How Do You Build for Global Scale?

As start-ups set their sights beyond domestic markets, the challenge is shifting from ambition to architecture. International expansion is no longer a later-stage decision, but a design principle embedded from inception – determining whether a company can scale seamlessly across borders, or struggle to adapt when it arrives there. Dr Sonia Szamocki, founder & CEO of Balderton Capital-backed AI healthtech start-up 32Co, reveals the foundations required to build a business that can expand across international markets.

What’s your top strategy for scaling a UK start-up internationally?
It’s crucial to consider early whether you are building a truly location-agonistic product, or not. In healthcare, which is highly regulated, this is even more important. It doesn’t mean committing to a build which serves the whole planet from day 1, but it’s considering carefully whether you are building in a way that scales seamlessly, or whether it’s going to be painful to undo earlier work. We knew early on that our business model and architecture would be built to support international scale, allowing us to make key decisions around things like regulations and compliance early on. 

Which tools or platforms helped you scale fastest?
The temptation when entering a new market is to immediately start marketing activities – you feel that your lack of brand awareness has to be counteracted by spend. But when entering a large market, like the US, that can get expensive quickly. So in our experience, it’s better to start experimenting in small regions or within specific personas, using a variety of tools whether its platforms like Google or Meta, or AI sales tools which automate outbounding. Once you get traction, you can double down. For us, growing into a tight-knit community of doctors, reputation is everything. Word of mouth does the rest. We’ve focused heavily on delivering the best experience for dentists regardless of age, experience, or geography. We’ve noticed that the highest quality scaling has occurred through channels we don’t directly control, like private Facebook groups and communities with special interest. 

What role do accelerators or networks play in international growth?
I’ve been fortunate to access networks which have allowed us to shortcut learnings it would otherwise have taken years to build. For example, access to trusted local operators to give early feedback, faster understanding of nuanced market dynamics, and early distribution partnerships.  However, building networks takes time and effort, and asking people for help only works if you’re clear on what you need. Broad “exposure” is far less useful than targeted access to the 5–10 people who actually unlock a market. For us, specialist healthcare networks and operator communities have been more valuable than general startup accelerators.

How do you tackle regulatory differences across countries?
If you are operating in a regulatory space, take the requirements seriously early on. Most companies building in healthcare will be familiar with this, and will know which approvals they need to serve a new market. There is lengthy administration work required to support this, whether it’s filing with regulatory authorities or updating your terms and conditions – and it can feel painful, time consuming and expensive. For us, our customers are themselves licensed, regulated doctors, and our suppliers are additionally licensed to supply countries. We sit in the middle and provide the infrastructure connecting all parties seamlessly.

What’s the biggest mistake UK startups make when going global?
Having spoken to many founders and operators about this, the main pitfalls are typically: not spending enough time on the ground in your new market to understand the nuances, and assuming that the challenges you solved in your home market will translate directly. Small things like using British English spelling in your product will feel odd to an American user, and it can be enough to make the product feel unfamiliar. When looking to launch your product in a new market, it can be difficult to hear feedback from potential new customers that your product isn’t quite right for them in its current form, particularly if there is investor pressure to expand geographically. It means making tough decisions about whether to develop the product with the new market in mind, or whether to continue building for your home market. But facing up to that strategic question and being deliberate, instead of sitting on the fence and trying to do both, is essential.