What is the 'valley of death' in healthtech innovation?

The valley of death refers to the gap between successful pilot projects and system-wide adoption in the NHS. Common barriers include fragmented procurement across 42 ICBs, lack of interoperability with existing systems, insufficient real-world evidence, and difficulty demonstrating cost-effectiveness at scale. Innovators must navigate evidence requirements, regulatory approval, and commissioning pathways — unlike commercial markets where a good product may sell itself.