When Graham Prestwich was first involved as the lay member of a local prescribing committee, which aims to safeguard the health and wellbeing of the people of Leeds in relation to all aspects of their medicines, he had a watershed moment that fundamentally changed how he viewed the role of patients in their care.

“Clinicians routinely hand out prescriptions and often leave patients to figure out the practicalities on their own,” Prestwich explains. It made him realise how much responsibility patients carried: managing their treatment, weighing up advice, coping with side-effects. And often with little support and guidance.

Prestwich co-developed, with dozens of patients from West Yorkshire, the ‘Me and My Medicines’ charter, a campaign rooted in patients’ lived experience and designed to support their more meaningful involvement in the choice and use of medicines.

Instead of viewing innovation from a purely system or service delivery lens, Prestwich and his colleagues flipped the perspective: what if we began by walking through the patient journey through the care system and learnt from their experience?

Now Health Innovation Yorkshire and Humber are encouraging this approach when it comes to medical technology and commissioning to drive the uptake of NICE-approved technologies.

The seven-step framework essentially envisages the patient as a “project manager”, including patient experience and insights into the contributions made by every stakeholder involved throughout their care journey. The outcome is greater collaboration through co-production involving everyone including patients, clinicians, commissioners and service providers.

“If everyone shares in one agreed plan,” he says, “each part of the system can rely on the other contributors, with a consistent approach along the entire patient journey. The patient isn’t left navigating conflicting advice or filling in the gaps as they move between the hospital, GP, the pharmacist, the nurse.”

As is so often the case, by improving the quality and consistency of communication of key information and advice, the more likely patients will be able to take on their role as their own health and care project managers, organising and delivering many aspects of routine wellbeing improvement.

At its core, Prestwich’s framework aims for consistency in communication and information, all prioritising the patient’s perspective. This, he says, is something that is often missing in the NHS, particularly for those from underserved communities. “What do I need to know to try this, how do I get it, how do I know it’s working and how will it be reviewed? Only when all those patient questions can be answered will more patients be able to contribute to  informed decisions about their own care.”

The use of the framework is in its early days, but Graham and his team are currently in the process of presenting to different Health Innovation Networks across England. One example of an innovation being successfully driven through the framework is the NICE-approved non-invasive Aposhealth, a pair of shoes with two curved pods calibrated by clinicians to be worn at home to reduce pain and improve function in patients with knee osteoarthritis.

“The device has experienced many barriers and sometimes scepticism,” adds Prestwich, “but there’s growing support among patients and clinicians for the device. The framework encourages patient experience to help inform decisions by everyone involved in the choice and adoption of novel and effective treatments.”

Prestwich also sees this framework as a valuable contribution to the Government’s three reforming shifts: moving care from hospital to community; implementing digital transformation; and shifting from treatment to prevention. When asked about progress in patient involvement, he says that the rhetoric is in the right direction, but the delivery is short and has a long way to go.

“The Government’s three big shifts for reforming the NHS will require me as a patient to do more.” The reality is patients are going to have to take on more, and will be expected to do more, for the ‘three shifts’ to happen. Across our diverse communities people have different and changing needs and this variation must be understood and appropriate support and help made available.

“I’m worried that the true value of authentically involved and supported patients will be diminished at a time when the walls are seemingly closing in on time and resources for more patient involvement. I’m hoping this framework will help the system realise how important authentic patient involvement is if we’re to build a more modern and sustainable national health service.”

The Framework for Driving Innovation Adoption Through Patient Insight from Health Innovation Yorkshire and Humber can be accessed here.

June 2025