I made it to the final. I did not get in. Here is what happened next.

Something happened last week that I was so hoping would have a different outcome!

I made it to the final of AI Health Techstars, the global accelerator programme running out of Baltimore. For those who do not know it, Techstars is one of the most prestigious startup accelerator programmes in the world. The AI Health edition specifically is exactly the kind of platform that can change the trajectory of a company like ours.

Sadly, I did not get in.

Being totally honest about what that feels like, because building in public means sharing the moments that sting alongside the ones that go well. Getting to the final is meaningful. Not going further is a reminder that this journey is not linear. I felt sorry for myself, I said thank you and asked for feedback, then I went back to work.

Which brings me to this week. Four things are keeping me busy and all four of them feel like forward motion.

One thing I find with building a company is that the weeks when something does not go your way are often the weeks you move fastest on everything else. This is that week.

Something came out this week that I want to flag, because its relevance extends well beyond community pharmacy.

The 2026 GP Patient Survey was published, and Community Pharmacy England moved quickly to headline the results. 89% of patients said they had a good experience of community pharmacy services. 87% had used at least one community pharmacy service in the last twelve months. Pharmacy is now the highest-rated service across all of primary care, with satisfaction improving year on year.

Community Pharmacy England's chief executive said they will be using this evidence in discussions with Government, NHS England, and national policymakers.

This is the part I want to expand on.

Patient experience data, gathered systematically and presented credibly, is already being used as a policy and procurement lever. Not as a nice-to-have. As active evidence in negotiations that determine funding, commissioning decisions, and political support.

The community pharmacy sector has understood something that the clinical research industry is still learning: if you collect patient experience data in a format that holds up to scrutiny, it becomes an asset in every room that matters. Government rooms. NHS commissioning rooms. Parliamentary committees.

For clinical development teams, the implication is direct. An Inclusion and Diversity Plan backed by properly collected, structured patient experience evidence from underrepresented populations is not just a regulatory document. It is a demonstration of value that travels into access and reimbursement conversations. The NICE submission. The payer meeting. The HTA discussion. Patient experience evidence that meets a defensible standard does not stop being useful once the trial ends.

The pharmacy sector figured this out. Clinical research is catching up.

Source: Community Pharmacy England. Response to 2026 GP Patient Survey. July 2026. cpe.org.uk

Something I want to flag for anyone building a patient data platform or operating clinical research programmes in Europe.

The European Health Data Space regulation is hardening its timelines. Two frameworks are moving in parallel and both have direct implications for how patient data platforms need to be built and governed.

The first is MyHealth@EU, which governs cross-border care. The second is HealthData@EU, which governs secondary use of health data. The secondary use framework is particularly material for any platform collecting patient-reported data for research purposes. When HealthData@EU becomes operational, accessing health data for secondary use across EU member states will require alignment with the interoperability standards, processing environments, and governance frameworks the regulation specifies.

The honest message here is this. If you are building a patient data platform with EU ambitions, the time to align your architecture to EHDS requirements is now, not when the milestones land. The processing environment requirements in particular are not trivial to retrofit.

For Unwritten Health, our consent-based, community-driven model already operates within GDPR rather than around it, which gives us a structural alignment advantage. But the interoperability expectations of EHDS are a separate layer, and one that every platform in this space needs to have a credible plan for.

Source: Uroweb. The European Health Data Space Regulation. uroweb.org/the-european-health-data-space-regulation-ehds

We have just published a new free guide specifically for teams working on patient evidence in Germany.

Germany is one of the most demanding and most misunderstood markets for patient evidence in Europe. AMNOG has been in place for over a decade but the expectation for patient-reported outcomes in HTA submissions continues to evolve. The Joint Clinical Assessment under the EU HTA Regulation adds another layer. And the relationship between IQWIG methodology and patient-relevant endpoints is not something you can navigate without understanding the specific German context.

The guide covers what patient evidence actually needs to demonstrate in Germany, how the German HTA landscape has shifted in the last eighteen months, and where the most common gaps show up in submissions that try to apply a generic European patient evidence approach to a German regulatory question.

Free to download.

Last week on Now Written: Live, I had a really interesting conversation about one of the most persistent and underexamined problems in clinical research: how do you create a representative trial when the study design itself does not adapt to the patient population?

It is a question that sounds straightforward and turns out to be anything but. The barriers are not just logistical. They are structural, embedded in how protocols get written and how sites get selected. The conversation got into the specifics of what adaptation actually looks like in practice, and why the industry's default response, try harder at recruitment, misses the point entirely.

Worth an hour of your time if this is a live challenge in your work.

The people who understand the healthcare system best are often the ones it works hardest to exclude.

Robert Joyce lives with multiple sclerosis, sarcoidosis, chronic pain, and asthma. His daily life is structured around what he calls a 30-minute capacity window. He is also one of the most experienced patient and public involvement voices in Europe, a keynote speaker, and a blogger whose MS writing is ranked sixth in the world.

He is also the man who successfully campaigned to change Irish law so that people on Invalidity Pension could participate in patient and public involvement activities without losing their benefit.

Before he changed it, the system was telling its most knowledgeable patients a very clear message: you can contribute to research, or you can keep your income. Not both.

In this episode, we are going to talk about what it took to change that law, what it means that the same barrier exists across the EU, and what pharma and clinical organisations need to understand about the true cost of tokenistic patient involvement.

This is not a conversation about what good patient engagement looks like in theory. It is a conversation with someone who changed a government policy to make it possible in practice.

Wednesday 22 July. 2pm UK. 3pm CEST.

Thanks for reading. This newsletter exists because I believe the right framing, in the right hands, changes decisions. If it did that for you this week, even a little, that is enough.

Ashish