How to Build a Start-up, Part 6, Author: Simon Rasalingham, 2026 The product you launch with is rarely the one that makes the money. Ours took off a decade later, on the back of a single guideline. MEDICA started as a chest x-ray reporting business. The logic was easy to understand. As x-rays moved from pieces of film, which could be hidden in a cupboard, to images sitting on a system, radiology managers across the NHS suddenly discovered how many chest x-rays had never been

Author: Simon Rasalingham, 2026 On my first visit to the FDA, driving up to the entrance, I wondered why there were men with semi-automatic weapons at the gate. Then I took my shoes off to get through security, to attend a meeting about clearing an algorithm. The meeting was my team on one side and two rows of FDA people on the other. For a first meeting. That is where most British founders' regulatory strategy gets decided. It is very intimidating, and it can put you off for

How to Build a Start-up, Part 4: The Financials, Author: Simon Rasalingham, 2026 You have a customer, a solution and a business plan. The next step is the financials, and most founders build the wrong spreadsheet first. They start with the five-year model: revenue curves, a hiring plan, a profit-and-loss forecast that turns positive in year three. It looks rigorous, and it answers a question nobody is asking yet. The question that matters in year one is simpler: how much cash