On a busy day in an NHS operating theatre, some of the most important information is still gathered by walking around with a clipboard, making phone calls and asking colleagues for updates. A coordinator checks whether theatre four has been cleaned, whether the anaesthetist has arrived and whether the next patient is ready. Someone updates the whiteboard. By the time everyone has established what is happening, twenty minutes may have disappeared and a surgical slot that could have accommodated a hip replacement has slipped away. Anyone familiar with the workings of an acute trust will recognise the routine. It is precisely this everyday inefficiency that Akara, a Dublin-based technology company, hopes to address after securing $5.5m, approximately £4.1m, in a funding round led by Locke Health.
Its proposition is relatively simple. Wall-mounted thermal sensors monitor activity within clinical spaces, while software running on the devices interprets the information and alerts staff when rooms become available or particular events occur. The sensors detect heat patterns rather than capturing detailed images, meaning patients and staff are not filmed, according to the company. Processing also takes place on the device, reducing the need for hospitals to overhaul their existing IT infrastructure. Akara says its technology is already operating in hospitals across Ireland, the UK and the US. The latest investment will support expansion into further markets, increase the size of its Irish engineering and operations teams and develop its AI agents for additional applications.
The funding round itself is unlikely to change much for the NHS. At £4.1m, the investment is relatively modest in the health technology market, while the company’s claims have yet to be demonstrated at scale across British hospital trusts. The more important question is why a business selling sensors has attracted attention in the first place. The NHS is managing an elective waiting list running into millions, with recovery dependent on extracting more activity from the same theatres, beds and clinical workforce. Yet many trusts still struggle to establish precisely how long operating theatres remain unused between procedures or where delays accumulate during the working day. When available capacity cannot be measured properly, managing it becomes considerably harder. The most accessible additional capacity may already be sitting inside the hospitals themselves.
This is where ambient sensing makes its strongest case, although expectations need to be kept in check. A sensor can generate information, but it cannot change a rota, accelerate theatre cleaning or persuade a surgical team to begin its first procedure on time. The NHS has repeatedly encountered this difficulty with productivity technology: information is collected, dashboards are introduced, but working practices remain stubbornly unchanged. Turning data into action requires operational leaders prepared to challenge established routines and address uncomfortable findings, including those involving senior clinicians. Without that authority, a trust risks acquiring another digital dashboard alongside an additional annual subscription.
The privacy argument also deserves closer examination. Thermal sensors avoid capturing identifiable facial images, but they still reveal where people move within clinical spaces and how long they spend there. In a hospital, that information inevitably includes staff activity. Trusts will need data protection impact assessments, while union representatives are likely to question whether occupancy records could eventually be used to assess individual performance, monitor breaks or scrutinise compliance with rotas. NHS morale remains fragile after years of industrial disputes. Technology introduced to improve coordination can easily acquire a different reputation if employees believe they are being watched. Suppliers that underestimate this concern may find projects delayed or abandoned during local consultation. Processing information on the device addresses some security and infrastructure questions, but leaves a more difficult issue unresolved: how will the hospital use the data once it has collected it?
Procurement presents another obstacle, and this time the responsibility rests firmly with the buyer. Smaller technology suppliers often struggle to move beyond a successful pilot in one theatre suite and secure adoption across an entire provider collaborative. Better theatre utilisation may generate additional activity income and reduce waiting times, but those benefits do not necessarily appear in the same budgets that fund digital equipment. The Government’s ten-year health plan places considerable emphasis on technology, and political enthusiasm for operational innovation is clear. Yet trusts still have to establish what evidence they require, who will fund the purchase and where the financial benefits will ultimately land.
Investors appear to recognise the opportunity. Healthcare executives with commercial experience are backing a hospital operations business because they believe the underlying problem is substantial and that hospitals have a genuine need for solutions. Their assessment is understandable. Operational waste in acute hospitals is both considerable and visible. But it also exposes a familiar weakness in the health service: the tendency to treat the arrival of an impressive piece of technology as though the difficult work has already been completed.
The more revealing aspect of Akara’s funding round is the imbalance it exposes. Investment is flowing towards businesses promising to uncover capacity hidden within hospitals, while the technology itself may prove the easiest part of the exercise. The NHS still needs the managerial expertise to commission these systems, govern the information they collect, secure staff confidence and translate findings into changes on the ground. Trusts capable of building that expertise may discover that the cost of the sensors is small compared with the capacity they recover. Those that cannot may end up paying for a sophisticated way of confirming that their operating theatres are still sitting idle.
