Most companies that fail to win public sector business do not lose at the moment they think they did. They lose earlier, quietly, at a point where nobody told them a decision was being made. This paper walks through a typical public sector purchase and identifies where smaller suppliers drop out.
1. Before anything is published
Public buyers shape requirements through market engagement, supplier days, clinical networks and conversations with people they already know. By the time a notice appears on the Central Digital Platform, the problem definition, the budget envelope and often the expected shape of the solution are settled.
Smaller companies tend to start at publication. Larger competitors started months earlier. This is the single most common structural loss, and it is also the most fixable: engagement before procurement is permitted and encouraged, provided it is open and does not give one supplier an unfair advantage.
2. The budget question nobody asks out loud
Enthusiasm from a clinical team is not a budget. In the NHS, a further problem is the split between capital and revenue funding and the pressure on in-year spending, which makes it hard to buy something today whose benefits accrue over several years. Industry consultation has repeatedly flagged in-year accounting and the focus on current-year cost as an obstacle to value-based purchasing (Global Counsel and ABHI).
If you cannot name the budget line, the budget holder and the financial year in which money is available, you do not yet have a deal.
3. Qualification and financial standing
Selection questionnaires test financial standing, insurance, policies, certifications and comparable experience. Loss-making early-stage companies can fail on turnover ratios or accounts history regardless of product quality. Mitigations exist: parent company guarantees, evidence of funding, performance bonds, consortium bidding or subcontracting to a prime supplier. They have to be arranged before the questionnaire, not after a rejection.
4. Assurance requirements in health and care
In healthcare, a second layer of assurance runs alongside procurement. For software-based digital health technologies in England, buyers use the Digital Technology Assessment Criteria (DTAC), covering clinical safety, data protection, technical security, interoperability, and usability and accessibility. NHS England updated DTAC in early 2026, introducing a shorter form with around a quarter fewer questions, clearer guidance, and a decision tree to help suppliers work out whether their product is a medical device and which clinical safety standard applies. The previous form was withdrawn from 6 April 2026 (Burges Salmon, 2026; Med Tech Reimbursement Consulting, 2026).
Clinical safety under DCB0129 sits with the manufacturer and requires a named clinical safety officer and a maintained clinical safety case; DCB0160 applies to the deploying organisation (NHS England DTAC guidance). Companies that start this work when a buyer asks for it typically lose two to three months.
5. The pilot that goes nowhere
Pilots feel like progress. Many are not. A pilot becomes a commercial step only when three things are agreed in advance: what will be measured, who decides on the basis of that measurement, and what budget the decision draws on if the result is positive. Without those, a successful pilot produces a case study and no revenue.
The 10 Year Health Plan for England acknowledges the duplication problem and promises an “innovator passport”, delivered through a platform called MedTech Compass, so that a technology robustly assessed by one NHS organisation can be adopted by others without repeated assessment (Hill Dickinson, 2025; National Health Executive). The direction is helpful. Until it is fully in place, plan for repetition.
6. Scoring you did not design for
Awards are made on published criteria and weightings, which typically combine price, quality, social value and sometimes implementation risk. Smaller suppliers often write a compelling narrative that scores poorly because it does not answer the question as worded or provide the evidence the scoring scheme requires. Social value in particular is frequently under-answered, despite carrying meaningful weight.
7. After the award
Winning a contract with one organisation is the start. Spread across other trusts, boards or authorities requires new information governance reviews, new integrations, new clinical safety assessments and new budget conversations. Companies that plan for one sale, then discover they have bought themselves an unfunded roll-out programme, run out of cash at precisely the moment their traction story looks strongest.
The pattern
Public sector procurement rewards preparation over persuasion. The suppliers who win are rarely the ones with the best pitch on the day. They are the ones who shaped the requirement, understood the money, cleared assurance early, structured the pilot as a decision, answered the scoring scheme as written, and planned for the second and third deployment before the first one closed.
How FastForward can help
We help health technology and software medical device companies convert interest into contracts.
- Deal mapping. We identify the real decision makers, budget holders and assurance gates for a specific opportunity, and what each one needs to say yes.
- Assurance readiness. DTAC, clinical safety, information governance and security evidence prepared ahead of demand, not in response to it.
- Pilot design. We structure pilots as commercial decisions with defined measures, decision rights and a funded route to scale.
- Bid and proposal support. We help you answer scoring criteria as written, including social value, and review responses before submission.
To discuss a live opportunity, email hello@fwdtech.co.uk.
References
1. Global Counsel and ABHI, Unleashing innovation in the NHS — https://www.global-counsel.com/insights/report/unleashing-innovation-nhs-barriers-and-opportunities-adoption-and-uptake-healthcare
2. Burges Salmon (2026), New NHS Digital Technology Assessment Criteria — https://www.burges-salmon.com/articles/102mnjh/new-nhs-digital-technology-assessment-criteria-what-health-tech-suppliers-need-t/
3. Med Tech Reimbursement Consulting (2026), Updated DTAC guidance and form in England — https://mtrconsult.com/news/updated-digital-technology-assessment-criteria-dtac-guidance-and-form-england
4. NHS England, DTAC: assessment criteria — https://transform.england.nhs.uk/key-tools-and-info/digital-technology-assessment-criteria-dtac/assessment-criteria-assessed-section/
5. Hill Dickinson (2025), The 10 Year Plan: a focus on healthtech and innovation — https://www.hilldickinson.com/insights/articles/10-year-plan-focus-healthtech-and-innovation
6. National Health Executive, New innovator passport — https://www.nationalhealthexecutive.com/articles/revolution-nhs-new-innovator-passport-slashes-red-tape-and-speeds-life-saving-tech