Developed in Birmingham, now in routine NHS use

"Most people referred with blood in their urine won’t have bladder cancer, but they enter the same urgent pathway as those who do," says Jeff Bousfield, CEO of Nonacus. "GALEAS Bladder helps clinicians identify the patients most likely to have cancer sooner, so they can get to diagnosis and treatment faster, while an immediate cystoscopy can be safely deferred for some lower-risk patients."

This June, Nonacus’s at-home bladder cancer test moved from evaluation into routine NHS use. Nine hospitals, led by University Hospitals of Leicester, have adopted GALEAS Bladder to help patients to avoid cystoscopy, which has long been a core part of the standard diagnostic pathway for people referred with suspected bladder cancer.

A recently published prospective real-world evaluation of 964 patients across seven NHS urology departments found GALEAS Bladder detected 71 of 77 cancers (92%), including all 17 muscle-invasive cancers and 35 of 36 high-grade cancers, with a negative predictive value of more than 99 per cent.

"Urologists develop exceptional skill in performing and interpreting cystoscopy, often in complex and challenging circumstances," says Jeff Bousfield, Nonacus's CEO. "GALEAS Bladder gives them an additional, highly accurate tool to help prioritise the patients who most need that expertise, and to discharge others safely and sooner."

Bousfield describes the development as the result of a decade-long relationship with the University of Birmingham which began with people, rather than Intellectual Property.

Co-founder Lee Silcock studied at the University of Birmingham before training as a clinical scientist in the NHS and the underlying science behind GALEAS Bladder was developed through a long-running collaboration with Professor Rik Bryan and Dr Doug Ward at the University’s Bladder Cancer Research Centre. Nonacus was founded in Birmingham in 2015 and initially operated from Biohub Birmingham® at Birmingham Research Park on the University of Birmingham campus, before moving into larger premises in Quinton in 2022. Physical location matters, says Bousfield, for the ongoing relationships between the University and Nonacus.

Collaboration between Nonacus and the University is deepening. Nonacus and Bryan's team have run a string of studies together, including BC-RECON, a 3,200-patient study evaluating GALEAS Bladder against cystoscopy in NHS clinics. A follow-on study, TRAIN-gen, began in April 2026 with NIHR funding to test whether the urine test can safely reduce how often patients need repeat cystoscopies during monitoring. "We've got maybe half a dozen other studies in the works," Bousfield says, "to continually build the evidence for GALEAS Bladder."

The scale of the problem is significant. Of the many people in the UK who see their GP each year with haematuria (blood in their urine) only 7 to 12% turn out to have cancer. Most people referred with suspected bladder cancer currently enter the same urgent cystoscopy pathway, although only a minority are ultimately diagnosed with cancer. "We want to make early cancer testing available to absolutely everyone, wherever someone is, or whatever their background or socioeconomic status," Bousfield says.

Eleven years in, Nonacus remains employee-owned, giving the business the freedom to take a longer-term view on investment and growth.

"By August 2025, Nonacus and the University of Birmingham had achieved a cumulative total of over £5 million in funding to deleop GALEAS Bladder (including ongoing trials). This is a testament to the preceding eight years of collaborative research and development between the University of Birmingham and Nonacus."