> ## Content Index > Fetch the complete content index at: https://med-techinsights.com/llms.txt > Use this file to discover other available public pages before exploring further. # Putting collaboration at the heart of NHS pathway redesign - URL: https://med-techinsights.com/putting-collaboration-at-the-heart-of-nhs-pathway-redesign/ - Published: 2026-11-11T14:34:08.000Z - Updated: 2026-11-12T15:54:14.000Z - Description: “Collaboration needs everyone in the same room working for the patient” How can we bring together different bodies across the NHS, from patients to providers, to improve the spread of innovation and improve outcomes for patients? This is the focus of the Medical Technology Group’s latest report on c - Author: Oliver Johnson - Tags: Insights, Policy & Regulation ###### **“Collaboration needs everyone in the same room working for the patient”** --- How can we bring together different bodies across the NHS, from patients to providers, to improve the spread of innovation and improve outcomes for patients? This is the focus of the [**Medical Technology Group’**](https://mtg.org.uk/?ref=med-techinsights.com)s latest report on collaboration. One of the case studies to highlight what this looks like was the Rapid Access to Valve Assessment, which has transformed outcomes for hundreds of patients in Greater Manchester. The MTG sat down with one of the pathway’s architects, Professor Keith Pearce, to discuss the why and how of what collaboration looks like on the NHS. ###### ***MTG: A key part of the RAVA pathway was the involvement of patients in its design, something our report calls for at a more systematic level. Can you tell us exactly how this took place and what was learnt?*** **KP:** We had about three engagement sessions. Some had ICB representatives, physicians and sonographers there, and everybody got to speak, in a virtual room like this one. We also held stakeholder-specific sessions. We brought patients together on their own so they could speak openly and freely, with no fear of a clinician or the ICB hearing what they said. The perfect example is one of the patients from our internal charity, the Ticker Club. Its members have all been through a pathway from beginning to end of an intervention. One patient essentially said that the journey was fragmented and disjointed, and that they didn’t feel truly cared for until the operation. Under the old pathway you’d tell someone they had a valve problem, send them to various people for various tests, and only at the end would the surgeon say, “Yes, you’ve got this valve problem and we’re going to operate.” One patient told me: “The moment you tell me I’ve got a diagnosis and that you’re going to do something about it, I feel safe.” Now we give it to them at the beginning, and the psychological impact on the patient is huge. ###### ***MTG: Our report was an attempt to understand what creates this sort of collaboration. Is there an organisational structure or a cultural feature in Greater Manchester that encourages this kind of collaboration, in this clinical area and others?*** **KP:** In this case, I had a vision of where we were and where I wanted to get to. What made the difference was using an external organisation, the NHS Transformation Unit. It doesn’t sit within my trust; it works across the NHS. I said to them: “I need you to design something you’ll live and breathe every day of the week, because I can only live and breathe it for the two hours a week I spend on it.” They worked on it daily, brought the patients together, and opened all the communication channels, so that when I arrived to make the case, everybody was there. They were the project managers for the whole transition, and we wouldn’t have done as well without them. I think that’s where the NHS falls down. Clinicians lead these projects believing they know what’s best, and in fact the Transformation Unit made us do things we would otherwise have missed or skipped. Technology was the other part of it. Under the old pathway, the GP requested an echo and then referred on through ERS, the NHS electronic referral system, which builds in delay. In our pilot, the echocardiographer at the independent sector provider scans a QR code stuck on the echo machine. That links directly to a secure Microsoft referral form for our specialist clinic, so the patient is referred on the same day as the scan. ###### ***MTG: From the outside looking in, there can be a lot of frustration from a patient’s perspective when they discover this sort of innovative treatment isn’t available in their postcode. In short, if something like RAVA works, why isn’t it everywhere in the NHS? And what would other areas need to do to implement it?*** **KP:** Getting anything new into the NHS is a long-winded process, whether it’s new technology or a new service redesign. I think the beauty of the system we developed with the Transformation Unit is that the framework is simply to bring in specialist care earlier. How you do it can differ by region. We gave the framework to those five hospitals and told them to do it their own way, in a way that suits their population. All five are now up and running, and they’re due to present their first year of data back to us. At that workshop we’ll launch phase three, the national rollout. All the other surgical centres have been invited. It has to be surgical centres, because the specialist you see needs to be able to deal with the problem, and not every hospital operates on valves at this level. All of them have shown that putting specialist care earlier in the pathway produces better outcomes and better procedures. More importantly, patients aren’t sitting on long waiting lists and being readmitted, so you’re also saving money. At that meeting the centres will be asked whether they want to take it on, and the national Transformation Unit will support their local delivery. I’m hoping it will become a national programme. So to people asking why it isn’t everywhere already: testing takes time, and you need the data. I think our data is pretty substantial. We’ve now seen 200 patients in our clinic, 70 of whom have gone on to an intervention, probably 100 or 200 days sooner than they would have done before. ###### ***MTG: Our report calls for industry engagement to move away from transactional procurement discussions towards earlier strategic engagement, with the right governance. How do we get life sciences companies and other expertise from outside the NHS involved in pathway redesign and other innovation?*** **KP:** Because this project had such broad engagement sessions, we brought in the two biggest providers of echocardiography in Manchester, neither of which is based in a hospital. One is FCMS (Fylde Coast Medical Services) and the other is InHealth, which provides lots of services, including mobile vans. They’re an independent sector, third-party provider of diagnostic services. They’re absolutely key to the future of healthcare delivery. Without them we couldn’t deliver the 25,000 echocardiograms a year they do in Manchester alone; the hospitals don’t have the capacity. So rather than seeing them as competitors, we need to see them as collaborators. Our engagement sessions went to them and said: we want you to be part of the solution. Probably about 80% of the patients we see now come from them. They provide a service to primary care, but they link straight to the specialist centre. Previously they would do the echo and send it back to the GP, who would manage the patient. When you speak to primary care physicians, they don’t want a report saying “please refer to cardiology”. They want one that says “this is normal”, or “this is abnormal and I have referred to the RAVA for you.” That kind of collaboration needs the ICB, primary care, the independent sector, secondary care and social care providers all in the same room, working for the good of the pathway and the patient. I think that’s true collaboration. *Access the MTG’s latest report* [*Driving Collaboration: The role of Culture, Structures and Finance in Reforming*](https://mtg.org.uk/campaigns-and-reports/nhs-culture/?ref=med-techinsights.com)*.*