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On Wednesday 3rd June, ABHI International hosted its Global Ambitions Forum, hosted by Hale House in the heart of the Harley Street Health District. The event brought together leaders from global HealthTech companies, entrepreneurs, early-stage businesses and legal partners to help ABHI members better understand how to choose international markets, and how to actually operate in them.  Opening remarks came from Paul Benton, Managing Director of ABHI International, and Andrew Griffith, CFO of the Harley Street Health District, who outlined the opportunities the District offers for HealthTech innovation. The keynote was delivered by Stephen Williams, Group Sales Director at Intersurgical.  With over 40 years at the company, he reflected on a growth journey that was far from linear, sharing practical lessons from decades of international expansion. A clear theme from his talk was sequencing. Many companies instinctively look to the US first, But Stephen’s advice was to also consider starting in Europe. From his experience, expanding closer to home means businesses can build capacity and learn how to operate across borders before entering more complex markets. The Netherlands consistently stood out as a strong first step, given its proximity, accessibility and familiar healthcare structure.   

However, market choice is secondary to operational readiness. If a business is struggling to meet UK demand, exporting quickly will expose that weakness. Growth, as Stephen pointed out, rarely comes gradually, it tends to arrive in sudden spikes, where even a single contract can create significant pressure on supply.  The first panel, focused on the realities of international expansion, reinforced these points. Stories of “national” distributors covering only one city were not exceptions, they were cautionary tales. Due diligence was enforced as not a one-off exercise, and assumptions around market coverage can take years to uncover. Strong contractual foundations are essential, and wherever possible, product registration should sit with the manufacturer. If a distributor controls them, they control market access. There was also a clear shift in how market entry was framed. Shipping product alone is not enough. Success depends on active, ongoing engagement, supporting sales teams, building clinical relationships and driving adoption on the ground. Without this, businesses do not have a true go-to-market strategy, only a supply chain.   

The second panel explored what it really takes to operate internationally, adding another layer of complexity. Cultural differences emerged as one if the biggest factors.  The US healthcare system is generally more market-driven and commercially oriented, whereas many European healthcare systems place a stronger emphasis on cost-effectiveness in the context of public budgeting. In Saudi Arabia and across the GCC, relationship building takes longer, and negotiations follow a different pace, but strong relationships can deliver significant long-term returns.   

Regulatory environments also vary widely. In Saudi Arabia, new laws are introduced frequently, often with delays between legislation and full implementation. In the US, complexity stems from fragmentation, with 50 different state tax systems and sales tax obligations that can arise even without a physical presence. These are not edge cases, they are day-to-day operational realities. A consistent message throughout the day was the importance of validating product-market fit before expanding. One example highlighted a two-week accelerator programme in Japan that ultimately revealed no viable demand, largely due to demographic factors. Insights like this, gained early, can prevent years of misdirected investment. Government-backed programmes and networks were highlighted as valuable tools, offering subsided research and in-market access.  

Partnerships were also positioned as a key enabler of growth. Whether through formal international agreements or established local networks, the right partnerships can accelerate market entry, but only when supported by robust legal frameworks.  Engaging local legal counsel from the outset is critical, rather than waiting for issues to emerge.  Structural decisions play an equally important role. In the US, employing staff typically requires a local entity which also carries greater credibility with customers and investors. In Saudi Arabia, setup can be relatively straightforward but depends heavily on selecting the right structure early on. Across all markets, governance, tax, and compliance frameworks need to be designed upfront, and not retrofitted later. 

The overarching takeaway from the day was consistency. International expansion is not defined by bold moves, but by disciplined execution. The companies that succeed are those that stay closer to their markets, invest in relationships over time, and focus deeply rather than spreading themselves too thin.    

ABHI International, including its US and Middle East Accelerator Programmes, plays a key role in supporting UK-based companies as they develop and execute their expansion strategies with confidence. If you are considering your next step internationally, it is well worth engaging with the team to explore how they can help accelerate your journey. Get in touch today: USAccelerator@abhi.org.uk or MEAccelerator@abhi.org.uk.