Private & Confidential

The GGOMed
Private Urology Thesis

Prepared for Chelsea and Westminster Hospital | Jan 2026

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Doc: GGO-X-2026-V2

01. Executive Summary

GGOMed proposes a tiered transformation of Chelsea & Westminster's private urology offering, transitioning from reactive billing to fixed-price clinical pathways.

By leveraging existing infrastructure with zero initial capital expenditure in Tier 1, we can capture high-volume day-case surgery and diagnostics that currently leak to competitors (HCA, Cleveland Clinic). Tier 2 and Tier 3 provide a clear reinvestment roadmap to unlock specialized diagnostic capabilities and robotic-assisted MIST surgery.

"The Structural Arbitrage Opportunity"

C&W possesses sunk-cost infrastructure that for-profit competitors must amortize. By utilizing marginal capacity, we can deliver superior margins while undercutting competitor pricing by up to 55%.

Year 1 Revenue Target

£1.40M

Based on conservative benchmarks

Tier 1 Gross Profit

£318K

Zero Capital Expenditure required

Portfolio ROI

404%

Aggregated across Tier 1 & 2

02. Tier 1: Foundation (The Soft Launch)

Zero Capital,
Maximum Velocity

Phase 1 utilizes current theatres, outpatient rooms, and existing imaging capacity. We launch with 6 "Ready Bundles" where the trust already possesses a distinctive clinical advantage.

  • Adult Circumcision (56% price advantage)
  • Haematuria One-Stop (Integrated CT/Cysto)
  • ED Diagnostic Suite (Ollandini Protocol)
  • Microsurgical Fertility (Integrated ACU)

Tier 1 Unit Economics

Launch Investment £0 Capital
Marketing Budget £15,000
Average Bundle Margin 38%
Year 1 Profit contribution £318,090

03. Tier 2: Enhanced Launch

Moderate Investment Launch Month 4-6

Investment 2A: LUTS Diagnostics

Unlocks high-frequency prostate screening and bladder assessment. Requires capital for Uroflowmetry and PVR scanning.

Setup Capital £75,000
Est. Breakeven 2.7 Years*
*Without MIST surgery. With surgery conversions, ROI drops to 10 months.

Investment 2B: Li-ESWT Machine

Introduces regenerative shockwave therapy for ED. High-margin derivative revenue from initial diagnostic suite.

Setup Capital £37,500
Est. Breakeven 8 Months
Unlocks £3.5K protocol bundles with 45% margin. Equipment amortized in Year 1.

Financial Projection: Tier 1 + 2

Total Investment

£112,500

Annual Revenue

£1,399,500

Annual GP

£454,650

Aggregate ROI

404%

04. Tier 3: Future Expansion (MIST Surgery)

Strategic Recommendation: HOLD

Do NOT Invest in Year 1

Wait until Month 12 to evaluate LUTS diagnostic volume. Tier 3 investment (£70K - £600K) unlocks surgical conversion for LUTS patients, capturing up to £150K+ per year in additional revenue.

Wait & Verify: Evaluate average prostate sizes and patient willingness after 80+ assessments.

Technology Choice: Decide between Rezūm (£70K), GreenLight (£245K), or Aquablation (£610K).

Rezūm Water Vapour Fastest ROI
Capital Required £70K
Breakeven Cases 44 Cases
GreenLight PVP Laser Best Balance
Capital Required £245K
Breakeven Cases 91 Cases

05. Implementation Roadmap

Phase 1 (Weeks 1-4)

Governance & Approval

Critical Path

- Medical Director/COO/CFO sign-off
- Radiology SLA negotiation (CT slots)
- Marketing (£15K) and IT (£8K) budget allocation

Phase 2 (Weeks 3-6)

Service Network Build

- Recruit 2-3 additional consultants to Ollandini Panel
- Standardize professional fee agreements

Phase 4-5 (Weeks 8-12)

Soft Launch (Tier 1)

G&O Live

Digital pre-payment portal live. Google Ads launch (£15K budget). Service launch for ED, Haematuria, Circumcision, and Microsurgery.

Phase 6 (Months 4-6)

Tier 2 Capital Commissioning

Uroflowmetry, PVR scan, and Li-ESWT machines installed and staff trained. Launch LUTS diagnostic bundle.

Month 12 Decision Point

Tier 3 (MIST) Investment Review

Full audit of LUTS volumes. Decision on Rezūm/GreenLight acquisition for Year 2 surgical capture.

06. Verification & Governance

Objection Handling

"Radiology doesn't have CT slots."

Solution: Negotiated SLA for 2 designated slots/week. C&W currently underutilizes evening/weekend capacity for self-pay.

"Consultants won't accept bundled fees."

Solution: Lead Consultant (Ollandini) has verified benchmarks. Integrated model increases patient volume, offsetting lower per-case fee.

Data Quality

All competitor pricing is validated from Jan 2026 published data. Cost assumptions for theatre and imaging are based on standard NHS Trust PPU internal transfer pricing models.

View Full Methodology Report