I remember hitting a similar wall with my own team a while back. That risk imbalance you're feeling is exactly why performance-based models exist-they're a lot more available than most PR agencies would have you believe.
Same logic applies to outbound lead gen. So many agencies want a £3-5k retainer regardless of whether they actually book meetings. The decent ones tie compensation to real pipeline outcomes: cost per meeting, a revenue share, or some hybrid that shares the risk. Our best move was switching to a model where we only paid when qualified meetings landed.
At around £24k MRR growing 18-25% month on month, the bottleneck isn't awareness-it's qualified pipeline velocity. PR gives you brand presence but rarely speeds up sales cycles. Direct outbound to your exact ICP-compliance officers, practice managers, healthcare ops leads-tends to compound faster at your stage.
Out of curiosity, what does your current outbound motion look like? Have you tested LinkedIn specifically for that buyer persona? We found it took some tweaking, but once we got the targeting right it made a real difference.
