Zoe, a startup founded by doctors and researchers out of London and Boston, made its name during the pandemic with a popular — dare we say viral? — self-reporting Covid-19 app. Embraced both by consumers and researchers, it provided early data into how Covid-19 spread and the symptoms associated with the initial infection and its lingering after-effects (Long Covid) — insights that were hard to come by virtually anywhere else.

Then as the virus moved from pandemic to endemic and attention shifted to other ways of tracking, Zoe also shifted, back to its original, pre-Covid mission: using self-reporting tech to track and build a nutrition study of the microbiome, and to provide personalized insights to individual users of its app based on their reporting of what and how they eat and the wider insights gained from the research.

That app is now is taking the next step in scaling its operations, as it looks to onboard 250,000 people off a waiting list it’s had going for over a year: it’s announcing £25 million in funding (around $30 million at today’s rates), an equity investment that CEO Jonathan Wolf said values Zoe at £250 million ($303 million).

U.S.-based venture firm Accomplice is leading the round, with previous backers Balderton Capital, Ahren, Daphni, and new backer L Catterton also participating.

The funding comes on the heels of a Series B of £48 million, which closed with a $20 million injection in May 2021 (a number that bumped up to $25 million after we published our story). Since then, it has onboarded some 50,000 active paying users, alongside the nearly 5 million people who have self-reported nutritional data free of charge. Wolf said that most of the last round in still in the bank; the latest funding is an opportunistic extension, made to shore up capital in the face of potentially stormy waters in the markets next year.

“We are seeing a big acceleration in customer demand so what we want to do is scale our business significantly to be able to meet that demand,” Wolf said. “Given the tough economic environment, we wanted to make sure we have the capital to do this. In fact, the vast majority of the $25 million raised in the last round is still in the company.”

And alongside the venture round, it’s also hoping to bring on more interest through a crowdfunding campaign. Taking into its wider community of interest that Zoe says numbers 2 million (this likely includes many who follow Zoe and have provided contact details by way of its previous Covid work, but it also has a podcast and related content) it will be running a campaign for investing via crowdfunding site Crowdcube. That will open on December 13 to that community and a day later to Crowdcube users, and then to the public at large, with investing starting at £10, “at the same share price as ZOE’s private investors.”

In addition to onboarding more users waiting to join, the plan also is for Zoe to expand beyond diet.

“We are looking to deepen our research into nutrition, the gut microbiome, sleep, mood, activity and other factors to improve long-term health,” said Wolf, who co-founded the startup with Professor Tim Spector of King’s College London and George Hadjigeorgiou. It plans also to expand research and studies in the ZOE Health Study; with a greater number and variety of health and lifestyle studies advocated by our contributors and scientists that will cover areas like menopause and more.

While it does not have plans to build any of its own hardware — it does send out glucose monitors and other physical products as part of its assessment (see below) but these are not made by Zoe — it will be making more integrations with hardware already out in the market, an approach that is essential for triangulating data and getting more complete pictures of each individual reporting in which is essentially a big data analytics exercise.

“I don’t see us dong anything in hardware. So many are already in this area and it’s exciting to take inputs from a variety of them. No single measure is more important or determines something. It will take a combination,” he said. “In the future we’re excited about integrations with Apple Watch and more.”

The reason for the slow movement in bringing those waiting off the list is because of the process involved in doing so — one reason for the funding injection to speed up how it scales.

The 50,000 active users it has have opted to pay £299.99 initially to get a test kit to run an initial analysis of their systems. The price is high, Wolf said, because it includes a gut microbiome test, a blood fat test, standardised test meals of muffins (!), real-time blood sugar sensor (CGM) if opted in to our science study; and then in return a gut health report and a personalised insights report.

Users are then given an option to take on memberships at different price points to continue the work and insights. These start at £59.99/month and go down to £24.99/month if you take out an annual subscription.

In a consumer world of health apps that include free, ad-supported options, it’s a big ask for users to step up and put in hundreds of dollars into a service to improve how they eat. Wolf said that Zoe had found that one of the lasting impacts of the pandemic was that there’s been a shift in how the general public regarded their health and the role that their activities played in it.

“I think the pandemic has had a profound impact on how people think about their health,” he said. “They noticed how what they do and how they eat and exercise impacted on a disease. That doesn’t mean everyone is healthier but now more see that it’s not something you wait to do until you’re sick. You have to take responsibility for it and add to it over time.”

Indeed, Covid-19 saw a boom in activity: people were walking, cycling and running more; some were buying more fitness equipment for their homes when their gyms or sports clubs closed; and generally more people were trying to do more not just to be healthy in case they too got hit by the virus, but because they were no longer coming into work every day and found themselves more sedentary by default. Of course, there’s been a big shift back to old pre-Covid ways, but there has also been a lingering shift, which is something that Zoe hopes to play into — not least because of its traction with users during the peak of the pandemic, when it had amassed more than 5 million users in the U.S. and U.K. for its symptom tracking app.

Zoe has naturally conducted a study on its users — 500 of them — and says that those actively following its program for 12 weeks or more said they felt “healtier” for eating following Zoe recommendations. “Their top improvements were; improved mood & alertness, better bowel habits, improved blood sugar & fat, less bloating and better sleep quality,” said Wolf. Some 85% said they had reduced constipation, reduced bloating, improved mood, and reduced diarrhoea, he said; and 70% said they had more energy and less bloating. It’s running a larger randomized study now to get more insights, which will be ready next year, he added.

Additional reporting Natasha Lomas

Zoe, which went viral with its Covid-reporting app, raises $30M to track nutrition and health by Ingrid Lunden originally published on TechCrunch

Verlinvest, a family-backed, “evergreen”, growth fund investor, that has previously funded a few well-known consumer brands like Oatly, Vita Coco, Tony’s Chocolonely, Who Gives A Crap, Pedego, Chewy.com, Hint & others, is getting into the venture game.

After putting around €50m into VC initiatives globally, it’s now embarking on being the kick-starter LP in a new VC fund dubbed V3 Ventures, the idea being to invest up to €100m into founders and brands directly.

While being independent of Verlinvest, V3 will still be able to leverage the former’s international network. The plan is to target startups in the UK, Europe, US, and India, focusing on pre-seed to Series A investments across e-commerce, health and beauty and food and beverage.


Lopo Champalimaud, who previously founded hair and beauty booking platform, Treatwell, after a stint as MD of lastminute.com, is V3’s co-founder.

I spoke to Champalimaud about the move and what V3’s strategy would be: “I’ve got over 25 years of being an entrepreneur and I figured the next 25 years helping entrepreneurs build their businesses,” he said.

“With V3 we plan to invest in consumer-focused companies, be global, and very much focus on ESG, because that’s where consumers are. It’s really about trying to think about how the consumer evolves and to remain at the forefront of that.”

V3’s Indian deals will be led by Arjun Vaidya, who sold the D2C ayurvedic medicine brand to the Dr. Vaidya’s brand.

To date, V3 Ventures has already invested in UK-based personalized cat food brand Katkin, US skincare startup Revea, and French supplement experts Cuure.

V3 Ventures launches to put €100M into startups in health, beauty and food by Mike Butcher originally published on TechCrunch

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Build for the future now with Mammoth Biosciences and Mayfield by Matt Burns originally published on TechCrunch

I’ve been tracking PsycApps, a startup that came up with a gamified mental health game ‘eQuoo’, since 2016, and this company – and its founder – is nothing if not persistent in ‘pivoting into the wind’. The last we heard it had been approved by the UK’s National Heath Service and was even distributed by Unilever. And, of course, the after-effects of the COVID-19 pandemic has only created a greater need for startups addressing mental health.

But now it is winning approval from the investment community in the shape of a $1.7 seed capital raise from US-based Morningside Ventures.

Describing itself as an ‘evidence-based gamified mental health game for teens and young adults’, eQuoo is now aiming its platform at the 50% of teens and tweens who self-report struggling with one or more issues of mental health.

PsycApp’s platform offers a mental health intervention game aimed at higher education institutions, many of which are now legally obliged to take care of students’ mental health. And because eQuoo has gone through clinical trials, it’s securing contracts with schools that need that validation in order to offer it to students. In theory, this means that any other platform trying to do the same thing will meet a barrier to entry into this market.

In a statement, Stephen Bruso of Morningside Ventures commented that low engagement in mental health apps is a problem, but he thinks eQuoo has cracked the model: “Digital health interventions will be critical in the way that our society addresses the second, ongoing pandemic of mental health issues. However, designing these interventions to maximize long-term engagement and outcomes will be critical to making a difference. Silja and her team have shown robust engagement and outcomes data in large clinical studies.”

Clinical Psychologist and Founder Silja Litvin – together with Co-Founder Vanessa Hirsch-Angus – points out that 70% of 16 to 28-year-olds are casual gamers, hence why she eQuoo has had staying power amongst young adults used to the gaming mechanic.

eQuoo’s EdTech appeal – it says – is that secondary schools, colleges, and universities are legally required to keep their students healthy, and that increasingly means mental – as well as physical – health as well. In the UK, Ofsted, the UK’s education regulator and schools and colleges assessor, has made it a requirement for schools and colleges to include a ‘resilience and personal growth program’ within their curriculum before they can achieve a top rating.

eQuoo claims it is the only tool covered by Ofsted that has clinical trials ‘proving positive impact on student’s resilience, anxiety, and depression,’ it says.

Regional College and Paragon Skills are two of eQuoo’s newest clients, covering nearly 20,000 students and apprentices in the UK.

Speaking to me over a call, Litvin said the startup had gained traction after switching from a short-term game to a long-term one, a move which tipped the balance for Morningside’s investment.

“We’ve done a complete reboot of the game, adding multiple stories, an in app arcade, and an in-app chat bot that gives you feedback on your well-being. We went from five weeks to 52 weeks. We have an in-app arcade with many games and many exercises that are all mental health related,” she told me.

“With this funding, we’ll make sure that it never ends. You could potentially use the game for the rest of your life if you wanted to, which is not an issue because it’s also in the domain of personal growth. So it’s not just about addressing mental health.”

I put it to her that selling into the education market is notoriously difficult, especially for startups.

She countered: “Ofsted just published an update that said if a school wants a full rating, it needs to have a resilience and personal development product program in place. We are the only evidence-based, indefinitely scalable product made specifically for that youth age bracket, that has clinical trials to prove its efficiency in resilience and personal development… Schools are scrambling to find a programme and most of the programmes aren’t evidence based and aren’t scalable, as eQuoo is.”

She added that Moningside has lines into “all the major universities in the US” which will help it to scale in North Amervia.

Litvin also added that the company had had to “run on fumes” for a while before securing the Seed round: “We scaled down. We didn’t pay ourselves for quite a few months. With this money, we can go into growth mode.”

Healthcare startups often face unique challenges — something Well Health founder Guillaume de Zwirek understands. Together with Freestyle Partner, Jenny Lefcourt, the two will speak on the strategies used by de Zwirek as he built and scaled WELL Health into a leading healthcare startup.

This TechCrunch Live event opens on August 31 at 11:30 a.m. PDT/2:30 p.m. EDT with networking. The interview begins at 12:00 p.m. PDT followed by the TCL Pitch Practice at 12:30 p.m. PDT.

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As developed-world populations increasingly get older, healthcare is being rapidly digitized and “platformized” in order to meet the huge scale of change heading our way. I recently covered how Cera in the U.K. just raised $320 million to shift monitoring of patients into the home rather than over-flowing hospitals.

Now another startup aims to create an almost “gig-economy style” platform for people providing live-in care to the elderly, this time in Europe.

Marta, the European digital platform for live-in care, says when people try to arrange this kind of care for their elderly relatives, there are up to six intermediaries involved, and four out of five placements fail. Marta’s solution is an AI-driven matching platform where carers can be found for live-in positions. I guess you might call it UpWork for live-in care?

It’s now raised a €6.6 million seed round led by Capnamic, alongside co-lead Almaz Capital. Ithaca, GMPVC, SumUp Impact Fund, Verve Ventures and angels also participated. Existing investors such as Christian Vollmann, Johannes Schaback, Laura Esnola, Dr. Steffen Zoller and Julian Stiefel also participated.

The startup plans to now scale up in its European markets of Germany, Poland, Romania and Lithuania.

The market it’s addressing is an €18 billion market in the DACH region alone.

Given that Germany alone has more than 4 million people seeking at-home care and there are only 280,000 caregivers able to do this, the market is sizable.

Marta’s says its algorithm-based marketplace enables matchmaking between care seekers and caregivers, increasing transparency and a person-to-person experience.

“There are hundreds of examples of how elderly care can go wrong and it’s almost impossible for humans to accurately predict placement success because it’s just so many data points. We have seen how difficult it was to organize care with our grandparents. Aging is a normal process and should not pose a major problem. We believe that we can leverage technology significantly to help elderly people and their families as well as the caregivers,” said Jan Hoffmann, co-founder of marta in a statement.

Marta’s founders, Philipp Buhr and Hoffmann started marta in 2020 after having problems finding carers for relatives.

“Marta has created a transparent marketplace where it connects caregivers directly with families seeking care. At this point a truly unique approach based on digitization. We have been following marta for the past months and are impressed by the technology and traction the team has delivered. Most importantly, we are excited about the teams’ enthusiasm for solving a paramount societal problem,” added Jörg Binnenbrücker, founding partner at Capnamic.

Meet 28: A U.S.-based femtech startup founded by a wife and husband team that’s scored $3.2 million in seed funding in a round led by Thiel Capital with a fitness & wellness pitch that aims to connect women to the hormonal phases of their menstrual cycle for physical and emotional gain.

The startup is drawing on recent popular science that suggests there may be benefits for people who menstruate in adapting their workouts, nutrition other types of wellness-focused activities to the hormonal changes they experience each month, through their natural cycle.

The founders were bootstrapping prior to scoring backing from Thiel Capital. Others investing in the seed round include Learn Capital, Steel Perlot, and some unnamed private angel investors.

“A lot of women I know were experiencing painful periods and other hormone related symptoms. Women were tired of the pill and the negative impact it’s had on their brains and bodies. They were getting off it in droves and looking for natural alternatives,” says co-founder Brittany Hugoboom, discussing her inspiration for starting the business in a call with TechCrunch.

“Many women voice experiences of being dismissed or even gaslit by their doctors who would just tell them it was all in their head. And most alarming of all it became crystal clear that most women are totally clueless about their cycle works. And it’s not their fault because most women don’t get a lot of sex education. So the idea was born from those problems — we want to democratize the science of hormone and menstrual health. And provide women everywhere with tangible tools to physically and emotionally flourish.”

Hugoboom, who is a model as well as an entrepreneur, says she originally had the idea over three years ago but only started filming content for the program around 1.5 years ago, to prepare for a product launch.

The team is kicking things off now by offering free “cycle-based” fitness and wellness programs — which are soft launching (on the web) today, starting with a focus on gaining users in the US market. (NB: Android and iOS apps are in the works and slated to launch soon, in a month or so.)

28’s product takes the form of daily exercise videos, nutritional profiles — and “science-based emotional insights”, as its co-founder tells it — which are pitched as customized to the user’s cycle (and, at the least, that looks like savvy marketing which could help the startup stand out in a very packed fitness/wellness space).

The fitness/wellness program is geared towards four distinct cycle phases related to the female reproduction system’s hormonal fluctuations: Namely, the period itself, when hormone levels (and potentially energy) are low, as the body sheds the uterine lining it built up over the cycle to prepare for the possibility of a fertilized egg; the follicular phase, as the cycle starts again with hormones like estrogen and testosterone rising to encourage the release of a new egg; ovulation, when an egg is released, the window of fertilization opens and sex drive (and energy) is high; and the luteal phase, before the next period begins, when progesterone dominates and women may experience associated symptoms like PMS.

The startup classifies these phases into a low energy, self-care-focused “restore” phase; a replenishing, muscle-growth-focused “awaken” phase; a positive, high energy “perform” phase; and a winding down “balance” phase — to get an idea of how it’s configuring workout and wellness content to the user’s cycle.

The four hormonal phases of the cycle 28’s program is targeting (Image credit: 28)

“The great thing about 28 is that we’re incorporating a lot of different types of functional movement during different parts of your cycle,” says Hugoboom, suggesting there are both physical and emotional benefits for women in aligning their training, nutrition and other lifestyle factors with their cycles.

“So, for example, when it’s your menstrual phase you’re going to be doing more like a yin-yoga stretch detox. You’ll start doing more pilates-based workouts in your follicular phase. Ovulation you can do the hardcore kickboxing, circuit-training. And then you kind of go back down — but you ebb and flow with your cycle. So I think that’s what makes it really unique.”

She also emphasizes that while fitness is a big focus for 28 it’s just “one component” of a broader ‘holistic wellness’ play.

“When they log in it’s going to show them a workout of the day they can do, it’s going to show science-based horoscopes on their emotional insights, it’s going to show different nutrition you can have during that time that’s better for you — like maybe that time of the month you need more salmon or omega 3s and during another time of the month you need more iron. It depends on your cycle but it gives you all that information,” she explains, fleshing out how the product looks from the user point of view.

It’s worth noting that 28 is not (currently) providing a period tracking app itself (there are of course plenty of those already). Nor is it offering any hardware or other technology for women to actually track their hormonal levels, as some other femtech startups are. All 28 users need to do to get content configured to their cycle is to input the first day of their last period. (If a user doesn’t currently have a period, say because they’re pregnant or on the pill for example, the startup suggests using the lunar cycle as an alternative.)

Given that approach to on-boarding, it’s clearly only going to be able to approximate the hormonal phases of each user, since cycles can vary in length and regularity — which suggests there’s a limit to how close to the “science of the cycle” it can really get. (And talk of ‘detox’, or indeed ‘science-based horoscopes’, will surely get the average scientist hard-cringing.)

But a single data-point method is the obvious choice if you’re gunning for maximum consumer uptake, ease of access and scalability. (An FAQ on 28’s website also notes users can adjust the date point “as needed if future periods come late or early by updating your cycle in your profile settings”.)

Hugoboom does hint that the team is looking at developing additional technology — to boost personalization. “Right now we’re not a cycle tracker — but we are working on technology to make it more personalized and accurate,” she suggests.

Discussing 28’s overall approach to fitness and wellness, she says her experience of over-training — and associated injury issues — in her twenties, when she was routinely racking up six hardcore workouts a week, led her to seek out different trainers with a more “prehabilitative” approach, focused on injury prevention. And that philosophy has fed into 28 — with the website describing its “method” as “a rejuvenating, stability-based approach to feminine fitness designed by supermodel trainers and medical experts to work with your natural cycle”.

Co-founder Brittany Hugoboom (Image credits: 28)

While 28’s first wave of customized lifestyle content is free to consume, it’s clearly not free to produce which could raise privacy concerns as there is the question of what happens to user data? The startup is alive to these concerns — and an FAQ on its website claims “we will never sell your data” (although targeted advertising may entail the sale of attention, rather than the actual user data itself, so privacy claims that frame the issue as all about the sale of data bear close scrutiny, at the least) — while lauding the “support of patient investors who share our vision”. (But, well, even very patient investors will want a return eventually.)

“We’re not going to be doing any third party advertising that has to do with selling user data,” says Hugoboom when asked about wording in its privacy policy that could imply it’s leaving the door open to monetizing user attention, such as via targeted advertising.

“We’re not doing any monetization that way whatsoever,” she reiterates when pressed for confirmation that the startup won’t be participating in monetizing user attention via ads. “The data we collect is strictly confidential and only used for the purpose of providing a customized user experience.”

So how, then, does 28 intend to monetize the product — assuming it’s able to scale usage as hoped? (She says its goal is to get to a million users in the next 12 months.)

“Right now we’re a freemium model and luckily our investors support that decision because we want to get as many women in line with their cycle as possible and learning about their cycle — but when we do monetize in the future it’ll likely be through premium content and physical products,” she suggests, hinting at a possible subscription plan ‘premium’ option down the line.

“We have some R&D on a physical product right now in development that will go with 28,” she adds, declining to specify exactly what kind of kit it’s working on. (It’s not hard to imagine the wide range of products that could be offered for sale to a community of active, health-conscious women — not least supplements which the product may simultaneously be suggesting a user ‘needs’ at a given point in their menstrual cycle.)

Who is the typical 28 user? The service is being geared towards women of any age, per Hugoboom — and is generally aimed at “holistic, health-conscious” woman — but she suggests young 20s is “probably” the primary demographic — as they may be at an age where they’re looking for a natural alternative to hormonal contraception.

Is she comfortable building a business out of the US that’s focused on women’s health — and processing data about their reproductive cycles — at a time when women in the country can face stark legal consequences for trying to access health services like abortion following the Supreme Court decision to overturn Roe v Wade? The decision, earlier this year, led to a number of states banning abortions and means pregnant women in affected regions of the US can risk prosecution for seeking an abortion or if they lose their babies and authorities suspect a termination is not a natural miscarriage.

“We’re not selling any user data so I don’t think there would be an issue. It’s just women learning about their natural cycle and how they can benefit themselves so I don’t really think there’s any conflict there,” she responds on that, adding: “We talked to our lawyers about it a couple of weeks ago, when the decision [to overturn Roe v Wade] came out, and realistically it would be very hard [for state prosecutors to subpoena data that could pose a legal risk to users].”

We were also curious about 28’s choice of lead investor.

Peter Thiel, whose fund Thiel Capital is leading its seed, may not seem the obvious choice of backer for such a female-focused business — given certain (infamous) libertarian views, expressed in an essay some years ago, when he implied that the enfranchisement of women was bad for democracy. But Thiel’s interest here is perhaps a measure of the rising value investors are, at long last, beginning to place on women’s health startups — as the white-male-dominated VC class is, seemingly, starting to cotton on to the scale of the opportunity to sell stuff to half the world’s population.

Hugoboom says the seed investment from Thiel Capital came about after her husband (and her co-founder) got an intro to Peter Thiel through a mutual friend. “While I can’t speak for him I think the idea of creating a whole new category in women’s health was what intrigued [Thiel]. Like, why hasn’t anyone done this this way was the general feeling?”

“I think he’s a brilliant investor and he’s known for investing in people solving difficult problems so I’m excited to have him on board,” she adds.

Sajith Wickramasekara co-founded Benchling to improve laboratory data collection and collaboration. Since its 2012 founding, the company has grown to a valuation of $6.1 billion. Wickramasekara will join TechCrunch Live, along with Benchmark general partner Miles Grimshaw, to discuss its recent acquisition and growth.

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UK health tech startup, Babylon Health is pulling in its horns in its home market, blaming challenging global and macroeconomic conditions for the termination of a couple of multi-year contracts it had inked with two NHS Trusts in England in recent years — including one from the start of 2020 that had been trumpeted as a ten-year partnership with the Royal Wolverhampton NHS Trust (RWT).

Another contract, with University Hospitals Birmingham (UHB) NHS Foundation Trust which dates back to 2019, is also being ended — in that case at the request of the Trust itself — with the service slated to terminate in October.

Both NHS Trusts were contacted for comment. The contract terminations were reported earlier by the Health Service Journal.

At the time the Wolverhampton tie-up was announced (January 2020), Babylon suggested its digital health services would be touching as many as 300,000 patients across the city (although it’s not clear how many actually used its digital-first services). Last year, in an apparent expansion of the arrangement, it signed up around 7,000 patients to what was billed as “an integrated digital care service”, focused on its Babylon 360 service — targeting a potential reach of 55,000 patients at nine GP practices.

Speaking in a telephone interview with TechCrunch, Babylon Health’s general manager for the UK, Tim Rideout, fleshed out the company’s reasons for pulling the plug on what it had thought would be both a a long term and wide-ranging partnership with the Trust, using digital tools to try to better integrate primary and secondary healthcare delivery to improve access, boost care quality and — the hope was — drive efficiency savings.

But he said the economics did not pan out as Babylon had hoped.

Not economically sustainable

“We entered into an agreement with [the Trust] that would start with improving performance of primary care as a way of reducing secondary care costs — because, effectively, if you’re got a really good primary care service the evidence is really good that downstream costs reduce.

“But — I think you’ll see this across the NHS with a lot of different private companies now — the economics of the contract were really tight because of the funding pressures that the NHS is under. And those funding pressures have just grown since we entered into the partnership. And then, for us, capital is becoming more expensive. It’s becoming more expensive to raise capital for development — so you have those two things coming together.

“So we reviewed the position a few months ago and what we concluded was it just wasn’t economically viable for us to continue with the partnership,” he said, adding: “The work that was required to develop the service in a way that integrated with their key operating systems, we just wouldn’t be able to make that economically work. So we reached an agreement with RWT that we would cease the partnership.”

The ending of the contract with the RWT won’t mean the service is withdrawn immediately, per Rideout — who said Babylon will work with the Trust to continue to serve the ~7,000 patients signed up to the Babylon 360 service until it finds a new digital provider for them to transition to.

“NHS finances are — every day — becoming more challenging,” he added when pressed on why Babylon is ending provision of a service it only launched a year ago. “The government pay award that’s been announced for clinical staff is only going to be part-funded by the Treasury so the NHS itself is going to have to find a chunk of money to fund it. And, for us, capital has become much more expensive since that launch.

“In the original context we were prepared to play the long game and try and make it work — but the way things are now, the cost of capital now, the pressures on NHS funding, we just concluded we wouldn’t find a way of making it work economically.”

As regards UHB, Rideout said the Trust gave Babylon notice last month that it plans to end the ‘virtual’ A&E contract the pair had signed back in 2019, which saw Babylon offering AI-based triage as a first port of call for patients with an urgent healthcare need, with the goal for the Trust of reducing unnecessary visits to A&E.

In that case, he pointed to an NHS decision to prioritize a 111 urgent help service to explain the Trust’s decision to shutter the contract for Babylon’s AI-based triage. (The NHS 111 service offers a web-based symptom checker or lets patients ring a phone number to speak to a fully trained (human) adviser about their urgent medical concern.)

“It’s been superseded with what the NHS is doing with 111,” he said, adding: “It’s really down to an issue of deployment — they’re deploying it in a way that’s very similar to what we did with Birmingham for Ask A&E… So we decided not to develop that product any more for the UK market.”

Outside the UK, the Saudi-backed health tech has some 24 million users of its AI-based symptom checker chatbot — and Rideout said it will continue development of the product globally.

GP At Hand

He also said Babylon is not calling time on its other (loss-making) digital healthcare offering in the UK market, aka its “GP at Hand” telehealth-first primary care service — which has registered around 115,000 patients, the majority in and around London — with Rideout saying it will continue to operate that for the foreseeable future.

“Our primary engagement with the NHS is running GP At Hand and we’re absolutely committed to maintaining the GP At Hand service in London,” he told us.

But he confirmed an earlier report in the Telegraph that it will not look to expand service provision in the UK — again blaming the economic downturn but also pointing to particular challenges for Babylon’s approach being economically viable within the context of the NHS funding model.

“We’re committed to running it as is in London but we’re not going to expand it,” he confirmed of GP At Hand in the UK.

“If you look at the percentage of GDP that’s spend on healthcare, in the run up to 2010 that was increasing — getting towards Western averages — and then since 2010 it’s diminished… So year-on-year the levels of UK funding compare, every year, less favorably with some of those other countries,” he added. “The payer systems are [also] very different. I think the UK system has innate economic challenges hard-wired into it.”

Last month Babylon announced it planned to cut costs by $100M in Q3 — by reducing what a spokeswoman referred to as “non-core activities” — targeting multi-million dollar losses ($402.5M in 2021) which have outstripped its annual revenue ($323M in 2021), although the latter metric was up 4x last year.

Seemingly, the efficiency reductions have included some jobs cuts, as Bloomberg reported last month — although Rideout said layoffs in the UK cuts were limited. “We have reduced the staff numbers by a bit but not by a lot,” he said, saying this process of “tightening up” staffing only  affected non-clinical, non-front line employees.

Babylon’s decision to pull the plug on its service provision in Wolverhampton appears to fall into this cost savings bucket — with Rideout saying it would “definitely” have continued with the partnership if the economics had worked out.

But he suggested the ending of the UHB deal was more a case of changing NHS priorities. “Simply the market changed and with the development of 111 we wouldn’t have continued to develop the symptom checker, simply because the NHS had access to its own free good,” he said on that.

Babylon has faced a bumpy ride since it went public, via SPAC, last October — losing more than 90% of its market cap, with shares cratering in value from trading around $10 to less than $1.

Turning years of hype-heavy claims about its AI-fuelled health tech and digital-first approach as a winning formula for transformative disruption of traditional healthcare provision into an actually profitable and sustainable healthcare service delivery business — i.e. that can survive and thrive in harsh economic realities — remains Babylon’s key conundrum.

Very evidently, its model does not work everywhere. The broader question is whether it can find a service combination (and market configuration) that lives up to billing for patients’ health and delivers Babylon profitability. It’s certainly not there yet.

(Here’s some snap analysis of Babylon’s financials — courtesy of TechCrunch+‘s excellent EiC, Alex Wilhelm: “With Q1 2022 revenues of $266.5M, why is Babylon trading at such a low valuation? Its model is delivering huge growth – the company expects $1BN in revenue this year or more – but at a level of profitability that makes it hard to understand when it will be able to cover its own costs. For example, in the first quarter Babylon’s revenue was stacked against a combined $271.5M worth of costs related to insurance claims, and care delivery. By our eye that makes the company effectively gross-margin negative. Given a general market tilt away from unprofitably growing companies towards those closer to self-sufficiency, Babylon has found itself operating in an effectively 2021 manner in 2022. If its cost-saving plan can help it right its income statement this year, perhaps it can recover some of its value. But it has a long way to go.”)

“What we’re trying to do is be even better at prioritization — be, kind of, ruthless at focusing on the things where we can make a real difference,” is how Rideout sums up the company’s challenge.

Despite a pressing need to shrink its own costs, it seems notable that Babylon is sticking by the loss-making GP At Hand service in the UK — at least for now.

Possibly that’s a vanity play — given the service won it high profile publicity in its home market when the (now former) health secretary, Matt Hancock, signed up as a patient. (And Rideout is quick to point out it’s the fastest growing GP practice in the UK, while also touting high patient satisfaction rates.) But shuttering such a flagship service in the middle of a UK primary care access crisis would generate the polar opposite of good PR for Babylon. So maybe it’s keen to avoid its brand taking that kind of hit.

In the meanwhile, it is lobbying for the government to change the NHS payment framework to better incentivize private providers. And, clearly, it has more leverage on that front if it’s actually operating a patient-facing service.

“We think the service we run — well, we know it, because the evidence tells us — that the model we run saves money downstream,” said Rideout of GP At Hand. “Some peer reviewed work we had done shows that our patients use secondary care between 18% and 35% less than a similar cohort of patients in the NHS. So we know our model works but frankly the [NHS] framework doesn’t adequately fund it. But we’re not alone in that — a lot of private companies have had to make decisions about what they do or don’t do in the NHS because of the economics.

“We see across the whole of the system primary care is under significant pressure — so… [really the question is] what are government going to do about making these services sustainable?”

Asked about the scale of Babylon’s GP At Hand losses in the UK, and whether it can actually sustain them for the long haul, he told us: “We do a lot of economic modelling and we can sustain the position — so we’re prepared to continue to provide the service with the level of challenge it presents but what we can’t do is expand it. And ideally we would… So if we were incentivized we would expand and everyone would win — the service would save money and patients would have great access to primary care but the economics just don’t allow us to do that.”

“The UK market is really important to Babylon. GP At Hand is really important to Babylon. And our intention is to continue to develop it and at the point which the economics are right we will go back to expanding it,” he added.

In recent years Babylon has been increasingly focused elsewhere — on the US market — where healthcare privately delivered.

Rideout’s comments suggest the US insurance-based healthcare model is a better fit for Babylon, enabling it to achieve the kind of deeper integrations it apparently requires to stand up CEO Ali Parsa’s claims that its AI-driven tech is able to generate cost reductions of 70%. (Although he denied it’s lobbying for the UK to abandon publicly funded healthcare and switch to a US-style insurance model.)

“In the US we’re serving the whole population and their whole needs so — effectively — because we’re able to support patients in staying healthy and get treatment sooner what our model demonstrates is their downstream costs were saved so the model is absolutely economically viable when you look at the whole patient journey and the whole population. The problem for us in the UK is we receive the money for primary care — we’re not managing the whole budget — so we don’t benefit from the savings that make the whole model viable,” he said.

“We’re continuing to look at developing the UK market. What we have to do is find a way of making it work within the economic frameworks that are established and lobbying for changes to those frameworks. We’re continuing to make GP At Hand as efficient as it can be. At the point at which it stops losing money we would be able to expand it again — so I think at the moment what you’re seeing Babylon do is regroup, focus on key priorities and then go forward — and that includes the UK.”

“It’s not about private or public [funded healthcare], it’s about the way the economics are structured in funding primary care services and funding services in real terms. There needs to be incentives for services such as ourselves to help the whole system save money,” he added. “At the moment the system isn’t geared up for that.”

When She Matters co-founder Jade Kearney launched her company while a graduate student at NYU, she was looking to train psychologists to be culturally sensitive to the needs of Black women experiencing postpartum depression, women often left behind or ignored by the medical profession.

Since taking the company to TechStars at the end of last year, she has expanded on that idea to include a variety of problems related to Black women and postpartum health, partnering with healthcare systems. Today, the startup announced a $1.5 million pre-seed investment. Her eventual goal is to expand the platform to include other groups of underrepresented women, who have had similar experiences getting postpartum care.

She said that the original focus of the app was on postpartum anxiety and depression in Black women, and connecting these women with culturally sensitive therapists, but she saw an opportunity to help across a range of postpartum issues.

“We’ve since changed to focusing on [training] healthcare networks and independent healthcare practitioners. And we’re focusing on postpartum comorbidities. So that includes postpartum mental illness like anxiety and depression, but also preeclampsia and hemorrhaging, which are two of the biggest postpartum comorbidities that Black women experience,” Kearney told TechCrunch.

She says the new approach has enabled the company to move beyond just training individual therapists to healthcare networks where they sign up the entire network for cultural competency training, and these tend to be much bigger deals. “On average, when a hospital works with us, that contract is about $1.2 million and my my favorite aspect of this is that we do not charge Black moms for therapy,” she said.

The way it works is the hospital buys a subscription to the app and gives patients access to it as part of the care package they offer. While moms don’t have to sign up, they have the ability to do so with participating healthcare providers for free.

The company currently has six employees and is hiring with plans to have 15 by the end of the year.

As for the future, Kearney is planning on expanding the app further. “We just want to take the secret sauce that we have for Black women where we’ve made Black women feel comfortable and given them the tools to advocate for themselves, and we want to use that same approach for other folks,” she said.

The company has hired researchers and cultural experts for each one of those other groups  to make sure that they’re giving the same amount of care and authenticity as possible, she said. Upcoming products will include ‘Ella Importa’ for Latina women, ‘They Matter’ for LGBTQ people and ‘Native Her’ for Native American women.

As she told TechCrunch earlier this year, trying to raise money as a Black woman building a company aimed at Black women and other underrepresented groups has been challenging for her, a process that she says left her emotionally drained and physically exhausted. “I feel like so many people don’t believe you. And this is not only white venture capitalists. This is Black venture capitalists who continue the tradition of marginalizing Black female founders because they want to be part of the status quo. I do not have one Black VC on my cap table. I have angels that are Black, but I don’t have one Black venture capitalist investor,” she said.

But she has found plenty of allies along the way, people who believe in her vision and keep pushing her. She said in particular the TechStars experience really helped her flesh out the company, and CEO Maelle Gavet was a real mentor to her, helping her navigate the difficult path to this funding round. She also points to her new board members including Alexander Packard, president at Iora Health, who has been appointed her board chair and Eric Ries, Author of The Lean Startup, who is a member of the board, as two people who have helped her get to this point.

Today’s $1.5 million pre-seed investment came from Oxeon Ventures, Chingona Ventures, The Fund and Emmeline Ventures.

Swathy Prithivi started Found with the goal of improving the journey of weight loss. The company quickly discovered a huge demand and rapidly scaled its operations and expanded throughout the United States. The company’s story started in an Atomic incubator. On this episode of TechCrunch Live, we hear from Found’s co-founder and COO Swathy Prithivi and Atomic’s Jordan Kong on raising capital and scaling to meet demand.

We hope you can join the live event on Wednesday, August 10, at 12:00 p.m. PDT. Register here for free!

You can apply for TCL Pitch Practice by completing this application. We’ll select the startups 24 hours before the episode. If you’re selected for one event, you can apply for future events too. We want companies to present more than once, using the feedback provided from previous experiences.

TechCrunch Live records live every Wednesday at noon Pacific Daylight Time. Join the event here. It’s free, and attendees have the opportunity to ask guests questions, participate in Pitch Practice and network with other attendees. The show streams live on Twitter, Facebook and YouTube, but only viewers on Grip get access to the additional features.

Cera, a U.K. provider of healthcare inside people’s homes augmented by a platform that allows carers to monitor a patient’s health and potentially flag problems, has raised $320 million (£260 million) in an equity and debt financing round, split roughly 50/50.

The equity side of the funding round was led by Cera’s existing investor Kairos HQ, alongside the Vanderbilt University Endowment, Schroders Capital, Jane Street Capital, Yabeo Capital, Squarepoint Capital, Guinness Asset Management, Oltre Impact, 8090 Partners, technology investor Robin Klein (of LocalGlobe fame) and others. Cera declined to name it’s debt partner.

The company now plans to expand from servicing 15,000 patients to up 100,000 each day. Ironically, 15,000 patients is the bed capacity roughly equivalent to the 40 NHS hospitals promised more than two years ago by Britain’s ruling Conservative Party, which have yet to be delivered.

The statistic is indicative of how in-home patient care is being radicalized by tech startups that either use remote monitoring, or employ carers to manually enter patient data into apps. Eventually it is likely to make long-term care inside hospitals obsolete, as the home can be just as efficient a place to deliver care.

More than 88% of hospitals and health orgs in the U.S. are estimated to be investing in remote patient monitoring technologies. U.S.-based startups in the sector include GYANT, which has raised $23 million, Neteera ($8.5 million) and Binah.ai ($13.5 million).

Cera’s proprietary system is less tech-heavy, but all the same is clearly on the path toward greater automation, in the same way that Uber and Lyft drivers may one day be replaced by driverless taxis.

The company, which also operates in Germany, delivers care, nursing, telehealth and prescription delivery services in the home, and claims it is 10-times cheaper than servicing a patient in hospital. Staff collect patient symptoms and health data in the home, which is then used to predict deteriorations in conditions before they occur, triggering medical interventions. The company claims this can reduce hospitalization rates by over 50%, and has other benefits, such as reducing patient falls, infections and improving medication and prescription compliance.

With hospitals under strain after the worst of the pandemic, and staff at a premium, it’s likely that these technology-augmented services will take off amongst healthcare providers.

Dr Ben Maruthappu MBE, who launched the startup in 2016, told me: “What we are doing is just mirroring what has happened in other industries, such as ride-hailing or other services that come straight to your door. Most healthcare tech is now graduating to healthcare in the home. We have started with older people as they have a high frequency of care visitors.”

He said that Brexit had a negative impact on healthcare in the U.K., given that as much as 7% of NHS staff are from the EU, but claimed that Cera is able to retrain people from other industries fairly rapidly into healthcare roles. “Over 60% of people we are hiring are from outside healthcare. It’s like when ride-sharing had a breakthrough when it became more accessible to non-taxi drivers,” he said.

Maruthappu added that the company intends to eventually move toward a SAAS model, where it would allow other tech and care providers to use its services.