Why Pathway Redesign matters
A practical guide to Pathway Redesign for commissioners, providers and service design leads. Learn the governance, evidence and delivery steps that improve outcomes and reduce risk. Service solutions are stronger when pathway design, workforce, finance, governance and mobilisation are considered together from the outset.
Understanding Leveraging Data for Pathway Redesign across the NHS
The Provider Selection Regime (PSR) replaced the previous NHS procurement rules in January 2024, introducing new decision-making processes for awarding healthcare contracts. Unlike the previous Procurement, Patient Choice and Competition Regulations, the PSR provides commissioners with greater flexibility — including direct award options where continuity of care, patient safety or service integration justify it. However, the regime also requires commissioners to demonstrate transparent decision-making and to consider whether competitive tendering would better serve patients.
Providers need to understand the three PSR decision-making processes: Direct Award Process A (for services where there is only one capable provider), Direct Award Process B (for services meeting specific criteria around continuity and integration), and the Most Suitable Provider process which involves competitive evaluation. Each route has different evidence requirements and timelines.
The PSR also introduces new requirements around stakeholder engagement. Commissioners must demonstrate that they have considered patient views, provider feedback and clinical input when making award decisions. Providers who engage proactively with commissioners — sharing outcome data, innovation proposals and partnership plans — are better positioned regardless of which award route is used.
The current landscape
Healthcare service design must balance aspiration with operational reality. The best service models are those developed with input from clinicians, patients, operational managers and finance teams — ensuring that the proposed model is not only clinically sound but also deliverable within the available workforce, estates and financial envelope.
Mobilisation is where many new services stumble. The gap between strategic approval and operational go-live is filled with complex dependencies: workforce recruitment and training, estates adaptation, IT system configuration, governance setup, stakeholder communication and patient pathway redesign. Without a structured mobilisation plan that addresses each dependency with clear timelines and ownership, services frequently launch with gaps that take months to resolve.
What organisations need to know
This article focuses on Leveraging Data for Pathway Redesign across the NHS and the wider priorities around Pathway Redesign, Healthcare Solutioning, NHS, healthcare strategy, best practice. The strongest organisations do not treat this as a stand-alone exercise — they connect governance, workforce, communication and evidence so leaders can make decisions quickly and confidently.
Commissioners, providers and service design leads should consider these questions before proceeding:
- How will you measure whether the service is achieving its intended outcomes?
- What problem does the proposed service solve, and for whom?
- Has the service model been stress-tested with frontline clinicians and operational managers?
Practical checklist
Getting Pathway Redesign right requires structured preparation and disciplined follow-through:
- Define the target model, the problem it solves and the outcomes it should deliver
- Stress-test workforce, estates, digital, governance and mobilisation assumptions before approval
- Write specifications and business cases that are practical enough to commission, mobilise and evaluate
- Translate Pathway Redesign into named actions, owners and realistic deadlines
- Keep evidence, decisions and outcomes in one place so future assurance, inspection or procurement activity is easier to manage
Evidence you should have ready
Organisations with strong evidence bases consistently perform better in healthcare solutioning activities. Key evidence includes:
- Stakeholder engagement evidence demonstrating clinical and patient input
- Options appraisal documentation showing evaluation criteria and scoring
- Workforce model with skill mix, capacity calculations and recruitment feasibility
Governance considerations
Strong governance underpins successful delivery. For Pathway Redesign, this means:
- Project governance with named SRO, clinical lead and operational lead
- Stage-gate approvals at key milestones (design, business case, mobilisation, go-live)
Common mistakes to avoid
Based on our experience working with commissioners, providers and service design leads, these are the most frequent errors:
- Designing new services without enough operational detail to implement them
- Underestimating mobilisation dependencies across workforce, estates and digital
- Producing business cases that describe ambition without evidencing feasibility
Avoiding these pitfalls requires leadership commitment, clear accountability and a willingness to seek independent review when internal perspectives may be limited.
How CPGB Ltd can help
We support commissioners, providers and service design leads with service design, option appraisal, business cases and mobilisation planning. Our team combines frontline health and social care experience with practical consultancy so recommendations are proportionate, evidence-led and built for real delivery.
With over 100 years of combined NHS experience and a track record that includes contracts worth over £200 million, investigations across 50+ NHS trusts and 40+ CQC improvements achieved, we bring both credibility and practical expertise to every engagement.
Contact us to discuss Pathway Redesign and the wider priorities around Healthcare Solutioning, NHS, healthcare strategy, best practice.