What Commissioners Actually Ask Us Before Approving a Rollout

When commissioners are considering a new pathway or system, the conversation is rarely about features. It’s about risk, assurance, and whether something will actually work in the reality of their local system.

Over time, a familiar set of questions comes up again and again.

Here’s what commissioners really ask us and how NHS teams are answering those questions in practice.

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1. “Will this actually reduce delays or just move them elsewhere?”

No one wants to digitise a problem and push it downstream. Commissioners want to know whether a new workflow genuinely improves flow across the whole pathway.

In practice, teams report:

• fewer rejected referrals
• clearer guidance at the point of referral
• faster specialist triage
• better visibility across providers

In Leicester, Leicestershire & Rutland, referral rejections on the cataract pathway reduced to near zero after moving onto Cinapsis, removing weeks of avoidable delay for patients.

That’s not optimisation around the edges, it’s a structural improvement.

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2. “How does this fit with existing NHS systems?”

Interoperability is non-negotiable.

Commissioners want reassurance that new tools won’t sit in isolation or create parallel processes clinicians have to work around.

Cinapsis is designed to work alongside core NHS infrastructure, including:

• NHS Spine
• eRS
• GP and Optometry EPR systems
• Other IT systems across community and acute care

For teams, this means:

• less double entry
• fewer workarounds
• more reliable data at every stage of the pathway

Digital change works best when it fits into how clinicians already operate, not when it asks them to change everything at once.

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3. “What’s the impact on admin and workforce pressure?”

With workforce capacity under strain everywhere, commissioners are rightly focused on whether digital change frees time or adds burden.

In Staffordshire & Shropshire, Diabetic Eye Screening referrals were historically paper-based, involving scanning, emailing and manual checks.

After rolling out Cinapsis, UHNM’s clinical lead reported:

“Admin teams estimate a 60% saving in admin time.”

That time doesn’t disappear, it’s redirected back into patient-facing work and operational resilience.

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4. “Will clinicians actually use it?”

Adoption is where many programmes succeed or fail.

Commissioners know that if clinicians don’t trust or value a system, it won’t embed regardless of how well it performs on paper.

Across regions, feedback from frontline users has been consistent:

• “Easy, intuitive and genuinely helpful.”
• “Communication has never been better.”
• “The platform has really helped me manage patients and workflow productivity.”

In Lincolnshire, improved communication between UTCs and hospitals was so significant that teams began developing joint clinical training plans, something that hadn’t been possible before.

That kind of behavioural change only happens when tools align with real clinical workflows.

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5. “How do we know this will work at system level, not just in one service?”

Commissioners are rarely approving isolated pilots. They’re thinking about scale, consistency, and system-wide impact.

That’s why confidence from clinical and system leaders matters.

An ICB Clinical Lead in LLR put it simply during a pathway review:

“Thank you for building such wonderful software… Every ICB should be using it.”

In Gloucestershire, former NHS CEO Mary Hutton echoed this sentiment:

“Keep up the good work, the NHS needs Cinapsis.”

When leaders see benefits across providers, workflows and pathways, it signals readiness for broader adoption.

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What this tells us about successful digital change

Across all these conversations, a clear pattern emerges.

Successful NHS digital transformation:

• reduces friction rather than adding steps
• fits existing systems instead of replacing them
• improves communication as much as efficiency
• delivers visible benefits quickly
• earns trust from clinicians and commissioners alike

That’s when change sticks.

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Looking ahead

Commissioners don’t need more promises.
They need confidence grounded in real outcomes.

If you’re exploring pathway modernisation and asking similar questions, we’re always happy to share what we’ve learned.

👉 Get in touch to discuss your local pathways and challenges.

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