Who's in the room: the stakeholder cast

A stakeholder is anyone who can influence or veto the deal. In a typical NHS software/AI deal, expect this cast — learn the titles; NHS-facing interviews probe for them:

• Clinical champion. A clinician (consultant, senior nurse, allied health professional) who wants the problem solved and will spend personal credibility advocating internally — in sales language, your champion: the insider who sells when you are not in the room. Almost no NHS deal closes without one — and most successful healthtech products trace back to exactly this person: a clinician articulating a need nobody outside the pathway could see.
• CIO and CCIO. The Chief Information Officer owns the technology estate and its risks (integration, cybersecurity, support burden). The Chief Clinical Information Officer is a clinician-informatician bridging clinical practice and digital — often the judge of whether your product fits real workflow. Win the CCIO and you gain a translator; lose them and clinical objections multiply.
• Information governance (IG) and the DPO. IG teams and the Data Protection Officer assess lawful basis, data flows and privacy risk — expect a DPIA (Data Protection Impact Assessment) for anything touching patient data. Trusts also have a Caldicott Guardian, a senior person responsible for patient-data confidentiality. IG is where unprepared vendors go to die; prepared ones treat IG as a stakeholder to be sold to.
• Procurement. The professionals who run the buying process — route selection, competition rules, contract terms. Not the enemy; the referee. Engage them early and the deal runs smoother.
• Finance. Tests affordability, recurring cost, and the credibility of savings claims — rarely believing "this will save money" without a mechanism: whose time is saved, which budget line shrinks, cash-releasing or not?
• Transformation / improvement teams. Programme managers running change projects. They often control the delivery capacity your deployment needs, and sometimes the digital budget — natural allies for anything needing pathway redesign.

Field note

The classic trap in this cast: a brilliant clinical champion who cannot buy. Months of warm meetings with an enthusiastic consultant feel like progress, but enthusiasm is not budget, and a champion without a route to the economic buyer is a friend, not a deal. Test early and kindly — "who would actually sign this off, and will you introduce me?" A champion who can't or won't broker that introduction is telling you something important about the opportunity.

Voice from the field

"Some of them are doing a great job of partnering with us, others are still telling us what to do. Regardless of size, I'm happy to work with anyone as long as they're a good partner."
— Rachel Dunscombe, then CIO of Salford Royal NHS Foundation Trust, CIO UK (2017)

The craft is multi-threading: building relationships with several of these in parallel rather than betting on one contact. The NHS cast has unfamiliar titles, but the discipline is general to all complex B2B selling — and it is a habit, not a talent: from your first deal, make "who else needs to be in this conversation?" a standing question.

4. How the NHS buys: procurement routes and compliance gates

Public bodies cannot simply pick a vendor they like; they must follow public procurement law. Learn the concepts cold and look up the current numbers — interviewers test for the mental model, not memorised figures.

The legal frame

Since Brexit, UK public procurement no longer runs under EU OJEU rules. The Procurement Act 2023 (in force from early 2025) is the governing regime for goods and services; above-threshold opportunities and awards are published on the Find a Tender service, with Contracts Finder covering lower-value notices.

(Both portals are free to browse. Reading real tender and award notices there is the cheapest first-hand market education available — and, as section 9 argues, very few candidates ever bother.)

A separate NHS-specific regime, the Provider Selection Regime, governs how NHS healthcare services themselves are commissioned — know it exists so you don't conflate it with buying software.

The three routes

1. Frameworks

A framework agreement is a pre-tendered catalogue: a public body runs one big competition to admit suppliers, and buyers then purchase via a call-off (an order under the framework's pre-agreed terms), sometimes after a mini-competition among framework suppliers. Faster and legally safer for the buyer than a fresh tender.

Names to know:

• G-Cloud (the Crown Commercial Service framework for cloud software — the workhorse for SaaS into the public sector)
• NHS Shared Business Services (SBS) frameworks (a DHSC–Sopra Steria joint venture whose frameworks are widely used across the NHS, covering many categories including digital health)
• NHS Supply Chain (consumables, devices and equipment into trusts)
• regional procurement hubs

Seller's implication: "Which frameworks are you on?" is a first-meeting question. Not being on one doesn't kill a deal, but it removes the buyer's easiest route.

Field note

Framework listing is not revenue. Plenty of suppliers celebrate getting onto G-Cloud or an SBS framework and then watch nothing happen, because a framework is a hunting licence, not a pipeline — buyers still have to choose you, and demand still has to be created deal by deal. Treat the listing as the removal of a blocker at the end of a sale you still have to run from the front.

2. Tenders

For larger requirements, the buyer publishes an open competition — historically via OJEU, now via Find a Tender — with a formal document set: ITT (Invitation to Tender), sometimes preceded by an RFI or PQQ/SQ (pre-qualification/selection questionnaire), scored against published quality-vs-price criteria.

Seller's implication: tenders are won before they are published — vendors who shaped the requirement during pre-market engagement write bids that fit; those who first hear of the deal at publication are usually column fodder. If you have ever answered a structured questionnaire under deadline — a grant application, a formal bid, a compliance return — the mechanics will feel familiar; the craft of shaping the requirement beforehand is what this module and module 04's discovery skills teach.

3. Direct awards and below-threshold purchases

Direct award most commonly means calling off a framework (like G-Cloud) without further competition — the legal competition happened when the framework was set up. Separately, below certain value thresholds, or in specific permitted circumstances, a buyer may purchase without full competition at all — small pilots sometimes start life here.

Thresholds are revised periodically — the durable knowledge: low-value purchases can be quick and direct; above threshold, expect competition or a framework route; never quote a threshold figure in an interview without checking it that week. This is why pilots and first deals are often deliberately sized small: they fit the fast route.

The compliance gates

Separate from procurement law, NHS digital buyers apply standard assurance checks. These are gates you must pass, and — better — assets you can arrive holding:

DTAC

DTAC — the Digital Technology Assessment Criteria: the NHS's baseline checklist for digital health technologies, covering clinical safety, data protection, technical security, interoperability and usability/accessibility. The NHS's standard due-diligence questionnaire; a vendor with a completed DTAC pack shortens every deal (the DTAC was refreshed in early 2026 — check the current form before quoting its structure).

DSPT

DSPT — the Data Security and Protection Toolkit: an annual self-assessment that any organisation handling NHS patient data must complete (its underlying framework has been evolving — check the current form). For a vendor, close to a licence to operate.

Clinical safety standards DCB0129 and DCB0160

DCB0129 applies to the manufacturer: clinical risk management on your product, a hazard log, a clinical safety case, and a named Clinical Safety Officer (a suitably qualified and experienced clinician). DCB0160 is the mirror obligation on the deploying organisation (both standards are under national review in 2026 — check current versions).

Seller's implication: the trust cannot complete its DCB0160 work without your DCB0129 artefacts — turning up with them is a differentiator; not having them is a stopped clock.

Medical device status: MHRA, UKCA/CE

Software that diagnoses, predicts or drives treatment decisions is likely software as a medical device: registered with the MHRA, carrying conformity marking — UKCA for Great Britain, with CE marking still recognised under transitional arrangements (deadlines have shifted; check current status).

Devices are risk-classified (Class I up to Class III), and classification drives the depth of conformity assessment; modern EU rules push most clinical-decision software above the lowest class, and UK device regulation is under reform with AI-as-medical-device an area of active MHRA work.

Seller's implication: know your product's intended use, classification and marking status — the buyer's first serious technical reviewer will ask.

Interviewers aren't testing recitation — they're testing that you know these gates exist, what each governs, who cares about which, and where to look details up (NHS pages for DTAC/DSPT/DCB, MHRA guidance for devices, Find a Tender for the procurement record).