CLEAR

What CLEAR does

CLEAR (Clinically-Led workforcE and Activity Redesign) is a UK NHS transformation programme operated by 33N Ltd, a private limited company founded in October 2017 by NHS clinicians Dr John Jeans, Dr Alex Monkhouse, and Dr Shruti Dholakia. CLEAR trains frontline NHS staff in data analysis, innovation, and leadership using a structured four-stage methodology (clinical engagement, data interrogation, innovation, and recommendations) and delivers workforce redesign and service transformation projects for NHS acute trusts, mental health trusts, primary care networks (PCNs), and integrated care systems (ICSs) across England. The programme is hosted by East Lancashire Hospitals NHS Trust through the National CLEAR Faculty at Royal Blackburn Hospital and has completed more than 50 projects spanning urgent and emergency care, elective recovery, mental health, primary care, and ophthalmology, with over 200 clinicians trained as CLEAR Associates.

The product portfolio includes the flagship National CLEAR Programme offered in three tiers (CLEAR Complete, CLEAR Compact, CLEAR Essentials), the CLEAR Living Well CVD Prevention Toolkit encapsulating seven models of care, the CLEARnotes AI patient consultation transcription tool (piloted at East Lancashire NHS Hospitals Trust with a 20% reduction in consultation time across 1,700 consultations), and the newly launched CLEAR AI-driven Midlands Radiology Transformation Programme in partnership with The Royal Wolverhampton NHS Trust. Technology components include the proprietary CLEAR methodology (trademark protected) and CLEARnotes AI, an audio-to-text clinical summarisation tool co-designed with NHS clinicians.

CLEAR's business model is a public-sector commissioned services model rather than a conventional commercial sales motion: NHS England, Health Education England (now part of NHS England), NHS regional offices, and ICBs sponsor and commission projects, with services delivered free of charge to participating NHS organisations. Go-to-market is via NHS commissioning channels and an expression-of-interest process for trusts and PCNs, supplemented by CLEAR's own webinar series, case studies, the annual CLEAR Week event, and regional sponsor relationships across England's seven NHS regions. No external venture or private-equity funding is disclosed in the source material.

Name

CLEAR

Legal name

33N Ltd

Website

https://clearprogramme.org.uk

Company type

Private

Founded year

2017

Operating status

Operating

Headcount range

11–50 employees

Short description

CLEAR (operated by 33N Ltd) is a UK NHS transformation programme that trains clinicians and delivers workforce redesign and service transformation projects across NHS trusts and primary care networks in England using a four-stage methodology, with an expanding AI offering via the CLEARnotes consultation transcription tool.

Ownership category

akta.pro rank

Product category

Healthcare Workforce and Service Transformation

SIC

Services-Management Consulting Services (8742), Services-Health Services (8000)

akta.pro primary industry

Change Management & Transformation Leadership (EDABAAAD)

Keywords

• NHS workforce transformation
• Clinical engagement methodology
• Healthcare service redesign
• NHS data analytics
• Primary care transformation

Headquarters

HQ city

Blackburn

HQ country

United Kingdom

HQ region

Europe

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure, Others

Revenue model

1. NHS Commissioned Services: CLEAR programme is sponsored by NHS England, Health Education England (now part of NHS England), NHS regions and systems. Projects are commissioned by NHS England, NHS England regions, and Integrated Care Systems for transformation and workforce redesign services.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

CLEAR (Clinically-Led workforcE and Activity Redesign) delivers a national NHS transformation programme that equips frontline clinicians with skills in data analysis, innovation, and leadership to drive workforce redesign and new models of care. Its core offering is a structured 26-week methodology of clinical engagement, data interrogation, innovation, and recommendations, delivered through commissioned projects to NHS trusts and primary care networks across urgent and emergency care, elective recovery, mental health, primary care, and ophthalmology.

Product overview

The National CLEAR Programme is a platform of interconnected NHS transformation offerings built around a core four-stage methodology (clinical engagement, data interrogation, innovation, and recommendations). The core programme is available in three tiers: CLEAR Complete (full 24-week programme), CLEAR Compact (condensed version), and CLEAR Essentials (foundational introduction). Distinct named products include CLEARnotes, an AI-powered patient consultation transcription tool; the CLEAR Living Well CVD Prevention Toolkit; the CLEAR AI-driven Midlands Radiology Programme; and the CLEAR Webinar Series. The programme operates across five clinical priority areas: urgent and emergency care, elective recovery, mental health, primary care, and ophthalmology. CLEAR is sponsored by NHS England, hosted by East Lancashire Hospitals NHS Trust, and delivered by 33n.

Differentiator

Problem solved

Functional benefit

Brands

• CLEAR Complete: Full 24-week CLEAR transformation programme with comprehensive training and support
• CLEAR Compact
• CLEAR Essentials
• CLEAR Living Well
• CLEARnotes
• CLEAR Living Well CVD Prevention Toolkit

Products and services

• National CLEAR Programme The flagship nationwide NHS transformation programme that supports clinicians and organisations to deliver workforce redesign and service improvement projects, training frontline staff in data analysis, innovation and leadership using a four-stage methodology (clinical engagement, data interrogation, innovation, and recommendations) to enhance patient care, efficiency and staff experience.
• CLEARnotes An AI-powered patient consultation transcription tool developed by NHS clinicians that automatically listens to and summarises patient consultations in real time, reducing consultation times by 20% in pre-operative settings and piloted across 1,700 consultations at East Lancashire NHS Hospitals Trust.
• CLEAR Living Well CVD Prevention Toolkit A practical toolkit commissioned by NHS England to support Primary Care Networks, ICSs and primary care partners in improving or embedding new cardiovascular disease prevention pathways, encompassing seven different models of care developed and tested by pilot PCN sites.
• CLEAR AI-driven Midlands Radiology Programme A fully funded AI-driven radiology transformation programme delivered in partnership with The Royal Wolverhampton NHS Trust and NHS England – Midlands, applying CLEAR methodology and AI to support radiology service redesign across NHS trusts in the Midlands.
• CLEAR Impact Webinar Series Monthly impact webinars sharing findings, learning and impact from CLEAR transformation projects, led by clinicians and managers across urgent and emergency care, elective recovery, mental health, ophthalmology, primary care, and cardiovascular disease prevention.

Quantifiable outcome

• Up to £14 return on investment over 5 years for every £1 invested
• +10 more outcomes

Named customers11 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability3 records

Feature3 records

Partnerships

Eleven partnerships are on record, tiered strategic, core, regional and pilot.

• Brunel University LondonstrategicStrategic or Co-development Partner · 8 June 2021Academic partner in CIRLC (COVID-19 ICU Remote Learning Course) development. Led by Dr Eve Corner, Lecturer in Physiotherapy. Partnership combining academic expertise with NHS clinical knowledge.
• East Lancashire Hospitals NHS TrustcoreStrategic or Co-development PartnerHost organisation for the National CLEAR Programme. Provides the faculty and infrastructure for programme delivery across NHS England.
• 33ncoreStrategic or Co-development PartnerCompany of NHS clinicians, education specialists and data scientists that designs and delivers the National CLEAR Programme. Co-founded by Dr John Jeans, Dr Alex Monkhouse, and Dr Shruti Dholakia.
• NHS EnglandcoreStrategic or Co-development PartnerPrimary sponsor of the National CLEAR Programme. Funds and commissions transformation projects across NHS priority areas including urgent care, mental health, and primary care.
• Health Education EnglandcoreStrategic or Co-development PartnerOriginal sponsor of the CLEAR programme. Now part of NHS England, HEE supported initial programme development and mental health commissioning.
• NHS England - North East and YorkshireregionalStrategic or Co-development PartnerRegional sponsor of the CLEAR North East and Yorkshire Capability Programme encompassing mental health and UEC projects.
• NHS EnglandregionalStrategic or Co-development PartnerCommissioned the CLEAR Women's Health Derbyshire project and CLEAR Living Well programme for CVD prevention.
• NHS Frimley Integrated Care BoardregionalStrategic or Co-development PartnerSponsor of the Frimley Health NHS Foundation Trust frailty UEC project through CLEAR methodology.
• The Royal Wolverhampton NHS TrustregionalStrategic or Co-development PartnerPartner with NHS England Midlands in the CLEAR AI-driven Midlands Radiology Transformation Programme.
• NHS Health Education EnglandstrategicStrategic or Co-development PartnerSupported rapid ICU training through CIRLC course during COVID-19 pandemic. Enabled national scaling of redeployment training.
• Cheshire and Merseyside PCNspilotStrategic or Co-development PartnerThree PCNs in Cheshire and Merseyside developed preventative care models for CLEAR Living Well 2023, informing national programme expansion.

Scale indicators19 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• PA Consulting: Global consulting firm with dedicated healthcare practice serving NHS trusts, arms-length bodies, and life sciences clients on transformation and workforce strategy. A broader incumbent that overlaps with CLEAR's NHS service redesign remit.
• GE Healthcare Partners: Consulting arm of GE Healthcare delivering hospital and health system transformation, command centres, and clinical operations redesign globally, including NHS engagements. Overlaps with CLEAR's operational transformation focus but at much larger scale.
• KPMG UK (Healthcare): Big Four consulting firm with a large UK healthcare practice advising NHS England, trusts, and ICSs on transformation, workforce, and operating model redesign. A broader incumbent serving overlapping NHS customers.

Others

• The King's Fund: Independent UK health think tank that influences NHS policy, leadership development, and service transformation. Adjacent to CLEAR through shared NHS transformation ecosystem and workforce narrative, but not a direct competitor.
• NHS Horizons: NHS England-hosted transformation and innovation network that supports large-scale change across the NHS. Operates in the same NHS transformation ecosystem as CLEAR but functions as an internal NHS enabler rather than a commercial programme.

Direct peers

• Carnall Farrar: UK-based health and care strategy consultancy that works extensively with NHS trusts, ICSs, and national bodies on transformation, workforce, and operational improvement. Closely comparable to CLEAR's NHS transformation and workforce redesign focus.
• Nuance Communications (DAX / Microsoft DAX Copilot): Provider of DAX ambient clinical intelligence, now part of Microsoft, which automates clinical documentation in NHS and US health systems. Direct competitor to CLEARnotes AI in the UK ambient clinical documentation market.
• Newton (European consultancy): European operations and transformation consultancy with a substantial NHS practice delivering clinical pathway redesign, workforce productivity, and service transformation. Comparable to CLEAR's methodology-led NHS transformation work.
• CF (formerly CfWI) workforce transformation consultancies: UK workforce planning and clinical workforce transformation consultancy with deep NHS experience in workforce redesign and clinical pathway modelling. Directly comparable to CLEAR's workforce and activity redesign mandate.

Emerging players

• Abridge: US-based AI clinical conversation platform generating structured clinical notes from patient-provider dialogue. Comparable to CLEARnotes as an emerging player in ambient AI clinical documentation with expanding NHS and health system interest.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/clear4care

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about CLEAR