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Good morning, everyone. Um Welcome to day two of the Asset Innovation Summit. Um I'm sure everybody's almost as excited as I am. Um Not that that's even possible. So we've got an amazing host of speakers today. Um We had a great day yesterday, lots of people from all over the world tuning in and we're gonna kick today off with three really, really inspiring er leaders of health tech um and the future of innovation really. Um So we'll just get straight on with it and I'll introduce our, our first speaker, Professor er Shai Ahmed. Um And this was a bit of a um a scary one to introduce looking at your linkedin bias. So I thought I would just give you the strap surgeon, futurist, innovator entrepreneur, humanitarian, and international keynote speaker. Um So it's a huge pledge to introduce you and we will hand you over to talk to us about the future of surgical robotics. No worries. Thank you so much. Um Matt um Well, congratulations, the whole team. Uh getting audiences from so many countries is a tribute er to what you've achieved so far with as its so well done. So I've been given the task of speaking over the next 15 minutes or so around the future of surgical robots or robotics. Uh, from the confines here of beautiful Cape Town in South Africa. If you haven't been to Cape Town, you should come. It's one of the most gorgeous place on Earth. So do visit if you can. I'm here teaching at the business. Yeah. All right. So, first we'll start off with, let's take a few concepts. Uh right out from the top Digital health was a concept coin about 10 to 12 years ago. And it's a multitude of items within a context of digital medicine. More recently, I'd say in the last three or four years, we've seen the evolution of a new term digital surgery and what does it mean? And so I actually wrote a whole piece on this and you can go look in and see one of my pieces on what I think digital surgery means. So robots is a part of a wider spectrum where we go from analog to digital surgery. And we've been analog for a long period of our lives. It's and recently be technologies to showcase that we can become what are called digital surgeons. First of all, we were more connected than ever before. We are hyper connected with 5 g 6 G7 G coming out fairly soon. And of course, Starlink from Elon Musk connecting the world around high um uh high bandwidth um connectivity we're also gonna be more having more remote collaboration as we're more connected, we are going to be more together. And that means preceptorship training, remote training, remote work. For example, it's where we are at the moment. Of course, I couldn't continue this conversation about putting data and A I in this. And that's revolutionizing medicine as a whole. And we just launched actually a company called quadrivial, the first ever conversation agent in A I for anybody. So do look at quadrivial dot A I uh and register if you wish to use it. And we were looking for partnerships, people can use A I in their clinical workflow that's through for another day. But do look at our work on quadrivial and the agents called agent Q qu. Then of course, there's robots, we sit in the center of this kind of schematic diagram of five different disciplines. And then of course, it's the world of extended reality, the world that I've been living in for a long time, building the metaverse innovation around A R and BR for example. So the robots themselves are one part of a wider remit of technologies and that's for you to remember. It's not just on its own. If you look at the future of the or for example, this was a concept that we built in uh Dubai a few years ago at the World Government Summit asking the question, what does the future or look like robots autonomous er surgery, 3D printing, for example, x rays, CT MRI S all amalgamated in the or where robot is one component of this amazing digital er surgical um operating room. So the thing to think about is robots amazing, very important but one component of explan technologies that really revolutionizing our water medicine and in particular surgery, all of these combined are now working to change the framework, the landscape of what we as surgeons will expect in the future with this wearable um tech, for example, internet medical things, 3D printing, for example A I, it's all going to be encapsulated into the or but also to robotics. What about robots that summarize what that might mean going forward? And here's my kind of description of the five areas where robots are going to be valuable connected. And of course meant that already remote collaboration, data A I driven autonomous surgery with robots. And now the world extent of reality, the three areas I think really worth thinking about the future robots. One is how they're becoming smaller and smaller and what we call micro robots and how we miniaturize everything together. So from going from microscopic surgery, that's, you know, um that's colorectal surgery, for example, or prostate surgery down plastic surgery, ent et cetera. We've gone from major surgery to micro using robots that are now much more sophisticated and much more agile. We've also seen te presence come in. So remote collaboration, avatars holograms, remote training and we'll show that in a while. And of course, this whole robotic surgery allows us to redefine what A I and machine learning will mean in the world of surgery, we'll have much more data. Imagine thing robot as we operate, we collect data intuitive surgical who have now been around 25 years, have collected gigabytes and gigabytes of data around our performance around how operating performance, for example, that or using data could allow us to be more objective about patient outcomes and human performance in the operating theater. So I think it's gonna be much more accurate into establishing how we perform as surgeons. If we look at pre planning. Now, pre prior to surgery, we're now seeing these planning technologies using a RVR for example, in the or allowing you to redefine in 3D mapping. Imagine that going into the robot once you've mapped it, it's in the robot, for example, allowing you to navigate through a surgical procedure. So the XR kind of platforms are now are becoming synonymous and seamlessly integrated into the robot situation in the or actually operating. Imagine a robot having data with navigation tools. This is the hollow eyes, er, some of my friends from er Japan, er Makimoto for time on the surgical field. Now imagine that overlaid of course in a robotic environment allowing to navigate through the procedure, uh may maybe allowing you to dissect the correct planes properly, allowing to take the tumors out on block with resection margins and also avoiding important structures. This is where we head towards training is changing. Robotic training will change. Xr is coming in to majority of surgical training and of course robotic training already. Uh they've been using er X RA RV, excuse me to train the future generation of robotic surgeons. And you've had a whole talk on training before I won't elaborate on the training pathway. And again, we've seen these kind of elaborative tools now allowing to overlay information uh using a number of modalities in the mixed reality division, allowing you to plan things going forward a certain amount of time. But these are now overlaid within the surgical robot. Already, a robot company is looking how they uh analyze and bring those technologies in. Of course, robots are um controlled by human beings. What if, what if if robots became autonomous? What if robots can help us automate our surgery by allowing us to perform better? Of course, I have a Tesla car like a lot of people and I have autonomous driving and I've been in California where you can pick up a taxi. When there's no driver, it takes you elsewhere and it drops you off uh seamlessly without any problems at all. And if you look the other verticals in how other verticals in technology like autonomous driving drive cars, you see the implications of our own profession. What does it mean having autonomous robots, for example? And so we're seeing these amazing examples where we're using A I now to drive change. Imagine in the or you're doing a robotic um um cholecystectomy, we know, for example, the area of concern is around KS triangle. We know that the comac is a risk of damage. And can we objectively use data and A I within the or within the robot system to allow us to navigate more closely? This was some work done in the US where they recorded many vasectomies and then they analyzed that allowed the A I then to establish where the common bar might be and to allow you to avoid injury, warning you about the area you got to avoid. For example, for the first time we've gone from analog to digital surgery. Navigation within the O ri think that's a good thing. Conventionally, surgeries are always written by analog, your intuition, your judgment, making those decisions, but actually may be, we could do a lot better uh with that kind of technology. So what about completely autonomous? Well, here we are. This was a few years ago, the first robot surgeon that performed anastomosis and joined two bits about together using a serum muscular stitch and apparently did better than a surgeon with a good strength, uh tensile strength and of course, no leak. We're not sure about this entirely because this video is quite sketchy. It wasn't reproduced, but it shows you what's possible in the word autonomous robotic surgery. I mentioned miniaturization, microbots and we are seeing to get smaller and smaller and there are a number comes out there um based in Holland and Italy, for example, building microsurgical robots allowing you to do precise surgery. For example, this is of course surgery on the eye. We see the CMR of course, a great company in the UK. Um really when intuitively their patents about 67 years ago, it allowed other robot companies to flourish, bring in new ideas, make the, make robots more cheaper and more affordable and the future of robotics is cheaper, more affordable modular consoles. Um And the whole business model of robots would change, allowing people to use less Capex in the beginning, allow you to buy these robots in a way that's much more er democratizing at the moment, they're quite expensive. So how do robots become cheaper and more affordable in the future? And we've seen of course these robots and CMR have done a great job to fly the flag for the UK. And of course, they're now in many countries around the world. So we're seeing how robots and now be more democratized, becoming cheaper and more affordable as time goes on. Of course, the biggest boy in town is intuitive if you go back 25 years when they did the first robot in the surgical research center, sorry, the Stanford Research Center um when they built the first robot, then we've seen how far we've come prostate surgery was the first one, of course. And now we're doing lots of different procedures across different specialties. This latest one, of course, this is the one that is on a single port allowing to come into a single port into a robot allows many limbs to come out, for example. So this saves more ports. For example, when I was doing the very first seals operations, that single surgery 12 years ago, this is what I needed. I needed a robot like this to do a single port surgery to allow the manipulation. When I was doing colectomies. In those days, it was quite difficult. We had different ports from econ, from er Cydia and others that just weren't fit for purpose. So I'm really glad we're now doing single port robots. For example, I mentioned before going m this is the Mims, for example, tiny plastic surgical robot allowing you to minimally dissect tissues, perform microvascular tomos using magnification. So we've got the extreme of the possibilities of the surgical robot. What about remote work? Let's take you back to the Lindberg operation in 2020 22,000. Sorry where J Morisco from? ERT was in New York and the patient was in Strasbourg in France, having laparoscopic CST. But the surgeon was transatlantic based in New York. First time it was called Lindberg operation. Charles Lindberg was the first person of course to cross the Atlantic. So they called it Lindberg operation groundbreaking. But of course, the connectivity in those days wasn't as good as it is at the moment. So imagine that in 2024 was possible. We now saw about uh in 2017. So in 19, the first surgery operation has been performed on an animal model in China using 5 g connectivity using a robot, for example, and showing seamless way of operating. First time we use 5 g five GS um is super connected. It's high bandwidth download speeds of 2345 gigabytes per second and a latency. Importantly of 0.1 millisecond which is imperceptible to human, human kind of um er brain behavior and vision. So we saw that of course, we're going to collect more data in robotics. And what we're seeing now is the or the robot, everything within it. All the data are being collected, there are black boxes worked by TDA grandchild from Stanford and they create all bring all the data into a black box and then you can analyze if things go wrong. For example, was it the patient? Was the, was it the road box? What happened? We get much more data now having a digi digital dashboard in the or uh company I support and advise called vit po amazing team got what they're doing. They play super high cameras in the or they collect all the data now using A I ALYS and they look at efficiency looking at how you perform and also how their team performs and also looking at things like um movements and efficiency in the or, and now they had to roll out across the world with their A I machine learning company. They're the same team who built um uh what's it called? Amazon. Go, when you go into Amazon store, you take what you want, walk out, they built the computer system for Amazon and now they're using that same technology much better for the Air Point theater. So you see that technology coming in just last week, we saw a how robots now can be trained themselves. So here we are a robot that watch surgery videos, performs with skills of human doctor. What they did in the US at John Hopkins, they trained this robot, watched lots of videos and they let it loose doing some simple task and this is, it is learning, imagine rebel learning from your operations, making you better as you go forward. Last bit is the future. And I have been doing the metaverse for a while now. Imagine surgeons connecting, collaborating globally using web three technology, build the metaverse, using all these technologies we built through Avalon, our, the world's first health metaverse. And this is what we did a few years ago to demonstrate how we could coordinate telepresence. Hi, everybody. Nice. Happy. So the whole lens itself really allows us to reshape the way we connect people. We communicate with people also to be used in teaching and training. Initially, when you put the whole lens on, it feels a bit strained, but actually in a few minutes, it becomes quite normal. It feel as though you're just discussing cases with people in the same room. For example, like we do in normal hospital practice. So three surgeons, three continents three times are connected through their avatars holograms. Imagine that as a presence we're building virtual worlds. Now imagine robotics in virtual worlds in the future. This is our virtual world called AON. It's the world's first half metaverse. In web three, we've launched four worlds. We can now get treatment, get consultations, get rehabilitation and be taught in various education centers. So we're building the future. What I think of health care and metaverse is one part of partel of building in terms of infrastructure. For that last thing to really get this information. Guys, I launched Surgery international about 18 months ago is a free online platform magazine that brings all the news of the world together because I felt one thing was missing in the world of surgery is sharing stories on a global level. So b to please register for surgery International is free. We, we have a lot of stories. We have a whole section for example, on robotics and we ran the first Global Surgical Robotic Summit uh earlier this year in collaboration with CMR. So do join and you look at all the new stories that we can capture from around the world and we have a, a talk surge webinar series where we talk about the latest technologies in surgery. Um, and that's all I have to say for now. Um, I'm just going to stop that share. So Andy Warhol often says everyone has their 15 minutes and that was my 15. Is that right? Matt? Yes. No, that was absolutely perfect. And, and just like, really, just incredible showcase of just, you know, how far things have come in in a, just a relatively short time. And I guess how far we're still to go. Um, I guess from, from all the, the stuff that you've shared there, I guess what, what do you sort of view as being the sort of most impactful or maybe the most important thing that's going to, you know, be most impactful to the future surgical care. Uh It's II think you have to accept A II mean, the genes out of the bottle with the large damage models, of course, for A I is here to come. Imagine if you imagine surgery has been analog for such a long time, right? It's based on two things, intuition and judgment to a large extent, never really data driven. And therefore we can do a lot better with that. Now we're collecting much more data, say with a robot, for example, and also with these new companies producing camera systems to allow you to get more data like vit or others, we're going to have a really rich data source now to collect and then work out hands that objectively train people, assess their performance and assess the outcomes. And of course, it also gives you a mechanism that if things go wrong to go back and say, well, what went wrong at the moment, we, if things go wrong with surgery, we have discussion. We think we know it's not really that scientific. If I'm honest, this could be much better. A way of saying how they oi performed, could it be more efficient? Can we be better? And I think that's the future, it's going to be data driven A I platforms, machine learning allowing us to be better surgeons. No, I think a absolutely. I think it's, it's fantastic. Um, opportunity, II guess maybe just on that topic, I guess with this sort of advent of all these sort of new technologies, you know, hopefully coming into practice and, and being used much more. What, what do you think are the skills that are gonna be most important for future surgeons going forward? And I, and I guess maybe the, the other side to that is what do you think? You know, there'll be perhaps less focus on? Uh, that's a really good question. I think, you know, the young generation of docs and surgeons now they're different to, uh when I trained and, and for the better. Um, then we work excessive hours over 100 hours a week. Was it good? Not really. Did we learn a lot from that? No, they're much more targeted. They were. So the new generation Gen Z or Gen Alpha now, I think we're on now. They're kind of, they want flexible, working part time working, they want to be entrepreneurs, uh they want to have quality of life, family life, all the things I think are important in the long term. So just got to adapt to what's required by the new generation to get the best out of them and also invest time back into them. So I and the MBA teaching um all of Africa around leadership and training, for example. And so we need to teach more of those skills within the surgical framework and training allow them to flourish to be more creative, to bring innovation into their workplace and also to support them through their maturation over a career lifetime. And I think as we have longevity, people live longer, uh people with health plan is bigger. People may, may have more than one career over the course of a lifetime. I want to nurture that we're not one dimension anymore. I think we're multidimensional and bring people into the fray from different perspectives, allow them to flourish. I think we just missed that opportunity so far. Brilliant. Um And I think we've got a question in the chart which right, we have a question in the chat. So um in the NHS where funding is limited and allocation is multifaceted. How can we be sure there is equitable access of robotic surgery for patients. Uh That's a really good question. Yeah, a very good question. Look, same thing happened in laparoscopic surgery if I go back and I'm old enough to, to go back in many cycles. So when laparoscopic surgery came in, um, for colorectal surgery, take example, it took about 10 years or so before the whole mechanism worked. The people, enough people got trained, the there's enough um people in the system, enough robots for it to flourish and then everyone got experience. There's going to be a lag, of course, there is, it's a Capex, much more expensive laparoscopic surgery. Uh A surgery robot may cost 2, 2.5, 3 million, for example, or less for some others. That's a Capex. First of all, um that um makes it difficult for a lot of people. Secondly, is the training a learning and I can see the frustrations in trainees who want to get trained at the moment. It's consultants and senior people. And we have the same problem with the laparoscopic surgery where people who felt they left out, they were just holding a tractor for example. And I get that it's just where we are 1015 years online. This conversation will be um old and it will be disseminated across the system. Um So I it just will take a bit of time for people to understand that the patient themselves will get different levels of treatment until there's enough of them in the system. For example, just a laparoscopic surgery at the time, people who have an open surgery still and then slowly change over the course of time, we have to accept that to learn from what happened. Laparoscopic surgery. Right. No, thanks so much for your time. Uh, I think we'll move on to our next book now. Um, So I like to have a Mike Cullen here, um who is the head of Value and Access Bron UK, who've been a long standing member of a long standing supporter of uh asset. Um So delighted to have you here talking about um your experience. Thank you very much. Hello, everyone. My name is Mike Cullen. I'm head of Value and Access for B BRA in the UK. We are really pleasured to have this slot on the agenda. Hope you're having a great Innovation summit. Um First, I'm gonna give you a video on a bit about the history of a really interesting company that's 100 and 85 years old this year. Bear with me and there you have. Pardon me, a whistle stop tour of uh the Bron History. We were 100 and 85 years old and we wouldn't have got that far if it wasn't for innovation. So innovation really does has powered us to this point as you can see from all the different broad family members. We're still a proudly family owned company and we've only been able to keep that family ownership through the power of growth through innovation all the way back over 100 years to the first catgut suture through all the products you've just seen. There have been really good examples for our company over over 100 100 and 85 years of innovative um for growth to enable better patient care. So where are we today? In, in 2024 we are empowered by technology. So our strategy and our mission is to protect and improve the health of people around the world through sharing expertise and the power of technology. We drive advancements in healthcare. We've been growing, like I just said, at a steep rate and you can't do that without innovative products and services. And as you can see here um that, that's AAA graph that shows uh the growth. Um We've got over 63,000 employees, €8.7 billion. But look how much we invest in R and D because we recognize the need to continually innovate as well as be on top of important topics such as reducing our carbon emissions and we're in 64 countries across the world. So we're on a mission to be a leading medical technology company across health care. Um And the four key pillars for that in the, in the next few years of our strategy period are built around firstly, next step, automation, how do we manufacture as efficiently as possible? Because we are a global organization, you need to be able to make a lot of products efficiently to in order to service all the billions of people around the world. So innovation does not necessarily mean inventing the next disruptive um technology all the time. It can also mean innovation in our factories um as well. Likewise, with additive manufacturing using novel product solutions and design options such as Escala 3d cages and innovative implants. Um The world of material sciences moving AAA rapid pace and developing and testing of first material alternatives for different types of plastic. Certainly in a world where sustainability is at the top of the agenda. This is another area where we're gonna have to innovate if we're gonna continue to grow in the coming decades. Finally, how can we talk about innovation without artificial intelligence? It's on our agenda, like it's on everyone's and therefore we're putting serious effort into developing A I enhanced products, services and processes in order to um you know, make it easier for everyone for the health system to be as efficient as possible. A I has some solutions there, but it's not the only answer. So by using these technologies, we can extend the benefits of our car products like uh infusion pumps, which may not be a surgical product, but you will definitely seen these in your hospitals again. Escala Aos is our new surgical microscope. Um A really core pillar of our strategy going forward is is sustainability. We need to integrate it into our processes, whether that's manufacturing or um building a circular economy, innovations into our proper pathways. It's incredibly important and we are an active member of the new Department of Health designed for Life Program, which has been rolled out just in the last month. So this will keep us busy and we've got lots to offer with our reusable surgical instruments and our sterile drug management, for example, diversity, equity and inclusion is so important. How can we get all the best ideas if we're not asking the breadth of people, what those ideas should be. And it's an absolute key pillar of our strategy going forward to get those diverse perspectives in order to come up with the best ideas to create the smartest solutions possible um in a world where everything is digitally connected and integrated, we need to really focus on improving efficiencies and outcomes. So this is our global picture. I've just whistled through our history and our current strategy globally. But what are we doing in the UK? Um which obviously I'm living in and responsible for. So I'm head of value and access and we're very much in the innovation space in my team and the real focus for um what we try and do um is based on what's coming from, you know, the government. So the Department of Health and social care have a new med tech directorate that in itself is progress. They recognize MedTech as a, as a sector that's really important and a crucial innovative partner in order to fix the problems of the NHS. For example, uh a shift away from focusing solely on pharmaceutical industry. So they launched the med strategy last year. Uh a really important piece of work. We're one year on priority too. As you can see on the right hand side is all about creating pathways to support industry and turning innovative ideas. So what does that mean for us? And I mustn't um I can't share this slide without um talking about the, the, the chart on the left, which is the true um Meaning of this piece of work is about the right products and the right price in the right place. And how can we play a part in that one year on the new schematic for this strategy is all around the innovation pathway, which is encouraging to see if they recognize that from entry point through to adoption, there are lots of initiatives that can be put in place to enable innovation to be uptake more broadly and at, at a faster pace. So we need to recognize how do we play our part? For example, I've just mentioned the design for life is on there. How do we work with all the key stakeholders? NHS England, NHS supply chain. Nice and the M HRA and there's lots of moving parts, it's a complex world, but in er, it's incredibly interesting and exciting for us to engage and to make sure we're plugged into all these initiatives. And I'll come to some of these in a little minute value based procurement methodology being one. But first, we now have a definition for innovation which helps. So how can we do innovation if we don't know what it means? So this is a government sponsored framework for innovation. Ultimately, the top right for a device to be defined as an innovation, it should demonstrate an incremental improvement, be a novel application or is a novel device that meets an unmet clinical need. So, are we meeting an unmet clinical need? Nothing else does that's really important. If, if the answer is yes, then the questions on the flow chart on the left, is it disruptive or transformative or incremental? Now, we're 100 and 85 years old. Most of our products frankly are incremental, but there will be some that are disruptive and transformative. But as long as it's innovative, it's meeting an unmet need, we can play another initiative coming from government is the new consultation. It's not signed off yet. But this is a rules based pathway again, showing the initiative and the um intent for NHS leaders and our government leaders to recognize better ways to um evaluate and adopt innovative products. So the very top line here, you've got the floor but you've also got early value assessment, which is a new mechanism for products that might not necessarily have evidence but look good on paper. There are new systems in place now for companies to work with nice and the NHS in order to get that evidence. So we'll be playing in that as well. Fundamental cornerstone that's driven a lot of what we do is value based healthcare. If you haven't seen the Michael Porter work from about 18 years ago, this is around value equals ultimately outcomes of the cost. So how do we as a business demonstrate the value of our products? Any innovator out there? Anyone want to innovate is this is the cornerstone of what we need to do. How do you demonstrate value of your products? You need to show that you're improving outcomes or improving patient experience um versus the cost outweighed. So this is what we try and do identify the et needs implement new solutions to capture the value that's better for patients or the environment or the system itself. So a consultative approach, building new pathways. So we're not just talking about the the surgical instrument like we would have been in the past to become a truly innovative strategic partner. And this is really a cornerstone of what we're trying to do. Our vision is to become a, a real market leader in value based healthcare um using value based evidence driven solutions. And you can see our values across the bottom here, evidence driven innovation, patient centric value creation with collaborative partnerships, we can do it all ourselves, holistic health care advancement without leadership and sustainable impact. This really is our core. Um My team work across our whole portfolio as you've seen in the initial video um which includes many, many products used in the or that you'll be familiar with. So we're a busy bunch creating lots of evidence with clinicians um to demonstrate the value and improved outcomes of our products and services. And this for us is real innovation and our value means different things to different people. So this is really important to understand when creating value based um proposals and discussions, is it to do with how far the patients have to travel or the reduced length of stay or the patient experience or less pain or better value for money up, you can do more in the same day as having a real understanding of what value is, is a really truly important element to, to understand at the very start of this, for any innovation to succeed. This topic of value based healthcare is absolutely fundamental today and going forward into the future. Well, just to finish with me, what's the secret recipe for success? And like I've just mentioned, we can do this on our own. It's all about collaboration. And while I'm here today, the finest example of that is our partnership with a, we are proud sponsors over many years now to be key partners for A I. And we um as you can see er with this on to the annual conference and Innovation Lead. I'm here today for that reason, but we also do other collaborative partnerships. We engaged with the clinical entrepreneur program, we partner with um start ups from that. We've got a great example in in med show and long standing partners with the Royal College of Surgeons and part of their expert Advisory network. Um So we recognize we'll never have all the answers ourselves and we need those partnerships. And here's Tony Young, I'm sure you've seen him on this agenda probably yesterday, er coming to our offices and there's Asher and me out as well. So this is a good example of how we recognize that and are open for business. So great to meet you all. Have a great rest of the show. Thank you very much for your time today. Thank you very much for that presentation. Um Great to hear about Bron. Um I think I've got a couple of questions for you and the first one is really um what do you look for if an innovator comes to you with a pitch? Well, that does happen quite a lot. Um because II, II go to lots of conferences and II hang around the innovation space. So, and um it's a good question because, you know, we can't do everything um with the resources we've got but we are in 15 therapy areas. So usually for us, what we look for is a synergy, something that can add value to our pathways, right? This really is around taking the conversation away from. Here's our widget Mr Surgeon. It's shinier than the other companies. It's a how do we provide a better end to end pathway experience for the patient? So put the patient first, understand the patient journey from end to end to end. And we can't always do that, right. So we recognize that we've got, we've got the bit in the or in the, in the surgical space. We've got some kit in the or but we may well not have the digital app for when they get home or you know, a, a complementary product for prehab even. So there's, there's the pathway is a long thing. WW we have got a big, a big range of products. So we, we might be in three elements of the five stages of a pathway, but we won't be in five. So that kind of thing is what we look for. How can we, how can we get values? It's a win, win, win for us, win for the innovator, but also more importantly, a win for the patient. I'm the healthcare provider, of course, because they have to buy it as well. So that's in a nutshell. What we look for. Fabulous. Um It was really good to hear about uh your involvement in sustainability. Um really as it's really topical um at the moment and what do you think is the biggest challenge for industry to create sustainable solutions? No, that's a, that's a question. How long have you got that? It's um we all, I think we're all on the same page in terms of having to do something about it, right? Um The weather events are happening in front of our eyes every, every month on the news. Um This is not, this is not skirt active, this is reality. So what, what can we do? How can we play our part? And there are, there are areas where it's easier for a company like ours than others. So we do a lot of reusable stuff. We've got, we've got products and services that can hold that agenda and move away from single use. But at the same time, our medical business, you know, we make billions and I mean, billions of bits of plastic wrapped in plastic. That's our core business. So what is the, what does that look like in 20 years? How are we gonna get in injectable drugs into people without using po bits of plastic? We haven't got the answer to that. So we, but we are looking, I was with an R and D guy the other day actually. So I can, I can answer this question better than I would have been able to this time last week. Um And we're looking at using um you know, cooking oil, um you can, you can make the plastics from different things, right? So reused, cooking oil can be the, the the starting material from which we make the plastics. So we, we might have to be stick with plastics for many years because of the way we need to get stuff inside patients. But we can, we can sort out material to make the plastic from different places. So things like that, but that's our biggest challenge as a company that makes literally billions or we can the infusion lines that we make in our factory in Germany, you can wrap around the earth 17 times a um I think the the amount we make in a year. So um that's a lot of plastic, but it's important plastic. We're not, you know, we're not, we're not doing it for the sake of it. It, it's, it's helping people stay alive. So how can we make that plastic in a, in a, in a more sustainable way is, is a big question for us. Thank you very much for the answer and thank you so much for the talk um as well. Um And um thank you from asset for all the support that you provide to, you know, surgical trainees and hopefully future innovators. Um I'm pleased to announce the next speaker, um Vishal Vii who will be talking about health care in the Social Aid. Um So we started his career as an NHS doctor, but then he moved in um strategy consulting and healthcare strategy and he's currently working um at youtube um where he's building the kind of brand new healthcare offering. Um And that's, you know, um empowering millions of people um to um an NHS organization as well um to improve.