I work as head of licensing at the University of Leeds. And what I do is lead a team who identify interesting new technologies that are developed by people working at the University of Leeds. So most of the time it’s academics, but occasionally PhD students and the like. My job really is to assess the commercial application of interesting new sciences, interesting new technologies, and, and then to try and seek a way to commercialise that. There’s quite a lot that goes into that process, but ultimately, we’re hoping to either partner with the company, or sometimes we create our own spin-off companies and raise investment into those.
You must have some interesting things cross your desk; what kind of things will be typical of what you work on? Or is there no ‘typical’?
That’s a good question. It’s really diverse. It can be everything from new therapeutics to treat cancer, all the way through to cybersecurity software, or robots that apply client masks and give information on structures. So it’s really diverse. And I would say that no two projects are the same, not just in the sectors that they present themselves to us, but also in the amount of work that may be needed to develop them, or the type of things that that need to be conducted to de-risk that project for somebody else to then take it on and commercialise it.
Are there common challenges with any business going from the academic sphere to commercial?
Yes, for sure; a key one really is really understanding that the product or the technology that’s been developed in the university solves a real world problem. And does it solve it in a way that is scalable? Does it solve it in a way that can actually be rolled out to hundreds of thousands, or potentially millions of people? That’s a really common theme. And although you might be serving a market need, are you going to be able to make any money from that market? And have the impact? Is it really going to be a step change from what’s already out there, and what the world is already doing? So that, I’d say, is a key theme across everything we do.
It’s interesting that you say ‘a step change from what’s existing’, because that’s what iConsentu represents to the dental industry. So perhaps you can take us back a bit to the story of how you can be working alongside Biju and his team on iConsentu.
It was quite a few years ago now, before COVID – and everything before COVID feels like a different lifetime ago. I was approached by a senior clinical lecturer, and dental orthodontist who was working at the University of Leeds, in the dental school – Alan Gowans is his name. He had experience in both the NHS and private practice, and really as a mechanism to improve his own approach to how he works with his patients, developed a program that looked at how to enhance the type of consent that clinicians can get from their patients before they carry out a procedure. Alan’s interest was obviously very naturally dentistry because that was his area. He had seen a number of issues over his working life where, maybe patients didn’t fully understand what they were agreeing to or maybe they didn’t really understand how they should look after themselves after a procedure seizure was carried out. And so we’d gone away and started to think about how it could be done better?
Certainly at that time, it was largely a paper-based activity. There were probably some question marks over how well anybody could understand that process. Let’s look at somebody who maybe didn’t have English as a first language or maybe it was a child; maybe they were very elderly, had dementia – all of these sorts of things. These were the considerations, and really the basis of where Alan had started to think about this particular technology. So he came and spoke to us at the university and we thought, actually, this is quite interesting.
One of the first things we did is what we normally do, to try and speak to as many people about this internally as possible. We have a lot of clinicians, obviously, at the university, not just dentists, but also surgeons, obs-gynae – all these sorts of people. We basically just went and had a chat with them. A lot of these people work primarily for the NHS, but some of them also work in private practice. And what became apparent quite quickly was that basically, this is a massive issue, particularly for the NHS. The consent procedures that they were using, or have been using today, really are not protecting them adequately.
It’s around £2 billion per year, I think, that the NHS spends on paying out after personal litigation. And a decent percentage of that is basically from procedures that haven’t been properly consented, or patients who didn’t really realise what was happening to them, who felt that they hadn’t been properly consulted. So it became quite apparent that this was potentially quite an interesting technology. And from there, it was really a case of, okay, we understand there is a need for this now. But then we had to think, how do we de-risk this? How do we develop it beyond what is essential? Essentially, what is the prototype and how do we actually get this out to a wider group of people, beyond something that the university itself isn’t ever going to sell as a product? That’s basically what led us to working with the guys at iConsentu.
Did the team have a very clear idea at the beginning of how this problem was going to be solved? What was the process to get it there?
Alan [Gowans] had done quite a bit of work around what the current processes and shortcomings were, and obviously a lot of those shortcomings are just user interfaces, and the ability to aid certain patient groups in actually understanding what they’ve been told. But the other really key thing was that he had worked with a number of legal professionals who are basically involved in litigation cases, to really understand from a legal perspective, what consent is and how it’s measured, and really how to move from traditional consent to an enhanced consent, where actually you really are measuring a patient’s ability to understand what they’ve been told – to be able to basically describe what is going to happen to them and understand the risks involved in that. So Alan himself has done a fair bit of work on that sort of thing. A lot of our work then was around how we could validate that this was definitely the correct approach. How do we validate that this will reduce user’s risk? Both from a patient point of view, because hopefully they have a better experience, but also from a clinician point of view, or user point of view.
Consent is not an isolated issue, is it? As you said, it is relevant for clinicians, but it’s not just medical – there’s a use case for cosmetics or beauty treatments, tattoo studios and more…
Yes, you’re absolutely right about its utility in different sectors. Certainly when we looked at it, there were so many standout markets. And there are those where you think there’s a big litigation problem waiting to happen.
That’s probably where you would start, isn’t it? Asking where are the cases? Where is there a hotbed of cases; which industry, or sector? And then follow it back from there? One of the pillars of iConsentu is education, which you alluded to. Was it clear from the beginning how you were going to demonstrate that understanding? Or was that a work in progress?
There was a good concept of, essentially, how do we test this properly? And a lot of this was related to basically quizzing and questions and answers, but in a way that didn’t necessarily take a lot of clinician time. Because that’s the first thing that any clinician will tell you.
When we started to work with surgeons in the NHS and the like, they’re incredibly stretched, so it’s very unlikely they’re going to adopt a solution that’s going to take more time out of their hands as it is. So the way that the solution is presented, through an interactive program on a laptop or a tablet, seems to be the most logical way. Then the program can report back to their clinician or the dentist, with the results, so that they can pick up certain areas where perhaps the understanding is not there and is not sufficient.
Looking at iConsentu from what was just a concept at the beginning to its current execution, has it matched or exceeded what you thought it could do as a platform?
I think it’s probably where it is in terms of what we wanted to get to, but there are quite a lot of interesting other elements that can be built into that built into the system. Additional features that we’re still working on at the university along with Alan, that – when those features are built into the platform – will take its utility beyond the medical. The features of testing understanding and testing people in a way that actually we should all be tested would work for things like entering mortgage agreements, or loan agreements. All of these sorts of things we do where we really understand what we’re getting ourselves into, or what our liabilities might be. I think there is potential for it to go wider: every website that you go on to where you have to click a button saying that you’ve read the 40-odd page terms and conditions that are written in quite challenging legalese – in reality, how many of us actually do that?
Lastly, James, you talked at the beginning about one of the common challenges for any new product, service or app is buy-in from the market. The reception that iConsentu has received as a concept, was that overwhelmingly positive?
I would say that more or less everybody we’ve spoken to – and that is people in private practice; people in some of the big private practice groups; people in the NHS; people at the top of the NHS; digital; leading clinicians in the UK; in multiple fields; in dentistry and orthopaedics – all of them have said that there is a big problem with the consent process.
What I would say about this particular opportunity was that it was quite unusual in that it was brought to us by somebody who would be an end user of the product. And I think that was a massive benefit to the overall program. Very often we’ll have people who, you know, they’ll bring something to us, like a professor of robotics, for example. But they themselves are never going to use that product. So they don’t really understand what a user is going to look for in it. I think the fact that Alan’s a fairly senior dentist, and a fairly specialist one, means he really got – both from private practice and his NHS work – what users are going to need, and that is unusual. So that is, I think, what’s made the whole process more straightforward as well.