Pathway
Clinical Pathway Feasibility & Redesign
NHS pathway targets, including the 62-day cancer standard and 18-week RTT, can be mathematically impossible under current resource and policy configuration. Standard improvement programmes address throughput and process efficiency but cannot resolve structural infeasibility: a programme applied to a structurally infeasible pathway will not move performance, and the evidence for why only emerges after significant resource has been committed.
What this delivers
Pathway Feasibility Certificate
A formal, evidence-grade verdict on whether your pathway can meet its target under current resource and policy configuration. The Certificate states whether the constraint is structural or capacity-related, and what resolves it. Suitable for Trust Board, NHS England, and CQC submission.
Bottleneck identification
Every bottleneck at every interface, diagnostic stage, and outpatient step, ranked by constraint severity. Where multiple bottlenecks interact to produce structural infeasibility, the assessment identifies the governing constraint and the dependency chain, so resource is directed to the right point in the pathway.
Redesign blueprint
The minimum change to pathway design, policy configuration, or resource allocation that resolves the structural constraint. The blueprint specifies what changes, by how much, and at which node: not a set of options to consider, but a calculated answer.
Evidence portfolio
Full documentation of the feasibility assessment, validated logic twin, and redesign blueprint. Formatted for internal governance sign-off, CQC scrutiny, and NHS England approval. Includes the dossiers required for business case submission and public-facing assurance where required.
How it works
We begin with a Baseline: extracting activity, referral, and flow data from the trust data warehouse, and conducting on-site observation to map the informal rules, escalation conventions, and consultant-specific decision patterns that govern the pathway in practice. The baseline captures what the pathway actually does, not what its documentation describes.
From the baseline we build the logic twin: a validated computational model of the pathway's rules, policies, and flow interactions. We validate the logic twin against two years of historical performance data. Where the model does not reproduce observed performance, we investigate further before proceeding. The logic twin is the evidential foundation of the Certificate.
Against the validated logic twin we run the feasibility assessment: stress-testing the pathway at increasing resource levels to establish whether and where a structural constraint exists. We identify every bottleneck at every interface and outpatient stage, and generate the minimum-change redesign blueprint. The Pathway Feasibility Certificate, the evidence portfolio, and the redesign blueprint are delivered together at the Assure stage, typically within eight weeks of data receipt.