Patient organisations are often the first to notice the gaps. As one patient organisation explained, “We're running a charity for patients with a rare blood condition who have so many unmet needs. We are having to run our own patient support programmes and fund them through the charity.” Their experience reflects a wider pattern of fragmentation – where every partner recognises the same needs, but few have the bandwidth to align their efforts.

Across the NHS, reform and workload pressures are reshaping what’s possible. “It’s a really scary time in the NHS – and the work doesn’t stop.” Another participant put it simply: “Healthcare professionals are a finite resource… these are shortages that create bottlenecks in the system.”

The impact is visible at every level. “Everybody in the NHS would love the time to be able to deliver the PSP… But you can’t. The resources aren’t there,” said a speaker from WM UK. Those within pharma acknowledge the limits, too. “We cannot boil the ocean,” one industry lead admitted. “Quite often we’re told to hunker down – go to three or four friendly ICBs, understand what’s going on in that environment, and learn.” Others called for clearer communication to bridge the gaps in understanding. “I think one thing I’d like to do is just demystify the word patient support programme,” said the WMUK speaker. “Talk about it from patient identification, diagnosis, activation, education and support all the way through.” In essence, PSPs extend the reach of treatment beyond the prescription, helping patients to navigate their therapy while allowing the health system to track and respond to what happens between appointments.

Each perspective highlighted how good ideas can get caught in the space between ambition and bandwidth. As one attendee reflected, “We all talk about partnership, but each circle has its own pressures – the system’s capacity, the company’s compliance, the patient’s day-to-day life. Unless those are designed to meet, the connection doesn’t hold.”

Examples of that approach are already emerging. One case study on multiple sclerosis highlighted how a PSP provided additional nursing capacity to help patients initiate treatment safely while reducing pressure on local NHS clinics. Another, in rheumatology, solved a straightforward but decisive barrier by arranging home delivery for patients whose conditions limited mobility. As Madelung noted, “Small things, like home delivery, can change whether treatment actually happens.”

Durability also depends on listening. Building a quality feedback loop into programme design allows patients to help define what “good” looks like for users. As IQVIA highlighted, gathering patient experience data throughout the journey creates a live view of what’s working and what isn’t. This can be used to drive continuous improvement, ensuring that support remains relevant as patient needs evolve.

Technology can help translate that feedback into action, as Personal Home Care Pharmacy illustrated. “We’ve implemented AI,” explained CEO Mohammed Sheikh. “It scans and recognises all the documents coming from the NHS – 80% are still paper – and posts them into our system. That used to take three days; now it takes one.”

“The technology should make care simpler, not more distant,” added Sophia Suleman, superintendent pharmacist and COO. “The right tools create time for people, not replace them.”

These examples reveal a shared principle: adaptability. By developing modular programmes – systems that can be scaled up or down, tailored to local capacity, and adjusted as patient needs evolve – organisations can build support structures that outlast individual products. “That’s what makes a programme worth commissioning,” one NHS participant observed. “It can flex around the people who actually have to deliver it.” .

For many in the room, that line encapsulated the risk of designing support around timelines rather than outcomes. Planning for legacy means beginning with the end in mind – treating the conclusion of a programme not as an expiry date, but as a handover.

Co-designing with the NHS is a key step towards achieving that kind of continuity. When programmes are built with the health service rather than for it, they’re more likely to align with its data systems, workforce models, and long-term priorities. It’s a form of shared authorship that helps new services outlast the commercial cycles that created them.

Co-design also means understanding where and how support fits within clinical pathways. Activation at key points, such as diagnosis, treatment initiation, or follow-up, ensures that programmes are embedded in routine care, making them easier for the NHS to maintain and measure once formal oversight ends.

IQVIA described this shift as designing with sustainability at the core. “The solution has to be practical and implementable,” said IQVIA’s Helen Miles, head of business development. “That means the NHS can run it, the patient can own it, and pharma can step back knowing it will still work.” The principle is echoed in their advice to partners: “Build the programme so the health service would want to commission it itself.”

That perspective reframes how success is measured. A strong PSP should anticipate the moment of transition – training NHS teams to maintain elements of care, equipping patients with tools for self-management, and ensuring that data collected during the programme can flow securely into existing systems. Legacy, in this sense, is about capability: a way to ensure that the knowledge, skills, and trust created through collaboration remain once the original framework moves on.

Other attendees called for co-creation to start earlier and run deeper. “Patients should be involved at the beginning, not when everything’s already designed,” one added. True collaboration, they agreed, is built into the foundations, not applied afterwards.

The discussion ultimately returned to the question of continuity: how to make partnership habitual rather than exceptional. IQVIA’s team described it as designing with “the health service in mind from day one,” ensuring that new initiatives strengthen what already exists, rather than creating another layer to maintain.

In the end, the conversation was less about technology than about culture. The most enduring collaborations are those that shift behaviour as well as process, where trust becomes the structure rather than the aspiration. The next step, as one participant concluded, is “to stop proving that partnership works and start living it.”