I'm presenting to you today from the Wurundjeri people of the Kulin Nation. Of course, I pay my respects to the people from the lands from which all of you are joining me today. I pay my respects to their elders past and present, and I extend that respect to all Aboriginal and Torres Strait Islander people who've joined us on the call today. I'm also joined on the call by our Chief Financial Officer, Matt Gepp. Welcome. I will take you through a presentation covering the key financial and commercial highlights for the quarter, followed by the opportunity for Q&A. All attendees will have the opportunity to ask questions at the conclusion of the presentation. If you would like to ask a question, please use the Q&A function button at the bottom of your screen, and we will aim to answer as many as possible.
Any questions that are similar in nature we'll combine, or if I've covered them in the presentation already. If we run out of time or are unable to answer any of your questions, please feel free to send them through to investor@alcidion.com, and we will seek to address those as soon as possible. A reminder to everybody that the webcast is being recorded today and will be available later today on our website. Q1, in this first quarter just passed, we continued with the positive momentum with which we exited the financial year just gone, FY 2025. We further expanded one of our flagship customer EPR contracts with North Cumbria, when we announced a partnership with Mosaic to provide North Cumbria with an electronic document management solution from Mosaic called ManyViewer.
You've probably heard me say a number of times how this is an example of the unique ability that Alcidion has to interoperate with a variety of third-party vendors to bring our customers the very best in class of capabilities to add to our electronic patient record offering. It highlights the value proposition that we provide to our customers by giving them the ability to evolve their product requirements as their budgets become available. We also secured several extensions for existing contracts, which helps us to continue to support to increase that recurring revenue position. In addition to new sales, we had a very active quarter in relation to new and successful deployments. We had deployments go live at University Hospital Southampton NHS Foundation Trust in the U.K. and at Northern Adelaide Local Health Network, or what we often refer to as NALAN in South Australia.
I'll touch on those in a little bit more detail later in the presentation. Despite Q1 typically being a softer quarter for us financially, we're really pleased to deliver our strongest Q1 in two years for both customer receipts and operating cash flow. It's really a positive sign of the maturing nature of the business, and it continues to underpin our confidence in delivering another year of positive EBITDA and positive cash flow. If we look at the financial highlights in a little bit more detail, I'll unpack them here on this slide for you. During the quarter, we signed new sales with a combined TCV of AUD 8.2 million, the majority of that relating to that contract with North Cumbria Integrated Care NHS Foundation Trust to expand the EPR offering.
Approximately 92% of those new sales relate to recurring product revenue, which includes, you know, multi-year license fees and renewals as well as the Mosaic deal. The balance of that, the other 8%, is related to services, which are almost entirely product implementation services related to deployment of our products. At the end of the quarter, we had AUD 36.3 million of contracted revenue reflecting both sold and renewal revenue able to be recognized over the course of FY 2026. Q1 cash receipts from customers were AUD 8.4 million, which is a strong result considering Q1 is historically the softest quarter due to predominantly the annual billing cycle of existing customers in that they haven't signed in the Q1 generally. That's due to, they couple that with the typical seasonal patterns we have around procurement in our key markets where Q1 is generally the softest for new contracts as well.
Driven by that above stronger cash receipts we talked about, we've maintained our operational expense at a similar level to FY 2025. As a result, we delivered an operating cash outflow for the quarter of AUD 600,000, which is a material improvement compared to the operating cash outflow of nearly AUD 4 million in the same period last year. As of the 30th of September, we had AUD 16.4 million of cash in the bank and no debt. I've already covered a lot of the information on this slide in that highlight slide, but I think it's probably worth just pulling out a couple of areas. On the left-hand side, quarterly new sales, the AUD 8.2 million that we delivered in this quarter was our strongest Q1 new sales result for the past three years, and it really positions us well for the balance of FY 2026.
On the right-hand side, you'll see this highlights the seasonality of the cash receipts, which I just alluded to, with that material uplift that we typically see in the second half of the year. The AUD 8.4 million of cash receipts we delivered in Q1 was our strongest result for the past two years. A key driver of new sales in Q1 was the AUD 6.8 million expansion of the North Cumbria electronic patient record (EPR) contract through our relationship with Mosaic, our third-party partner. Mosaic has a product called ManyViewer, and what that product will do, it will provide North Cumbria with an electronic document management system that allows them to ingest documents that are not generated via the Alcidion Miya Precision EPR, but are coming to the trust in a paper format generally.
This assists the trust to digitize fully the whole paper record experience, but also doing that while maintaining the clinical context and relevance of those paper records. We are able to share that clinical context between the Alcidion record and what ManyViewer is providing from the scanned records. ManyViewer is widely known for its strong usability, including its intelligent indexing of data. When you combine that with the power of Miya Precision, it enables documents to be seamlessly viewed from a single user interface, irrespective of where that data was recorded and whether it came from Miya or whether it was uploaded via ManyViewer.
This new contract will contribute around AUD 1.7 million to revenue in FY 2026, and as part of that AUD 36.3 million revenue figure that we put out for the first quarter today, including the recent expansion, the combined TCV of the North Cumbria EPR contract now exceeds AUD 45 million over a 10-year period. The implementation is progressing on schedule. Given the scale of the deployment, it will continue in phases for the balance of FY 2026 and then a little into early FY 2027. It is on track, and given the modular nature of how we deploy, a key feature of what we do is that North Cumbria will be able to start to realize tangible benefits for this very early in the rollout, with the expected first phase go live in the first quarter of 2026 from a calendar perspective.
During the quarter, we renewed another longstanding customer contract with Bolton, which is an NHS trust that expanded the use of Miya Observations and assessments for a further three years. You may, that's often referred to as Patientrack, you may also remember that Bolton also uses Miya Precision for flow, access, and command. We also renewed several smaller contracts in both U.K. and Australia, continuing to underpin the recurring nature of their customer base and the confidence that we have in the long-term proposition of the Alcidion business. Our delivery teams have also been very busy in the first quarter, working to support the deployment of Miya Precision at various new customer sites, which has come about as a result, obviously, of the ongoing continued sales momentum that we saw through FY 2025.
University Hospital Southampton, which we often refer to as UHS, which is in England, successfully deployed our Miya Emergency module, which is now the second customer to deploy this module and the first to replace an existing emergency department digital system from another supplier with the Miya Precision solution. As shareholders may recall, Miya Emergency was a module we developed in response to an identified need, particularly in the NHS, and it continues to demonstrate how we can innovate and commercialize that innovation fairly quickly to add value to customers. During the first week of live operations at UHS, the hospital experienced a record level of patient intake, and at one point, they were reporting they were able to efficiently manage 200 concurrent patients in the emergency department.
They're currently creating in excess of 5,000 documents per day for patients, and that demonstrates the scale at which Miya Precision can perform. Here in the Australian market, we went live just last week at Northern Adelaide Local Health Network, which is technically not the first quarter, but I thought it was worth letting you all know. They went live with Miya Precision using flow, access, and command modules. Our journey boards, our electronic journey boards, will replace all of the physical whiteboards and have done that across Lyell McEwin and Modbury Hospitals. Our bed management and operation centers capabilities are now in use in their network operation center.
You may recall that the command centre functionality from the Miya Precision platform gives hospital administrators a bird's eye view of every bed within not just a specific hospital, but also across an entire healthcare system, which could all be made up of many hospitals. In addition to that, the platform provides predictive metrics that allow hospitals to look at the predictive demand and utilization of their services and facilities. That in turn helps administrators manage patient intake, look at where potential bed blockage might occur, focus on increasing efficiency, which obviously leads to better decision making and ultimately better patient outcomes. We are very excited about the progress we're making across multiple customer implementations, and our delivery teams ought to be recognized for the tremendous work that they are doing.
Looking to the outlook from here, as of the end of Q1, Alcidion had approximately AUD 36.3 million of contracted and scheduled renewal revenue able to be recognized in FY 2026. That does represent the highest value of in-year contracted revenue we've had at the end of Q1 ever. Any new sales obviously are expected to increase that figure over the remaining nine months of the year. We confirm our FY 2026 guidance to deliver positive EBITDA and operating cash flow, with the quantum of that obviously dependent on the timing of contracts progressing through procurement stages, and I will keep you updated with that and get more granular about that as the year progresses.
We continue to progress our strategic analysis and entry to new markets, and just reiterating that that will take time, and I do not expect to be able to give meaningful updates at each quarter as to new deals every quarter. However, we are exhibiting in our first conference in Saudi Arabia this week, which is the Global Health Exhibition. That's all part of assessing the best markets and opportunities for Alcidion and identifying partners to work with in that region. We continue to work with our consultant on the ground in Canada on early adopter opportunities, and we're also attending a conference there, Canada InfoWay in November, and that will be to continue to progress opportunities available to us in that market.
We're confident of the progression of several opportunities across Australia and the U.K., particularly with the scale of our referenceability across multiple markets and the go-lives that we're talking about and how that's driving continued inbound interest in our products. At the end of Q1, we're very well positioned to take the momentum that we saw in FY 2025 through this financial year. Thanks very much for your continued interest, and I'm very happy now to take questions.
Thank you, Kate. We have a few questions that have come in before the webinar, which I will take us through. The first question is, how does Alcidion view the opportunity in Queensland? Are there any current tenders, or is there an expectation that we will go to market for a digital solution in the near term?
Look, we definitely believe there's opportunity in Queensland. We know that there are health services there looking for sophisticated flow solutions, and we know that the Queensland government's very focused on improving patient flow and ambulance ramp challenges. They have been very vocal about that. It's not a problem that's unique to Queensland, but there is a budget in place in Queensland to address these challenges, which may have a digital element. Obviously, we continue to work our sales activity in that market as we do across all of Australia.
Thank you, Kate. Do you have any updates in the U.K., and any impact that the new hires have had so far?
New hires, I guess you're talking about the CCIO and the Chief Revenue Officer, which is Darren and Tracy and Darren, respectively. They have only been in place just over six weeks, but I am extremely pleased with how they've settled in and engaged with our customers and staff. The U.K. opportunities continue to progress as we've expected them to, noting again for shareholders that we do not go for all EPR tenders. Last Friday, the NHS released the medium-term planning framework, which is giving some detail to the 10-year plan and what they're expecting to focus on for the next two to three-year period. Very pleased to see that that has a heavy emphasis on digital. We're working through that document at the moment, and that will inform a lot of our strategies as we move into 2026 and beyond.
Thank you, Kate. We have a question about New Zealand here. In terms of revenue growth, what are Alcidion's plans for New Zealand, and why have sales there been quieter in recent years?
Thanks. New Zealand continues to be an important market for us. To be fair, though, they have been undergoing a period of profound change in their healthcare system, which started with the abolishment of all district health boards. There were 20 of them under the previous government. When the new government came to power, they moved away from a fully centralized healthcare system to introducing four regions rather than that more centralist approach. This has had an enormous impact on the staff and the management and the stability of the healthcare system in terms of looking at new investments. Nearly all digital staff across the whole of New Zealand have been impacted in some way with the disestablishment of their roles and having to reapply for new roles, quite a lot of redundancies. That's been going on for two to three years.
I'm pleased to say it's settled down now, and the landscape, whilst it's very different, with that settling down and people being, you know, permanent in their roles and so forth, we're starting to see a little more thought go into investment in new digital projects. I'm pleased that we've maintained our customer base during that time in our position, and I do look forward to future opportunities in New Zealand now that the new structure's in place.
Thank you, Kate. Question here regarding Silverlink. Of the 12 NHS trusts that used Silverlink in December 2021, how many remain customers today?
All PCS customers that we acquired at the time are still Alcidion customers, with the exception of the previously announced Northwest London and Hillingdon trusts, which we knew were moving away from PCS at the time of the acquisition.
Okay, thanks, Kate. We've had a couple of questions come in during the webinar. Are we seeing the cadence of NHS decision making improving? Is the competitive landscape evolving?
I think the very large EPR deals take as long as they take. They take nine to 12 months to go through their process, and they are still doing that for the EPR deals. That is just a known process that all trusts have to go through. I think we will start to see more localized decision making coming in as a result of this medium-term framework, which, whilst everyone loves the big EPR deals, moving away from that centralist decision making to allowing decisions closer to the ICBs and the trusts, I think, will be of benefit to Alcidion. That will be, probably we'll see that happening more in calendar year 2026.
Thank you, Kate. Regarding your comment on the AUD 1.7 million of revenue for Mosaic for the Mosaic partnership, it's a question about the contribution. Will Alcidion be keeping all of those funds, or will there be an offsetting amount to Mosaic to reduce that number?
Yes, there will be money that goes to Mosaic as a third-party partner. Part of the software obviously goes to them, and part of the implementation as to what they will do goes to them as well. We are very happy with the margin that we get from that engagement with Mosaic.
Thanks, Kate. Multi-pronged question here, maybe half for you, half for me. Do you need to add new sales to the current AUD 26 million contracted revenue to meet your positive EBITDA guidance? Followed by, what does the contract renewal profile look like over the balance of FY 2026?
We do need to add a bit more new sales to hit EBITDA guidance, but I'm pretty confident of doing that. What does the contract renewal profile look like over the balance of FY 2026?
I can answer that if you want, Kate.
Sure.
Look, it's very weighted to the first quarter for ANZ, and it's very weighted to the third and fourth quarter for the U.K.. We've successfully renewed everything up until the end of the first quarter in ANZ, and we fully anticipate the same will happen in Q4 or late Q3 with the U.K. renewals. Sorry, just looking at guidance to EBITDA break even, is there investment in international expansion taken into consideration here? Thank you.
Yes, there is. We have planned out what I have always said is pragmatic and strategic investment without overplaying that investment in line with expectations on return in that investment.
Thank you, Kate. We're on to our last question, which is a bit of a long one. It's regarding, oh, sorry, there's another question just following what you're talking about. Regarding previous comments around acquisitions as a potential way to enter the Canadian market, what are some qualitative and quantitative boxes they must tick?
I think in respect of that, in all instances, when we look at acquisitions, they need to be aligned to what we're doing from a product perspective. They need to provide strategic advantage to us. We are very clear that we're not about investing in developing other people's products. We would be looking for, you know, earnings accretive acquisitions in that market as well, if that was the way to enter. I think that is a possibility, but we are very focused on direct entry into the Canadian market and certainly not relying on acquisitions as the way of doing it.
Thank you, Kate. Now we have an interesting question here on aged care opportunities. What does the opportunity look like in aged care and community care at a high level? Are there any leads? Are there public tenders, or is Alcidion going to talk to private groups to generate sales? Does Alcidion have the technology ready to be implemented in this space, or is there current R&D being spent on this?
Thanks. We believe that Miya Precision lends itself very well to add value to the management and efficient management of beds and people flowing through the healthcare and hospital system and the aged care system, and, quite frankly, aging in place. New models of care are really starting to be looked at, as we know that we've got challenges in our state public healthcare system where complex patients with frailty issues are, you know, once they're in the healthcare system, it is very difficult to move them out. If we can prevent them from ending up in the healthcare system, that is better for everybody. We believe Miya Precision, we're not talking about building systems to run aged care facilities.
We're talking about being able to offer insight and understanding of what is going on in both the public healthcare system and the aged care system in terms of bed availability, but more interestingly, monitoring or remote monitoring of patients who might be at home or in an aged care facility to ensure that they are, you know, maintained safely in that facility and not find themselves transferred to the healthcare system. Where we're at with that is really just talking to people about the potential for that. It doesn't require any further R&D and investment. We just believe it is an extension capability of the existing Miya Precision platform.
Thank you, Kate. That is all of our questions for today's webinar.
Thank you, everyone, for joining us. Again, I thank you for your continued support. It's an exciting time for Alcidion. I look forward to being able to keep you updated as our opportunities progress.
Thank you very much.