buy-in around technologies focused on prevention, and start-ups then need to convince commissioners and customers of the value of proactive and preventative services and products.

Ways forward

Darren Crombie, Bridgit Care: “Be optimistic. Be positive. There is so much opportunity to change this space and change the world. Give it a go. But with that, recognise it’s going to be painful. You’re going to have a lot of sleepless nights running a start-up. Things that are worthwhile are hard to achieve.”

Understand the sector and your market. It’s a confusing marketplace to navigate and many start-ups are driven by an innovator who has been frustrated by their own experience of a care system which is fragmented and in crisis. An understanding of how the sector works and the other products and services start-ups are competing with is crucial.

Hector Alexander: “Ally yourself with organisations like ADASS, the TSA and TECs Advisory. They’re a good place to bounce ideas off and a good way to find potential customers and collaborators.”

Start-ups need a clear story of what they do and how their product or services can enhance care. They need to talk the language of whoever their customers are - commissioners, self-funders, care providers - and put themselves in their shoes to tailor messages. The market is crowded, so innovators need to clearly demonstrate what sets them apart.

Darren Crombie: “For any start-up, find your story - what got you to the point where you decided to come up with this idea and why do you think you’re the person who can make that a reality. Because if you’ve got that, you’ve got a start-up. That’s the hardest thing - finding your story, what makes you special.”

Be focused and niche. Products and services focused on specific issues are easier for people to understand, to get funding for and demonstrate outcomes. Once you have momentum, you can start to expand to other areas and markets.

Hector Alexander: “Get very niche with the problem you’re solving. Try and get as specific as possible because then people get it and then it makes the whole process easier… So first of all, start small and start niche.”

Consider co-design/production in early stage development. Co-production and design can help to ensure devices and systems are as user-friendly as possible. Start-ups can endeavour to make systems ‘frictionless’ but also should take a broad approach to include everyone who will interact with the product, system or service - ‘end users’ are only one piece of the puzzle.

It’s important to be able to demonstrate quality and outcomes. Start-ups should consider these issues from the outset, and that different audiences might need different types of evidence or outcomes: ‘return on investment’ for commissioners whereas carers and people who use services might want evidence of improved quality of life.

Commissioners and customers also want to know if the product or service is safe for all users. Start-ups should consider embedding their product or service in a quality framework from the outset- this can build trust and confidence.

Learn more about the Sustainable Care programme