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Bridging the gap between approval and uptake in medicine and health technology
Bridging the gap between approval and uptake in medicine and health technology
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The life sciences industry is delivering innovation at unprecedented speed, yet across the NHS, a persistent gap remains: approval does not equal access.
In some cases, fewer than half of eligible patients receive approved treatments. Despite a 90-day funding mandate, consistent adoption can take 12 to 24 months or longer. For patients, that delay is not theoretical, it is time without potentially life-changing care.
This is not a failure of science. It is a failure of implementation.
For pharmaceutical and health technology organisations, this shifts the challenge fundamentally from generating evidence to enabling adoption at scale.
The real barrier: insight from the front line
Work and information overload are significant barriers. When cognitive load is high, attention is necessarily directed to immediate clinical priorities, leaving less capacity to absorb and implement new guidance."
This exposes a critical truth, the issue is not reluctance to adopt innovation. It is the reality of delivering care in a system under constant pressure.
Nic continues:
“Clear communication alone is not enough. We must deliver the right information at the right time, because clinicians cannot reasonably be expected to recall evolving guidance while managing competing demands."
Yet many adoption strategies still rely on exactly that, expecting clinicians to translate guidance into action, often outside the systems they already use.
That gap is where adoption breaks down.
Why adoption still fails
Across the NHS, structural barriers continue to limit uptake even for well-evidenced, guideline-supported innovations.
- Guidance does not fit easily into workflows — translating recommendations into day-to-day care is often complex
- Identifying eligible patients at scale remains difficult — particularly in fragmented data environments
- Local variation delays implementation — creating inequity in access
These are compounded in primary care explains Nic:
Limited funding and unrecognised workload can hinder adoption. Without support, new responsibilities are difficult to take on — making effective planning, resourcing, and decision support essential."
Even when funding is available, complexity slows progress:
“New medicines introduce additional monitoring, dose titration and decision-making alongside existing patient complexity. Building confidence takes time, so training and decision support are critical.”
And even after national approval:
"Integration doesn’t happen overnight. Practices and local health systems often need to update local guidance to align with national recommendations and this delay can reduce the speed of uptake."
The pattern is consistent. Innovation does not stall because it lacks value, but because it does not align with how care is delivered in practice.
From guidance to action: a different model
If adoption fails at the point where guidance meets practice, then the solution must sit within care delivery itself.
A new model is emerging, one that embeds adoption directly into clinical workflows, rather than relying on memory, training, or manual processes.
In this approach, guidance becomes actionable at the point of care through:
- Real-time prompts that support evidence-based decisions
- Identification of eligible patients using live data
- Structured pathways that move patients efficiently from diagnosis to treatment
- Consistent implementation across settings to reduce variation
Embedding decision support directly into systems like EMIS Web makes it easier for clinicians to act, reducing dependence on manual recall and bridging the gap between guidance and practice."
The shift is fundamental, from expecting behaviour change to designing systems that enable it. Adoption becomes part of care, not an additional task.
Moving beyond traditional approaches
Education and communication remain important but on their own, they have not solved the adoption challenge, and they will not.
What changes outcomes is the ability to apply guidance in real time, within the clinical workflow, where decisions are made.
Digitally embedded, connected approaches do this by:
- Translating guidance into action automatically
- Standardising delivery across care settings
- Enabling earlier intervention through proactive identification
This transforms engagement from intermittent messaging to continuous, contextual support.
Proof in practice
When adoption is designed into the system, the impact is measurable.
A connected approach by Optum has already:
- Identified over 52,000 chronic kidney disease patients for proactive care, enabling earlier intervention at scale
- Supported heart failure optimisation through more than 10,000 titration events, improving treatment quality
- Enabled the recording of 23.5 million COVID-19 vaccinations through clinical systems, demonstrating scalable delivery
In atrial fibrillation, treatment timelines have been reduced from approx. 30 months to just 10 weeks, a dramatic acceleration in patient access.
These outcomes illustrate a clear principle: when systems support action, adoption follows.
The implication for pharma
The commercial model is shifting. Approval is no longer the endpoint, and market access alone is no longer enough.
Value is realised only when patients are treated.
This requires a move beyond traditional engagement towards approaches that embed adoption directly into real-world care. Success is no longer defined by reach, but by the ability to influence decisions at the moment they are made.
Organisations that design for adoption, integrating data, workflows, and decision support will be best positioned to succeed.
From approval to adoption
The gap between approval and uptake is not new but it is now more visible, more measurable and more urgent to address.
The opportunity is equally clear.
By aligning innovation with the realities of care delivery and embedding guidance into the systems clinicians use every day, adoption becomes faster, more consistent, and more equitable.
The advantage is no longer approval – it's adoption.