HI Pathways Flow ChartAn ageing UK population has led to an increase in the number of patients with long term conditions and this number is expected to rise by a third in the next ten years, therefore healthcare needs to evolve to ensure more proactive management of patients through prevention and self-management.

To do this the needs of the population must be fully understood which will allow cohorts of patients to be identified and targeted for suitable, proven and cost-effective interventions. These interventions can range from self-management and active engagement with patients through to primary prevention, secondary prevention or medicines management. To ensure the effectiveness of these interventions they must be tailored and appropriate to the condition, for example structured patient education is beneficial to patients with diabetes.


  • Identifies groups of at risk patients through risk stratification
  • Offers Commissioners a library of appropriate interventions which are proven to be cost effective and improve patient empowerment
  • Allows Commissioners to model and select the pathways they believe will be most effective for their area before the system goes live