“If I can get a notification for my takeaway pizza, why can’t I get one for the result of a scan I’ve ordered?” That was the question my chief technology officer, Tim, asked a few years ago.
It sounded light-hearted, but it touched on something serious. Every hour of every day, doctors depend on radiologists to interpret scans. Without those scans being read, doctors are flying blind. In stroke medicine there’s a phrase: “time is brain” — each minute without a diagnosis risks lost brain function or even death.
When my colleagues and I at Hexarad — the company I co-founded — were preparing to support a hospital out-of-hours for the first time, we knew the stakes were high. Until then, our system had supported reporting on scans such as CTs and MRIs performed during the day. Now we were moving to a full 24-hour service, becoming the only support available to interpret scans overnight. At night, scans are rarely routine; they are almost always for the acutely unwell, the patients rushed in with a suspected stroke or serious trauma.
To prepare, we walked around A&E and talked to frontline clinicians. All four of Hexarad’s founders had done our time in A&E as junior doctors, but this walk with Tim gave us the chance to see things through his eyes. What we found was startling. Doctors would leave a patient’s bedside, walk over to a terminal, log in and repeatedly press “refresh” to check whether a scan had been reported. In an environment where speed can save lives, they were forced to waste precious time manually checking a computer screen.
For Tim, who had built logistics technology for Deliveroo before joining us, the answer was obvious. If customers could get real-time alerts when their pizza was ten minutes away, surely doctors should be able to get the same when a life-changing diagnosis was ready? Every industry runs on logistics, healthcare even more so.
When we spoke to A&E doctors, the response was unanimous: real-time alerts were a no-brainer. And so we built it — an opt-in system that sent a simple notification when a scan report was available. No patient data, no breach of confidentiality. Just a small, smart fix that freed up doctors to spend time with patients instead of screens.
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The doctors loved it. But as ever in healthcare, progress wasn’t straightforward. A local IT policymaker decided the system could only be used if every clinician carried a second, dedicated mobile phone, in case notifications became “intrusive”. What should have been a commonsense improvement became weeks of meetings. Only when a senior doctor intervened did we get the go-ahead.
One of the clinicians put it this way: “The advantage of working with you is that you build what matters to us and you can move fast. We don’t get stuck in a cycle of endless conversations.”
That line has stayed with me, because it highlights something deeper than a single feature. The NHS is full of smart, dedicated people. What it often lacks is the time and resources to turn obvious ideas into real improvements. Meetings multiply, possible risks are documented and debated, and before long the opportunity has passed. In many roles, the safest way to “win” is by being as slow and cautious as possible, saying no unless there’s no alternative but to say yes. In that environment, even simple innovations can struggle to take root.
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With productivity still lagging behind pre-pandemic levels, the NHS’s decision to prioritise technology and productivity in its ten-year plan is both essential and long overdue. These are the levers that will allow the service to do more with limited resources. But technology alone isn’t enough. The real challenge is making it work in the messy, pressured realities of hospitals.
As demand increases, the NHS will need more staff and more funding. But it also needs people and organisations who can work alongside it with urgency, pragmatism and trust. People who can look at a tired process and ask, “why not do it differently?” Sometimes the smartest fixes are borrowed from other industries and applied to healthcare. And every so often, the inspiration comes from takeaway pizza.
Farzana Rahman is co-founder and chief executive of Hexarad, a radiology specialist
