That disconnect planted an idea: could we bottle Premier League physiotherapy and hand it to everyone?

Below is the playbook my co-founders – Jason Ward, Samantha Medcraft – and I have tested while building a MSK tech solution, Phio, and integrating with 100s of NHS sites and private health systems. I hope the lessons help anyone building a healthtech company and turn their startup vision into a proven solution.

1) Start with a problem that won’t be solved by hiring more humans

MSK conditions sideline 20 million UK residents and soak up 25% of GP appointments. Even if we created 12,000 extra physiotherapists tomorrow, there would still be a number of barriers to translating this to improved treatment, access, and prevention for everyday people. What can the technology offer that humans can’t, and why is it needed?

2) Let frontline experience shape the product

When we designed Phio, the question was, “what will help clinicians and people most when the treatment room is overflowing?”

For clinicians:

• A triage system that surfaces red flags in minutes
• Feedback loops that show patient progress

For patients:

• 24/7 remote access to trained physiotherapists
• Tools for self-management based on clinical advice
• Clear exercise videos that mimic in-clinic demos

We knew we could achieve these things but each element needed to be applied at the right clinical touchpoints in order to create actual impact. Grounding product features in the clinical experience keeps the scope relevant and your evidence base easier to achieve.

3) Create shared-risk pilots, not free ones

Free trials often end with dusty dashboards. Instead we ask partners to commit resources, budget, clinician time, and data access – so success matters to everyone. Skin in the game = faster iterations and cleaner outcomes.

Passion powers the late nights; evidence opens the door; scale keeps the lights on. Prospective evaluations showed waiting-list cuts and cost-savings are key issues for the MSK teams in the NHS, whereas prevention and remote access are priorities for private healthcare. We focused on building an evidence base along these pathways, collaborating, listening and feeding back into the product. Only then did we start to think about nationwide roll-outs and larger scale global projects.

Skip this step and credibility or cash will break.

4) Measure what clinicians, commissioners and patients all care about

For MSK, those metrics lined up neatly – ultimately we all care about better health and injury prevention – but this can be applied to your specific technology, or the system you're targeting.

• Patients want less pain and faster recovery
• Clinicians want freed-up appointments for those who need medical intervention
• Commissioners want to reduce the cost per successful outcome
• Employers want to support healthy lifestyles and prevent long term illness
• Gyms want to support injury prevention

Keep laser focused on the actual wants and needs of your stakeholders – especially the pressing commercial or systematic need – rather than building the perfect clinical or tech solution. If your domain’s metrics diverge, report each viewpoint separately; don’t force a single narrative.

5) Respect the compliance stack early

Weave requirements like medical device regulations and cyber security into your early phases – retro-fitting these burns months of time, and trust. Think of regulation as the referee: strict, but the match doesn’t happen without them.

6) Build for equitable access, not just ROI

Physio in football is free at point of need, immediate and comprehensive; the same standard should apply to the night-shift worker with sciatica or an office worker with back pain. We hard-wired that principle by:

• Working with NHS trusts in high-deprivation regions where MSK burdens are particularly high
• Collaborating with health teams to identify the bottlenecks most relevant to their context
• Partnering with employers and insurers that cover all types of jobs relevant to MSK conditions
• Spreading awareness about MSK and helping people to both prevent injury and self-manage

Equity isn’t a CSR line; it expands the addressable market while doing the right thing.

7) Think upstream: health systems are complex

Digital triage clears backlogs; prevention shrinks them forever. Embedding self-screen tools in gym apps or onboarding packs catches dysfunction before it becomes chronic, saving workers pain and economies billions. Although you’re focusing on the commercial need, don’t be afraid to think about a plan of wider attack to the problem.

Passion meets pragmatism

I’ve always liked problem solving. I set out to give patients the same chance of recovery as professional athletes, and translate lessons from elite physiotherapy to the masses. If you’re sitting on a vision that feels too big, or tackling a health problem that feels too complex, remember:

• A personal story is a strategic asset. Partners bank on founders who bleed for the mission
• Evidence converts passion into policy. Generate it early, it’s not as hard as you think
• Be pragmatic with the technology and focus on who needs it most; it will broaden both impact and commercial viability

Solve for health and the economics will follow. In our case, MSK alone costs the UK economy more than £10 billion a year in lost productivity. Good care is good business, and ultimately everyone benefits.

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