Keith Nurcombe, Global Director of Telehealth and Telefonica and Managing Director for O2 Health, O2 UK, will be chairing the M-Health Focus Day at this year’s M2M Forum Europe. Here’s what he had to say about the industry today and tomorrow…

1. M2M Forum Europe
Keith Nurcombe, Global Director of Telehealth and Telefonica and Managing Director for O2
Health, O2 UK
Keith Nurcombe will be chairing the M-Health Focus Day at
this year’s M2M Forum Europe. Here’s what he had to say
about the industry today and tomorrow…
Telecoms IQ: Good afternoon, Keith. How are you?
KN: Good afternoon. I'm very well, thank you.
Telecoms IQ: Can you possibly begin by giving us some ideas as to the potential for operators when
it comes to M2M across the board?
KN: I think the potential for M2M operators in this space is really quite large. I think it probably falls,
for me, into two simple categories. I think there is a huge area of work to be done in the area of the
patient's home. So when patients are having treatments, medications, long‐term therapies at home,
then there is a significant opportunity for operators in this space in terms of managing equipment
that's in the patient's home, managing ordering in the patient's home. And a large portion of that, I
think, can be done easily through M2M. And then I think the second area is within the hospital
environment, the traditional secondary care environment, where, again, there is a lot of work to be
done these days in terms of managing equipment, tracking equipment, making sure that when a
nurse is looking for a blood pressure monitor, she can find one easily and quickly. So there are real
opportunities in both the key focus areas of the NHS, currently.
Telecoms IQ: And looking at the health service, where do you think the real points of interest would
be – the hot buttons, if you will – that are currently being chased?
KN: I think there are two really key areas for the NHS at the moment. As you're probably aware, and
everyone listening to this is aware, there is a significant push, as there has been for a number of
years, from secondary care into primary, i.e. treating people as close as you can to their home, or in
their home, in the community. And I think that continues to be a huge push for the current
government, along with the changes they're making in terms of GP consulting to fund that, with the
GP's managing, arguably 80% of the NHS' budget. And therefore, there are real opportunities in
terms of helping the NHS understand how they can efficiently and cost effectively – but also without
compromising patient care – manage patients in that environment. That has an implication in
secondary care because that changes the model that currently is working in the UK, where a patient,
whenever they need more significant help, is pushed into secondary care. And that will rely on
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2. hospitals, therefore, changing the way they work with the patient and changing the way they work
with GPs to make their services more efficient and more reflective of the needs of their local
community, rather than a set of standardised services, which is what tends to have happened in the
NHS over the last ten years.
Telecoms IQ: Do you think that'll be an easy adjustment to make?
KN: No, I think it will be an extremely difficult adjustment. I think the NHS doesn't do change
particularly well. It's a very large organisation with a huge structure, and large structures like that
struggle with significant change. I think you have started to see some change, and you have started
to see some trusts and some local community areas where quite significantly challenging services
are being managed in a different way. But like everything, I think there are earlier doctors, and there
will be a slower following of the larger part of the NHS. But I think it is... it's worth being aware that
it represents a significant challenge both in the mind and in practical terms.
Telecoms IQ: Is there any way that you could possibly recommend we grease the wheels to make it
easier for the NHS?
KN: I think it's about coming to the NHS with practical, sensible, well‐proven solutions which can
deliver that quality of patient care and deliver that quality of outcome, but allow the process to be
managed differently. But I think the difficulty has often been for the industry and the NHS, is that
often, that's unproven, and it's we believe we can do this, and we want to try it with you for the first
time. It's a little bit like the equity and acting; you can't act unless you have an equity card, and you
can't get an equity card unless you can act. And there is a danger that you have to be able to prove
your concept, but if you can't work with the NHS to prove them, then it's quite difficult to prove
them. So I think it's a little bit of give and take on both sides, about taking well‐proven, where
possible, good quality trial data to the NHS, and saying, actually, we can do this, and we can do it and
still deliver the outcomes you need. And the NHS has to take a slightly more open stance to saying,
actually, we can see what you're talking about and we're actually prepared to give it a go.
Telecoms IQ: Well, “well proven solutions” are three words we always like to hear together. Keith,
given your background in the health and pharma industry, have there been any specific lessons or
knowledge that you feel you you’ve been able to carry with you into your role at O2 to really benefit
your process?
KN: That's a very good question. For me, the real benefit is keeping the patient upper mind. I think
it's very easy for healthcare companies and industry alone to forget the patient in the middle of this
and concern themselves with either the product or the output or the process that they're trying to
deliver. I think it's absolutely critical to keep the patient top of mind, i.e. asking yourself, how does
this benefit the patient? What does the patient get from this? Does the patient see the district nurse
more often or for longer, which clearly has a benefit for them? Does the patient actually have to
travel to hospital less, or does the patient actually have their condition managed in a better way,
allowing them to work more regular hours, for example? So I think keeping the patients top of mind
is absolutely critical, and I think the other learning is probably understanding how different it is to
manage services in the patient's home than it is in a hospital or a community hospital because,
actually, although you'd think the principle is the same, they're actually very, very different. And
managing services and managing supply into patient's home is really quite different from that in the
hospital environment, where you have, for example, people around you 24 hours a day, which you
may not have in a home environment. So I think an understanding of the patient and working and
understanding how to deliver in the home are the... having done that, are services which have
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3. allowed me to kind of benefit and then tailor the offerings that we make to match the needs of the
patient in the home.
Telecoms IQ: I see, and by no means an easy task. But I believe the O2 business development
director, Tim Sefton, who you work quite closely with, has recently described M2M as a long‐term
ambition; looking at taking it from “acorn to oak tree”, I think, was the way he put it. Realistically,
Keith, where will the investment need to be funnelled to fully bring about this goal?
KN: That's a very good question, and Tim's comments are well‐founded. Telefonica, as an
organisation, as you know, a very large player in this field, has created a number of central core
verticals in areas of business that it wishes to focus in; for example, health is one, hence my global
role. But M2M is another one of those, so there is a clear focus from Telefonica that globally, this is
an area for us that we want to aspire and deliver well into. So I think that investment has already
started, but like anything, I think it takes time for that global investment to roll down into the
individual countries and operating businesses. There is a successful M2M business already in the UK,
but I think there are significant steps it needs to take forward to really start challenging and really
start delivering some leading solutions in the M2M space, particularly in health.
Telecoms IQ: To put it bluntly, is it being treated with enough urgency, do you think? And by that, I
mean to say, is it not important to beat others to the finish line when it comes to really cornering
this market?
KN: I think the simple answer to that, actually, is no. I think that it's not about beating others; it's
about having a measured and sensible approach which delivers you credible and the right solutions.
There is no point in being first to the end line if what you deliver isn't what the market wants. So I
think it's about understanding the market, understanding how you then tailor your offerings to that
market, and then putting yourself in a position where you can deliver really credible solutions well
and with a level of effectiveness that allows you to roll that up across a number of customers
simultaneously. And I think that's the position that Telefonica's taking, which is a slow, steady and
measured approach, but making sure that it delivers really innovative solutions, but it delivers them
well.
Telecoms IQ: Very well put. Just rolling back to the issue of working with the NHS, you spoke about
possibly helping them and supporting them, but how can they or other health services support
operators and providers in this endeavour? Is there perhaps any approach that you can
recommend?
KN: I go back to what I said earlier in the sense that I think it needs a considerable level of input
from both sides, and I think that has to be equal both from the NHS and from the industry. I don't
think this is an either/or solution; I think it requires both parties. I think it's about the NHS opening
up and allowing industry to really understand what their pinch points and what their issues are and
where they see they have problems, and then the NHS allowing the industry to go away and say,
actually, given our expertise, given our knowledge and our experience of maybe what we've done
here in Brazil or maybe what we've done here in the U.S., how can we bring that to bear and make it
relevant and specific to the issue you've got in the UK.
Telecoms IQ: As you mentioned, the barriers to implementation are seen as anything but trivial.
One of the factors, I think, that needs to be considered is the complex and, let's say, inefficient
environment that we'll have presented to us, just as competition in this area heats up and the field
really begins to take off. Is that a legitimate concern or is there enough low‐hanging fruit for most
providers to actually latch on to before they're outpaced by other leading competitors?
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4.
KN: Well, that's a good question. My instinct is there is a significant opportunity. We're already in
discussions with lots of organisations, ranging from the NHS to private organisations who supply
services to the NHS or on behalf of the NHS, and I think there are significant M2M opportunities now
where we could be delivering credible solutions into the marketplace that are capable of doing what
we need them to do in a way which benefits the patient and benefits the outcome, and I think we
can be delivering those now. And we're already starting to deliver those now, so I think there is no
reason to stop any organisation coming into this space as long as they have innovative and sensible
solutions in delivering that now for the NHS. I think the market has some way to go to fully develop,
and I think, you know, a number of companies that come in early at this stage and start delivering
those solutions will see considerable rewards if they can then go along with that, the drive and the
growth of the market at the same time.
Telecoms IQ: It's certainly an exciting subject and one that could have huge benefits for both
industry and society as a whole, so we look forward to learning more at the conference, Keith – but
until then, thank you very much indeed for your time today; it's been really great to get your
thoughts. Thank you.
KN: My pleasure; no problem at all. Thank you very much.
To register your place at the event, running between June 6‐9, in London, simply call us on + 44 (0)
20 7368 9300 or email to enquire@iqpc.co.uk. Visit our site at www.m2mforumeurope.com.
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5. IQPC
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