Scaling Healthcare Innovation Without Scaling Headcount

Overview

e18 Innovation is a leading provider of Intelligent Automation services to the NHS, competing against global consultancies to help healthcare organisations streamline operations. As they grew rapidly, they faced a choice: hire proportionally more staff, or find a smarter way to scale. They chose the latter—and partnered with us to build the digital infrastructure and AI capabilities that would let them grow efficiently while maintaining the responsive service their NHS clients valued.

"What impressed me most about working with Leverage AI was their strategic approach. They didn't just help us implement AI—they helped us build a digital foundation that transformed how we operate. The result is a solution that scales with us, helping us compete with much larger consultancies while maintaining the agility our NHS clients value."

— Louise Wall, Founder & CEO at e18 Innovation

Who are e18 Innovation?

e18 Innovation helps NHS trusts and healthcare organisations leverage cutting-edge automation solutions to streamline operations, reduce costs, and improve patient care. Competing with large global consultancies, they've established themselves as leading automation experts in UK healthcare—winning trust through deep domain expertise and responsive, hands-on service.

The Challenge

e18 was growing fast and winning important contracts. To sustain that momentum, they recognised the need to evolve how they operated.

Knowledge lived with individuals rather than the business. Like many growing teams, people had developed their own workflows and systems. e18 saw an opportunity to bring this expertise together into a shared foundation that would make collaboration seamless and reduce reliance on any single person.

Leadership wanted real-time visibility. As the client portfolio grew, Louise and the senior team needed a clearer view across accounts—spotting opportunities and potential issues proactively rather than relying on periodic catch-ups.

The team wanted to focus on value, not admin. Without unified systems, coordination overhead was consuming time that could be spent on client work. e18 wanted infrastructure that would make onboarding new staff seamless and support taking on more clients confidently.

e18 came to us interested in AI capabilities to support their scaling ambitions. Through our discovery process, we identified an opportunity to first build a strong digital foundation—unified systems and consistent processes that would make AI genuinely powerful rather than a superficial addition.

Our Solution

Phase 1: Building the Digital Operating System

Before any AI, we needed to get the fundamentals right.

We mapped e18's entire operation—sales, outbound marketing, customer success, client delivery, procurement—and designed a unified digital infrastructure. This became their single source of truth: one system where all activity, documentation, and planning lived together.

For the leadership team, we built dashboards providing real-time visibility across the business. Louise could now see at a glance: which accounts needed attention, where customer success managers were spending their time, how marketing campaigns were performing, and where bottlenecks were forming.

For customer success managers, we created streamlined workflows that eliminated duplication. All customer interactions—calls, emails, meeting notes—flowed into one place automatically. When someone was out, their colleagues had everything they needed to step in seamlessly.

The impact was immediate. Duplication disappeared. Visibility increased dramatically. The leadership team could finally see what was happening across the business in real time.

Phase 2: AI Agents That Know Everything

With a solid foundation in place, we could deploy AI in a way that genuinely transformed their operations.

We built AI agents with deep access to e18's entire system: customer notes, email correspondence, meeting transcripts, NHS performance data, project documentation—everything. These agents can synthesise information across all sources instantly, giving the team answers that would previously have required hours of manual research.

Account intelligence on demand. When Louise wants to understand what's blocking an account, she asks the AI agent. Within seconds, it pulls together information from across all data sources—recent meeting transcripts, email threads, customer notes, NHS performance metrics—and provides a comprehensive overview: what's happened over the past month, what the key blockers are, and what needs to be resolved in the next conversation.

Customer success at scale. For the customer success team, these agents are transformative. They have deep understanding of every interaction with every customer. Need to prepare for a client call? The agent surfaces relevant history, ongoing issues, and suggested talking points. Need to draft a follow-up email? The agent knows exactly what was discussed and what needs addressing.

Faster, higher-quality deliverables. Work that previously took hours of manual research and compilation now happens in moments. The agents help produce reports, prepare meeting materials, and generate insights—all grounded in the full context of e18's customer relationships.

Results

The combination of robust infrastructure and intelligent AI agents has transformed how e18 operates:

Dramatically increased efficiency. A small customer success team now manages a large portfolio of NHS accounts—something that would have been impossible before. The operational foundation means nothing falls through the cracks, while the AI agents mean the team can access any information they need instantly.

True visibility for leadership. Louise and the senior team finally have a real-time understanding of the business. They can spot issues before they become problems, identify opportunities proactively, and make decisions based on data rather than gut feel.

Competitive advantage against larger firms. e18 now operates with an efficiency that rivals—and often exceeds—much larger consultancies. They've maintained their agility and responsiveness while scaling their impact, exactly as Louise envisioned.

Industry leadership. The operational transformation has positioned e18 as true innovation leaders in healthcare automation. Their ability to deliver exceptional service efficiently has strengthened existing client relationships and helped win new business.

Acquisition by Digital Workforce. In 2025, e18 was acquired by Digital Workforce, a leading intelligent automation company. While many factors contributed to the deal, e18's ability to deliver enterprise-grade service with a remarkably lean team was identified as a key driver of the company's value. The operational infrastructure and AI capabilities we built together demonstrated something acquirers look for but rarely find: a services business that could genuinely scale without proportionally scaling headcount.

A Partnership for Innovation

This project demonstrates why getting foundations right matters. e18 came to us looking for AI solutions, but the real transformation started with building the digital infrastructure their business needed.

By taking a holistic view—understanding their operations, mapping their processes, and building systems that actually worked—we created a platform where AI could deliver genuine value. The agents we built aren't just tools; they're an extension of e18's team, with deep knowledge of every customer relationship.

The result is a business that scaled efficiently, competed successfully against global consultancies, and ultimately achieved a successful exit—exactly what Louise set out to achieve.