PRL Present · Case study · Case · Problem · Starting point
Slide 1 of 9 · Walk a caseWhich innovation are we walking through the Townhouse?
TakeawayOne case feeds every slide in this walkthrough.
01 · Case
One worked example, carried through every slide.
Selected · HEALTHCARE · Practitioner pull
Ward Handover Assistant
Nurses lose 20–40 minutes every shift reconstructing patient context. The problem is validated across four trusts, but the budget holder says "after v2".
02 · Pull vs push
PRL answers “should we build it?” before TRL asks “can we?”
Practitioner problem
“Critical patient information is missed at shift handover because notes are scattered across paper and three systems.”
Experimental proof of concept
PRL · Should we build it?
2.5 / 9TRL · Can we build it?
3 / 9Practitioners lead the technology: good.
03 · Starting point
Where this case stands before you walk the stages.
Case loaded
Each case is pre-filled to tell a different story. Change any answer on later slides and every gate, score and verdict updates live.
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 1 of 9
PRL Present · Case study · Stakeholders · Questions · Red flags
Slide 2 of 9 · Walk a caseWhat did each stakeholder say?
TakeawayNever skip a voice: 11 of 12 yes, and no unresolved red flags.
01 · The 12 voices
Ask each stakeholder their question and record the honest signal.
Yes
9
Hesitant
2
Red flag
1
Unasked
0
01 · PRACTITIONERS
Daily End Users
Do you face this problem daily?
02 · CUSTOMERS
Budget Authority
Will you pay real money for this today?
03 · ACADEMICS
Research/Evidence
Is this domain scientifically promising?
04 · SUPPLY CHAIN
Sourcing/Manufacturing
Can we source, build, deliver this reliably?
05 · INTERNAL CHAMPIONS
Organizational Advocates
Does our team need this yesterday to win?
06 · MARKET
Timing/Competition
Is the timing right or are we early/late?
07 · BUDGET HOLDERS
Finance Decision Makers
What's the budget cycle and approval process?
08 · FINANCE & PROCUREMENT
Economic Reality
What's the real Total Cost of Ownership?
09 · LEGAL & REGULATORY
Compliance/Risk
What are the regulatory barriers and costs?
10 · TECHNOLOGISTS
Implementation
Can we actually build this? What's cost-to-serve?
11 · NON-TECHNOLOGISTS
Non-technical users
Can non-technical users adopt this without technical support?
12 · COMMUNITY
Community network
Will the community adopt, share, and sustain this?
02 · Red flags
Any red flag means pivot or kill, or an explicit, recorded risk.
Customers
Red-flag answers: “Let me think”, “After v2”, “Maybe later”
Catches: Speculative interest; no budget; 'after v2' syndrome
PRL 3 voice check
9/12 YES
Not yet validated
Rule: consult all 12 (no exceptions). 11 of 12 must say yes. Any red flag means pivot or kill.
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 2 of 9
PRL Present · Case study · PRL 1 · PRL 2 · PRL 2.5 · PRL 3
Slide 3 of 9 · Walk a caseIs the problem real, shared, committed to and paid for?
TakeawayNothing gets built until PRL 3 shows economic pull.
01 · Levels
Establishes the foundational requirement for all R&D: practitioner-validated problem identification. Prevents innovations built for perceived rather than actual needs.
How to use
Tick the evidence you hold, then record the right person's answer. The gate on the right updates live.
02 · PRL 3 · Knowledge Transfer & Discovery
Is there demonstrable willingness-to-pay from both individual practitioners and institutional budget holders?
Evidence requirements
Right person · Customer (Pays) + 12 Stakeholders
“Will you pay £X today to fix this?”
Red-flag answer: Let me think or After v2
Decision required
PRL 3 also needs all 12 voices: 9/12 yes.
03 · Gate
Minimum dual-segment validation (≥30% small entity + 1 institutional LOI) OR single-segment validation at 50%+ to progress to Experiment stage
PRL 3 gate
Gate open
4 criteria left to meet.
Evidence complete
2 of 4 requirements met
Right person says yes
Red flag: "Let me think or After v2"
Never skip a voice
12/12 consulted · 9 YES · 1 open red flag
≥2 hard signals
0 of 10 exceptionally strong traction signals fully achieved
How the Townhouse helps
Handout · every level on this slide
PRL 1 · Practitioner-Identified Problem (passed)
Is the problem articulated by practitioners in their operational context?
Ask Practitioner (Daily User): “Do you face this problem daily?”
Red flag: Occasionally or Sometimes
Gate: Problem must score ≥60/100 on urgency-feasibility matrix to progress to PRL 2
PRL 2 · Cohort-Validated Problem (passed)
Does the problem persist across a statistically meaningful practitioner cohort?
Ask Practitioners (Sector Cohort): “Is this a sector-wide problem or just your organisation?”
Red flag: Only 1-2 organisations face it
Gate: Problem must achieve ≥65/100 on prevalence-impact scoring to progress to PRL 2.5
PRL 2.5 · Pilot Commitment Validation (passed)
Will practitioners allocate time and organisational permission to test potential solutions?
Ask Practitioners (Pilot Participants): “Will you commit 10+ hours over 2 weeks to test solutions?”
Red flag: Maybe later or If we have time
Gate: Minimum 5 committed practitioners with organisational approval to progress to PRL 3
PRL 3 · Economic Signal Validation (open)
Is there demonstrable willingness-to-pay from both individual practitioners and institutional budget holders?
Ask Customer (Pays) + 12 Stakeholders: “Will you pay £X today to fix this?”
Red flag: Let me think or After v2
Gate: Minimum dual-segment validation (≥30% small entity + 1 institutional LOI) OR single-segment validation at 50%+ to progress to Experiment stage
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 3 of 9
PRL Present · Case study · PRL 4 · PRL 5 · PRL 6
Slide 4 of 9 · Walk a caseDoes it work: on paper first, then digitally, then under stress?
TakeawayIf it fails in analogue form, technology won't rescue it.
01 · Levels
Practitioner-led testing from low-tech analogue prototypes to digital workflow integration. If it doesn't work in analogue form, adding technology will not rescue it.
How to use
Tick the evidence you hold, then record the right person's answer. The gate on the right updates live.
02 · PRL 4 · Stress Test & Validate
Does a non-technical solution approach achieve baseline efficacy in real practitioner workflows?
Evidence requirements
Right person · Supply Chain + Academics
“Can we source, build, deliver this reliably?”
Red-flag answer: Can't source materials or Impossible
03 · Gate
≥70% task completion + practitioner confidence score ≥75/100 to progress to PRL 5
PRL 4 gate
Locked
Pass PRL 3 first. You can still prepare evidence.
Evidence complete
0 of 4 requirements met
Right person says yes
Ask: "Can we source, build, deliver this reliably?"
How the Townhouse helps
Handout · every level on this slide
PRL 4 · Analogue Solution Efficacy (locked)
Does a non-technical solution approach achieve baseline efficacy in real practitioner workflows?
Ask Supply Chain + Academics: “Can we source, build, deliver this reliably?”
Red flag: Can't source materials or Impossible
Gate: ≥70% task completion + practitioner confidence score ≥75/100 to progress to PRL 5
PRL 5 · Digital Prototype Workflow Integration (locked)
Does the digital minimum viable product (MVP) integrate seamlessly into real operational workflows?
Ask Practitioner (Daily User): “Does this save you 2+ hours per week?”
Red flag: Maybe or I'd try it
Gate: ≥80/100 on workflow integration score + measurable efficiency gain to progress to PRL 6
PRL 6 · Immediate Switch Validation (locked)
Would practitioners immediately adopt if solution were available today, and would they resist its removal?
Ask Frontline Operator + Market: “Would you fight to keep this tool?”
Red flag: Silence, shrugs, or It's okay
Gate: NPS ≥80 + TVR ≥10 + ≥3 identified champions to progress to Build stage
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 4 of 9
PRL Present · Case study · PRL 7 · PRL 8 · PRL 9
Slide 5 of 9 · Walk a caseWill champions carry it, and will it become sector standard?
TakeawayAdoption must sustain itself without the vendor pushing.
01 · Levels
Champions co-own the build, then solutions spread from early adopters to sector standard.
How to use
Tick the evidence you hold, then record the right person's answer. The gate on the right updates live.
02 · PRL 7 · Practitioner-Led & Research
Are practitioner champions actively mobilising internal resources and peer networks for adoption?
Evidence requirements
Right person · Internal Champion
“Does your team need this yesterday to win?”
Red-flag answer: Nice to have or Eventually
03 · Gate
≥3 active champions + ≥2 organisational commitments to progress to PRL 8
PRL 7 gate
Locked
Pass PRL 3 first. You can still prepare evidence.
Evidence complete
0 of 4 requirements met
Right person says yes
Ask: "Does your team need this yesterday to win?"
≥6 hard signals
0 of 10 exceptionally strong traction signals fully achieved
How the Townhouse helps
Handout · every level on this slide
PRL 7 · Champion Advocacy & Mobilisation (locked)
Are practitioner champions actively mobilising internal resources and peer networks for adoption?
Ask Internal Champion: “Does your team need this yesterday to win?”
Red flag: Nice to have or Eventually
Gate: ≥3 active champions + ≥2 organisational commitments to progress to PRL 8
PRL 8 · Operational Embedding (locked)
Is the solution embedded within operational practice across multiple organisations with demonstrable sustainability?
Ask Community (Peer Network): “Would you recommend this to peers?”
Red flag: <30% referral rate
Gate: ≥100 users + 90% retention + 30% referral + operational embedding evidence to progress to PRL 9
PRL 9 · Sector Standard & Ecosystem Transformation (locked)
Has the solution achieved sector standard status with measurable ecosystem effects?
Ask Market + Customer: “Is this becoming sector standard?”
Red flag: No ecosystem effects visible
Gate: Community formation + professional body adoption + policy influence + ecosystem effects = PRL 9 achieved
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 5 of 9
PRL Present · Case study · PRESS · Hard signals · Decision
Slide 6 of 9 · Walk a caseIs this case busy, or actually validated?
TakeawayPRESS adds up effect sizes; the gates count hard signals.
01 · Traction evidence
Mark each activity not, partly or fully achieved. Each counts at its effect size.
Exceptionally strong signal · ≥0.80
Strong signal · 0.60–0.79
Moderate signal · 0.40–0.59
Weak signal · 0.20–0.39
Negligible / noise · <0.20
PRESS · PRL traction score
2.7
Weak validation
Pivot or significant rework needed
Success probability · 25–45%
PRESS = Σ(effect size × achievement), with partly = 0.5 and fully = 1.
Evidence-based decision
kill
Hard signals · Critical
0 / 10
Exceptionally strong signals (≥0.80) fully achieved. Likely to fail; pivot or kill.
PRL 3 gate needs 2: 2 to go
Vanity check
0.12 of this score comes from low-traction activity (below 0.30).
Busy is not the same as validated.
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 6 of 9
PRL Present · Case study · Score the case
Slide 7 of 9 · Walk a caseHow strong is this case's evidence, in one number?
TakeawayThe bar rises with each stage: 60, then 80, then 90.
01 · Five dimensions
Score each dimension 0–100 from the evidence you hold.
Pre-sale conversion, NPS, switch quotient, 'fight to keep it' responses
Gate: PRL 1-3: ≥60 PRL 4-6: ≥80 PRL 7-9: ≥90
Time saved (≥2 hours/week), error reduction, task completion rate
Gate: All stages: measurable improvement
Number of champions, budget mobilization ability, peer recruitment
Gate: PRL 7+: ≥3 champions
Willingness to pay today, LTV:CAC ratio, unit economics validation
Gate: PRL 3: £100 pre-sale or LOI PRL 9: Paying customer
Referral velocity (≥30%), community formation, policy influence
Gate: PRL 8-9: Active community
02 · Composite
Weighted sum of the five dimensions.
Working towards PRL 3
57 / 100
Needs ≥ 60: 3 to go
Gate pass requirements
PRL 1–3 · ≥60/100
+ all 12 consulted, ≥11 YES
PRL 4–6 · ≥80/100
+ no red flags
PRL 7–9 · ≥90/100
+ 7% week-on-week growth, no red flags
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 7 of 9
PRL Present · Case study · TRL · Rules · Path position
Slide 8 of 9 · Walk a caseIs this case's technology running ahead of its practitioners?
TakeawayPRL must lead or equal TRL at all times.
01 · Technology
Where is the technology today?
Experimental proof of concept
PRL · Should we build it?
2.5 / 9TRL · Can we build it?
3 / 9At PRL 2.5, technology may go up to TRL 3.
02 · The rule
Technology readiness answers “can we build it?”; practitioner readiness answers “should we?”
TRL 1-3 · Laboratory Research
PRL 1-2Cannot start TRL 1 if PRL <1
TRL 4-5 · Prototype Development
PRL 4-5Cannot start TRL 4 if PRL <4
TRL 6 · Demonstration
PRL ≥5HARD GATE: TRL 6 BLOCKED if PRL <5
TRL 7-8 · Pilot/Production
PRL 7+Cannot start TRL 7 if PRL <7
TRL 9 · Commercial Deployment
PRL 8-9Cannot reach TRL 9 if PRL <8
03 · Path position
Where this case sits on the practitioner–technology line.
Path position
Balanced
PRL leads or equals TRL. Build at this pace.
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 8 of 9
PRL Present · Case study · Signature · Decisions · Next steps
Slide 9 of 9 · Walk a caseWhere does this case stand, and what happens next?
TakeawayProceed, pivot or kill, decided on evidence.
Practitioner readiness
PRL 2.5
Technology readiness
TRL 3
Parity holds
PRL score
57
Gate needs 60
Traction (PRESS)
2.7
Weak validation · 0/10 hard
Tech value rating
0
≥ 10 at PRL 6
Voices saying yes
9/12
Open red flags
1
Readiness journey · Ward Handover Assistant
✓ 1
✓ 2
✓ 2.5
3
4
5
6
7
8
9
01 · Next steps
Most urgent first.
01 Resolve 1 red-flag voice: pivot, kill or accept the risk.
02 PRL 3 · Evidence complete: 2 of 4 requirements met
03 PRL 3 · Right person says yes: Red flag: "Let me think or After v2"
04 PRL 3 · Never skip a voice: 12/12 consulted · 9 YES · 1 open red flag
05 PRL 3 · ≥2 hard signals: 0 of 10 exceptionally strong traction signals fully achieved
06 Lift the PRL score to ≥ 60 (now 57).
02 · Decisions
Every red flag and what was decided.
03 · Verdict
The one-line answer for this case.
HEALTHCARE · Ward Handover Assistant
Pivot or kill
Unresolved red-flag voices block progression. Decide before investing further.
Notes
UKBT Institute · PRL Present · FORTRESS R&D · Walk a case · Case: Ward Handover Assistant · Slide 9 of 9