Elliot Moss
Welcome to the Jazz Shapers podcast from Mishcon de Reya. What you are about to hear was originally broadcast on Jazz FM however music has been cut or shortened due to rights issues.
Good morning this is Jazz Shapers, I am Elliot Moss. Jazz Shapers the place where you can hear the very best of the people shaping the world of Jazz, Soul and Blues and right alongside them we put someone who is called a Business Shaper, someone who is shaping the world of business. I am very pleased to say that that person today is Dr Ben Maruthappu; Co-Founder and CEO of CeraCare. A multi-award winning technology company transforming social care. As a junior doctor Ben Maruthappu witnessed the effects of a dysfunctional home care system and what I was having on patients and the NHS. Around 4,500 patients per day are stuck in hospital because their care hasn’t been organised on time and low quality home care means patients can ping pong in and out of hospital. While thinking on this, Ben had his own experience of organising care for a loved one. CeraCare was launched in 2016 fusing artificial intelligence with social care and aiming to change the world of home care by supporting the elderly people to live where they are most comfortable and happy. CeraCare now has a presence in fifteen cities across England and plans to expand into Europe and the US too. We will be talking to Ben in a few minutes about the fastest growing demographic in the West, that’s the retired population and the positive impact of technology. Also in Jazz Shapers today we’ve brilliant music from Dee Dee Bridgewater, Refugee Camp All Stars and Lauryn Hill. Before that here’s the one and only Quincy Jones with Summer In The City.
That was Quincy Jones with Summer In The City. I am with Dr Ben Maruthappu and he is the CEO and Co-Founder of CeraCare. It’s really nice to have you here.
Ben Maruthappu
Thank you, nice to be here.
Elliot Moss
Tell me why a doctor, I’ve had a few on the programme, why someone in the medical profession decides to become an entrepreneur?
Ben Maruthappu
I think working in health care at the moment is a unique opportunity and it is great to be able to serve patients and work with brilliant team members but at the same time you also see first-hand some of the challenges that patients, families, clinicians, nurses and so on are experiencing which puts you in a fantastic and almost privileged position to try and tackle those challenges. In our context at CeraCare we are trying to transform social care in the UK and Internationally through harnessing technology and I experienced some of the challenges in social care first hand through my role as a doctor where I used to see patients coming into A&E, unfortunately deteriorating in their health and getting worse because they hadn’t received the care that they needed in their home. I had also experienced it through organising care for my mother and then my grandmother and seeing how difficult that process was and finally I used to do a lot of policy work in the NHS and it became quite clear at the national level, one of the biggest challenged the NHS is facing is actually outside of it and that is social care because if people receive the services they need in their own home, or in a care home they don’t need to go to hospital or see their GP anywhere near as often and they can be kept healthy and happy there and part of our ethos at Cera is really to support people living their best lives in their own home.
Elliot Moss
Now I understand your exposition of that is spot on because you’ve seen it and you looked in and said ‘oh this isn’t working’ or ‘it could work much better’. From a purely medical point of view you could have taken the view that well I am in the system I am just going to do my best. You could have taken a policy view and said ‘well I am going to tell other people how to do it’ but you’ve gone a different route and that’s what interests me. Both of those two routes are laudable, and most people in your position, in fact 99% would do that but you chose the ‘I’m going to do something about this’. Why Ben? What’s in your DNA that pushed you that way?
Ben Maruthappu
Absolutely I think I have always been interested in building companies, organisations, even I think when I was a teenager I ran a small charity that supported people living in their homes by organising for students and volunteers to look after them and then I set up some organisations after that as well in the health care and medical space so I think I’ve always been a founder at heart but also from my point of view the solution in social care didn’t exist at that point and so we needed to build it and I think when it comes to harnessing technology most of the most or effective solutions and answers that have been created through innovation have been done so through businesses and ventures at a local level which then expand and scale as opposed to through National programmes. So even when the NHS is adopting technology there is a technology provider or company or start-up that has built that solution and the NHS partners with it to adopt it. In social care I didn’t think that solution existed and so I thought it was important to try and build it so that many families, patients and service users and also front line staff could benefit from innovation and from smart phone based technology in their day to day work.
Elliot Moss
And in terms of your journey to become a Founder, again I meet many, many people and all sorts on the spectrum, all sorts of spectrums to be honest with you but spectrum of academic, not academic and without labouring your own background, you’ve a triple first from Cambridge, you went to Oxford, you went to Harvard, that may not have led you down the entrepreneurial path either. Was there a moment actually where you encountered lots of other people who were thinking about founding businesses? Is that also part of the thing that happened to you?
Ben Maruthappu
That is also what happened. So when I was in the US on the East Coast I was amazed by how entrepreneurial people are. I mean you could look at a student in a University, you could look at someone, a surgeon in a hospital or a research academic, everyone has a start-up or a technology initiative that they are building either on the side or as part of their full-time job and that’s probably why we’ve seen major technology companies such as Facebook and Microsoft coming out of student dorm rooms on the East Coast in the US and you can feel it when you are there, you really can. You can feel it in the air how entrepreneurial, how innovative the culture is and that’s where I think I caught the start-up bug when I moved back to the UK, started practising and then doing some of my policy work, I really focussed on innovation technology because of that experience but also I had the itch to try and build something myself.
Elliot Moss
So now you are running a tech business, you’ve been funded to the tune of over 20 million pounds since you launched in 2016. How does the professional doctor who wants to be an entrepreneur get his head round the fact that he is not a technologist?
Ben Maruthappu
It has definitely been a steep learning curve.
Elliot Moss
He is smiling very broadly by the way at this point.
Ben Maruthappu
A very steep learning curve but enjoyable. I think some of the skills that you learn in medicine are definitely transferrable. Communication skills, being able to understand and empathise with the challenges your consumers or users are experiencing and then have an analytical approach to trying to tackle that but at the same time I’ve had to pick up a lot of things on the way, understanding how to actually build a technology platform, understanding product design, marketing, branding, raising money and legal elements to that as well all the way of course to the financial components of our business and how to make that as strong as possible but I think it has really been a result of the people around me. My team members, investors, our Board who are extremely supportive and have allowed me to have the relevant guidance, particularly the more challenging times in our company which has ensured that we’ve made the right decision.
Elliot Moss
And in terms of putting that team together, and those very early days when you’ve said ‘I am going to do this’. How did it work? Because again you are then really steering over an abyss? I mean an interesting one at that and the kind of what could be possible but where did you start?
Ben Maruthappu
I actually started with some of my friends from school.
Elliot Moss
Okay.
Ben Maruthappu
Who were in more the technology start-up space and helped to almost educate me on some of the process for trying to launch a business, raise investment, put together relevant team members so they were really helpful in that and also I had some mentors who I had picked up along the way and who I had met who had more business experience than I did, who also provided me with a lot of insights and expertise and once you laid out, kind of, the initial plan which of course you rebuild over and over again in a start-up, that served as the launch pad for setting up Cera.
Elliot Moss
And you continued to work I imagine for a period of time. How long were you kind of in your day job and then also planning and plotting before you actually said ‘I can’t do the day job anymore’. What point did you switch?
Ben Maruthappu
I think it was a period of months and then there was some period where I was still engaging with my medical training and trying to keep up-to-date whilst also running the business but now I am full-time, more than full-time in running Cera and I think if you are going to build a business effectively it does require you to really focus and dedicate yourself whole heartedly to it.
Elliot Moss
It always strikes me that doctors undergo huge amounts of stress because you know, most people in normal life don’t deal with life and death, they don’t see death very often, it’s a pretty you know, it’s a big thing. Is it stressful now or is there super levels of perspective that us mere mortals who don’t become doctors just don’t have because you’ve seen much worse or is it you’ve just forgotten your old world and gone ‘I’m really stressed because it’s hard’?
Ben Maruthappu
It definitely gives you perspective because let’s say when I worked on a hospital Ward and someone has had a cardiac arrest and we’ve had to try and do chest compressions and resuscitate them or there have been other very acute or sudden changes in their health that you’ve had to try and manage quickly. Those are very stressful and challenging situations which are also emotionally difficult the first couple of times that you are experiencing them but in a similar manner building a business can also have its stressful moments and experience is what’s ultimately most important I think.
Elliot Moss
The processing of emotions, just one quick thing before we go to some words of advice from our programme partners at Mishcon. That stress and as you said, the first time you experience something pretty big and traumatic it’s hard. Is it that you isolate yourself from it? Do you remove yourself or is it that you confront it and then you let it come in and you work it through? I am just interested on that because I think there’s a similarity in business as well?
Ben Maruthappu
I think you do need to confront. I think if you put your head in the sand things may get worse actually and I think it’s important to really sit down, absorb and reflect on what may have happened and in turn the way forward. You’ve got to be forward looking. You need to try and keep your steady head in the medical world, the business world and in others as well at any point of difficulty and then of course it’s really powerful to have a support network who can provide a more objective view on what’s going on and make suggestions or recommendations on how you can navigate the trials ahead.
Elliot Moss
Stay with me for much more from my very wise but young and clever too – how annoying is this – Dr Ben Maruthappu, he’ll be back in a couple of minutes but first, as I promised, some words of advice from one our partners at Mishcon de Reya for your business.
There are absolutely loads of ways for you to enjoy all our former Jazz Shapers and indeed to hear this programme with Ben again as well. You can ask Alexa to play Jazz Shapers and there you can hear many of the recent programmes or if you pop Jazz Shapers into iTunes or your preferred podcast platform you can enjoy the full archive. But back to today’s guest, he’s a doctor, his name is Ben Maruthappu, Co-Founder and CEO of CeraCare, multi-award winning technology company transforming social care. Ben I’ve got my head around the fact that you’ve created a team, that you asked for advice before from people that have created similar technology platforms or rather, a technology platform. Those first few months you had to raise money. What’s it like going to raise money the very first time?
Ben Maruthappu
The very first time it’s tricky because you get asked questions that you perhaps didn’t really think about but it’s also a really valuable process because you rapidly understand what investors are looking for because they tend to ask quite similar questions once you’ve met enough of them and in turn, what really is important about the business.
Elliot Moss
So go on, what are they looking for from your perspective?
Ben Maruthappu
It’s a combination of at an early stage you have to have a very strong team. You need to be tackling a problem that definitely needs a solution but also has a large market where the conditions of that market do make it amenable to disruption and transformation and then I think you’ve got to have a robust financial model. You’ve got to have or be in a sector where you can get some people would say, strong unit economics so that the cost of acquiring a customer is significantly outweighed by the revenue or the sales that you may generate from them based on the services that they request and that maybe sounds extremely simple and it probably is but validating those economics in an early stage of a business and making sure they are robust and as you get bigger and bigger they maintain the same or even get better that’s more challenging.
Elliot Moss
And how did they believe your answers to those three questions? I assume your team is robust, it speaks for itself, you can articulate and quantify the size of the problem and therefore the opportunity for disruption but financially you are kind of making it up aren’t you at the beginning?
Ben Maruthappu
You can test out what some of the interest might be in your product, or your service. You can look at bench marks in other companies in the sector to see how they are operating or even in other countries where there may be similar models that are embarking on the same journey. This type of information helps you in the earlier stages but then of course once you’ve been going for some months people want real numbers.
Elliot Moss
Did you enjoy the process?
Ben Maruthappu
I do enjoy…
Elliot Moss
I mean at the beginning, you know, the raising the money bit?
Ben Maruthappu
Yeah I really enjoyed that actually. I got to meet many interesting people from all walks of life who have become successful in their own way either as entrepreneurs or through being really astute investors or in other means as well or having a corporate life and it was a great networking opportunity, it was also a phenomenal chance to learn and hear about their stories as well. Which is a big inspiration.
Elliot Moss
And the team around you, as you talk about the business it is clear that you understand the different areas of it and the different variables involved, the direction you are going in. What would the team say about Ben, no longer the doctor but now the leader? If they were to describe you, a couple of adjectives?
Ben Maruthappu
Determined.
Elliot Moss
Yeah.
Ben Maruthappu
And ambitious. I think those would probably be a couple of words. Building a start-up is tricky but building it in the social care space is particularly challenging because here you’ve got, yes you have an amazing amounts of demand for the services because we have an aging population in the UK and Internationally but at the same time you have a shortage of suppliers, staff and you actually care workers leaving the country because of political challenges such as Brexit and other conditions. There have been reduced, there has been reduced public sector rates and spending on social care which is now starting to increase but that happened for many years because of austerity measures and structurally people have found it very difficult to scale in the sector as well in part because of the outdated business practices but all of this paints quite a challenging landscape that we need to overcome as a, as a business, as a start-up and Cera and that’s quite different to I think other start-ups that let’s say, operate in financial services where you can see a booming market potentially or you have many potential users for your product here and the climate of social care is intrinsically challenged, it is a difficult market and we are trying to tackle those challenges using technology but of course it creates a more difficult environment to build a business and build it quickly.
Elliot Moss
People are not commodities but business is about profit so tell me how you square that circle?
Ben Maruthappu
We think and I definitely believe if you can provide a better, higher quality service and really look after your customers and users well and in turn, their family members then the business will grow right so you start with quality, you start with them at the centre of it and of course actually are care workers themselves because they need to be valued, empowered, treated well and then the rest of the equation works itself out. Really our mission is to support users as well as we possibly can in their home and we back sort from there in terms of how we develop our technology, how we expand, where we invest, our financial model and so on.
Elliot Moss
But you are not selling bank accounts, you are selling a service of a human being going into another person’s home and looking after them in a way that’s not just appropriate but that’s fantastic and nurturing and all those other things. How do you guarantee the quality of this product?
Ben Maruthappu
So ensuring quality is one of the difficulties that I think the sector has faced. With us it really starts with our staff so ensuring that the care workers that we vet, we recruit on board and then we train are up to a higher standard as possible. This is in part through ensuring that the processes for boarding them are really rigorous and so we do have a very extended process for identifying potential carer workers, seeing how they may operate in a care space and in a person’s home, on boarding them, putting them through an induction and then even when they are delivering the service, getting regular feedback from service users, from family members and also supervising those care givers and care workers in the home to ensure that the service they are delivering is high quality and at a high standard. So I think it all revolves around your staff and who you decide to recruit and hire and then how you decide how to empower and support and monitor them in the home and where they are operating.
Elliot Moss
And over the course of the last few years, I know you’ve had lots and I think I was reading some fantastic reviews of the service as it were. Where you’ve had issues how have you dealt with them because I can imagine again, an issue, and we live in a very different world now to ten years ago where issues get quickly amplified on line and you know, you’re not finished but you’ve got a problem. How have you quickly addressed the problems and has it affected your reputation?
Ben Maruthappu
So it is always important to be on the front foot I think and that’s why monitoring your staff and care workers both digitally and in person is key so that you can pre-empt anything that may occur and so even now we have a data analytics part of our platform that automatically ranks the reports that come from any visit based on their risk profile and whether they need to be viewed by a person promptly and if anything needs to be done by it. Care also can be very subjective and it is very intimate. It can even depend on the personality difference that someone receiving care and someone giving care has. It can depend on languages. It is very intimate and that is why it is also important to ensure that the match between someone delivering the service and someone receiving it is extremely important. Then if something does occur, let’s say one of numerous staff that we have doesn’t deliver care to the standard that we’d hope, yes we need to nip it in the bud. So we need to communicate with them immediately, see if there is potentially another care worker who could potentially provide services in the interim and of course communicate with the person receiving the services and their family members, maybe liaise with other stakeholders as needed and then zoom in on what the issue may have been so that we can tackle it.
Elliot Moss
I imagine also the important part and you just alluded to it, the family members, the person who might indeed be organising and even paying for the care potentially, they are a critical stakeholder in this to use your language, critical person. Have you now developed methodologies to ensure that that person is also looked after because in a way they are not the end client but they are the client?
Ben Maruthappu
Absolutely. Engaging the family members is critical. When I’ve had to organise care myself that’s what I’ve seen as a short coming of the current care system because you may be organising care for a loved one, you may not live in the same place but that means that it is very difficult to be kept up to date and abreast of what’s happening and if there are any issues that need to be addressed and so using our platform, family members, assuming consent has been given, can access the care reports that our care workers are logging after every single visit and so they can see in real time what is happening and what time the service is being provided to their loved one and we in turn also do wellness checks where we will contact the family member on a regular basis to see what their perception of the service is and tell the how things are going so that they are really kept in the loop and the relationship and the circle of connectivity is as tight and as close as it can be.
Elliot Moss
Sounds like you are obviously on it and that’s an important part, as we said, it is not a product in the traditional sense. Stay with me for my final chat with my guest today, that Ben Maruthappu plus we will be playing a track from Refugee Camp All Stars and Lauryn Hill. That’s all coming up in just a moment here on Jazz FM.
That was fantastic wasn’t it, Refugee Camp All Stars and Lauryn Hill, The Sweetest Thing. I am with Ben Maruthappu, just for a few more minutes, we’ve been talking about the difference in running a business where people are at the heart of it and where the service is about people. So talking about people, in terms of your advisory board, who sits on it and why have they been selected?
Ben Maruthappu
So the Chair of our advisory board is Sir David Behan who formerly ran the CQC, the National Regulator for Health and Social Care in England and it is really helpful to get his expertise given we are striving to be compliant from a regulatory point of view but also trying to push the boundaries, see how regulation can be more innovative and how we can support that change as the sector also evolves itself.
Elliot Moss
And other people involved, you mentioned friends from school who helped you at the beginning. Are there other key people that are part of your support network as well, whether formally on the board or informally not?
Ben Maruthappu
Our Chairman, Peter Sands, so he formerly ran Standard Chartered Bank and Chaired Davos and now he runs the global fund to fight Aids, TB and Malaria but he’s a brilliant inspiration, very seasoned business man and always a wise counsel during points when we need to make decisions in the company and otherwise. I mean he is a great guy and he has been with the company since almost the very beginning. I knew him before Cera as well so I see him as a mentor as well.
Elliot Moss
How did you attract these people Ben? I mean these are proper names?
Ben Maruthappu
They really believe in what we are trying to do. I think most people who one means or another have experienced the care sector, their parent, their loved one, their relatives, friends and colleagues who may have had to organise care and so they see that there are challenges but challenges that can be tackled and the tremendous value that could create for people receiving services, people giving services and society as a whole. I think that mission is something that numerous people align with and believe in and that’s how we’ve been able to draw a great array of people to back and support us.
Elliot Moss
The other thing that strikes me about you is that you are still involved in the world of care from a completely not for profit perspective. You are Trustee and Board Member at Schools for Care, you are a Co-Founder of NHS Innovation Accelerator, you are the Founder and Chairman at UK Medical Students Association providing free educational resources. All these things are really, really good things to do. I often ask the question, how do you find the time? I am not going to ask that question because people like you find the time. What value do you get from it? Is it a sense of giving back or is a genuine sense of learning stuff that you also see as you are involved in these different spaces?
Ben Maruthappu
It’s both. So I think these are all amazing platforms to transform sectors, industries at a different level to perhaps what we are doing it at Cera, more of a National regional level and it is something that I enjoy right, I mean I loved my time as a medical student, there were lots of things I learned along the way. I think Chairing the UK MSA is a means of giving back to the medical student community, making sure people have the educational resources that they need regardless of their background to ensure their time at medical school is successful. With the NHS Accelerator is a means to support the NHS in continuously striving to revolutionise itself to adopt innovation at scale to improve the offering to patients and to staff. So I enjoy it. I mean it is a massive passion of mine, health care innovation technology and these are simply different means by which I can contribute to the sector and to society.
Elliot Moss
Where’s this going to go? Five years from now if we were to meet again, what would you be saying to me, what’s the post-script on this conversation?
Ben Maruthappu
Long-term in the future I think health care is going to move from hospital to home. As opposed to let’s say seeing your Cardiologist in the hospital or visiting your GP or seeing a nurse for let’s say, dialysis in the hospital. All of that will be done in the home. When and where you need it because it is more convenient, it’s potentially more affordable, it results in better patient outcomes and we’ve seen this movement in so many other parts of our lives. If you take retail, if you want to buy books or buy music or buy clothes you will do that most of the time now on line and you will get it delivered to your home within a few hours or same day and that’s extremely convenient, it’s affordable, it’s fast and we’ve seen that movement. Similarly in the banking industry where you manage your bank account on line. Even educational facilities which are available on line and I think health care as a result is going to move on line but also it is going to move to the home so if you need a nurse or doctor or a test you will get it in your own home as opposed to you having to go to a GP practice or hospital which has been the model frankly for over a century now and is in need of disruption and so Cera I think in five years’ down the line will be delivering that. Whatever health care service you need in your home, you may be an older person, you may be younger, we’ll deliver it but we will also do it through technology.
Elliot Moss
I like that vision, I wish you all the best because it has been fabulous meeting you, you are so clear and you have such an exciting view of what could happen and I really hope it does. For all of us, not just for you. Just before I let you go though, what is your song choice and why have chosen it?
Ben Maruthappu
It’s Sinner Man by Nina Simone and I think it’s a beautiful, timeless song. On the one hand you’ve got the piano which is pacey and light and then you’ve got these deep, soulful vocals. I think building on what we talked about before, if there are challenges or wrongs in your life you probably need to face them as opposed to running away from them and I think that links to some of the meaning of the song.
Elliot Moss
That was Sinner Man from Nina Simone, the song choice of my Business Shaper today, Dr Ben Maruthappu. Determined, mission led and someone who understood that confronting things and dealing with stress and processing it properly was the way through it whether it was a medical issue or a business issue. I think there will be great things coming for this person and this business in the future. That’s it from me and Jazz Shapers have a great weekend.
We hope you enjoyed that edition of Jazz Shapers. You will find hundreds more guests available for you to listen to in our archive. To find out more, just search Jazz Shapers and iTunes or your favourite podcast platform or head over to mishcon.com/jazzshapers.