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At Health Innovation Yorkshire and Humber, we believe that innovation adoption only succeeds when it is grounded in the lived experience of patients. That’s why we are embedding the Patient Insight Framework, a structured approach to incorporating patient and public insight into the adoption of AposHealth®, a non-surgical treatment for knee osteoarthritis now supported under the NHS MedTech Funding Mandate.

What is the Patient Insight Framework?

The Patient Insight Framework is a practical tool designed to ensure patient insight is meaningfully embedded in the spread and adoption of innovation. Rather than viewing care through existing care pathways, it follows the actual patient journey, recognising how people experience, access, and interact with services in real life. The framework promotes person-centred care by helping stakeholders, clinicians, commissioners, suppliers, and system leaders, understand and, importantly, act on what matters most to patients at each stage of their care. It promotes co-production, equity, and collaboration across the system.

Why APOS and why now?

With 5.4 million people in England affected by knee osteoarthritis, and more than eight hundred patients in our region waiting over a year for knee replacement surgery, there is an urgent need to expand treatment options.

AposHealth® is a wearable medical device that uses foot-worn biomechanical elements to retrain walking patterns, reduce knee load, and relieve osteoarthritis symptoms. It is non-invasive and has been recommended by NICE for use in the NHS due to its potential to improve pain, enhance function, and delay or avoid the need for surgery. As part of the NHS MedTech Funding Mandate, AposHealth® is now supported for wider adoption.

Despite this, key data is often missing at  system level, particularly the number of patients who meet the criteria for total knee replacement, but decline surgery. This information is not routinely recorded, making it difficult to estimate the true eligible population for AposHealth®.

This gap led us to undertake a focused patient insight piece, to understand why patients decline surgery, what alternative treatments they seek or need, and how AposHealth® might support them if integrated earlier into care pathways.

Even the most effective innovations can struggle to reach those who need them if we don’t understand the real-world patient journey – that’s where the Insight Framework comes in. We used this to inform our approach to how we embed patient insight into the co-production of adoption planning, implementation and evaluation.

Step 1: Gather insight and lived experience

We began by collecting and analysing patient stories. Reviewing existing research, such as the Versus Arthritis MSK report, revealed insights into the burden of knee osteoarthritis and how patients self-manage. But we found limited information on patient perspectives about treatment effectiveness, accessibility, and alternatives like AposHealth®.

To fill this gap, we partnered with Versus Arthritis and NHS acute trusts in Yorkshire and the Humber to recruit participants and conduct in-depth interviews with people at all stages of the knee osteoarthritis and total knee replacement (TKR) pathway.

These stories revealed common pain points: delayed diagnosis, fragmented care, poor communication, and emotional burnout. Most had never heard of AposHealth®, yet many showed strong interest when introduced:

“It looks very easy. Low invasiveness. Just wearing them indoors while doing chores. I’d definitely be interested.”

We also discovered that some GPs and clinicians were unaware of AposHealth®, underscoring the need for broader education and awareness.

Step 2: Understand the patient journey

Our interviews informed key stages where patients feel abandoned or unsupported. Between physiotherapy and surgery lies a frustrating treatment void. Patients want more control, earlier options, and compassionate communication.

We mapped these insights across different patient demographics and care settings, identifying opportunities to intervene earlier, especially for those not yet eligible or ready for surgery.

Step 3: Align stakeholder responsibilities

Using the framework, we translated patient insight into clear actions for each stakeholder group:

• Clinicians: Introduce AposHealth® appropriately into care pathways and be alert to the mental health burden of knee osteoarthritis.
• Commissioners: Address the funding and referral barriers limiting equitable access.
• Innovators and suppliers: Co-produce educational materials and training with patients.
• MSK programme managers and operational leads: Redesign pathways to be more holistic and responsive to patient needs.

Step 4: Act through co-production

In July 2025, we hosted a regional stakeholder event to put the framework into practice. We brought together local NHS teams and MSK clinicians, AposHealth®, NHS Supply Chain and most importantly patients.

Attendees heard firsthand the experiences of people living with knee osteoarthritis and the findings in our ‘Knee Osteoarthritis Patient Insight and Experience’ report and we discussed what needs to change. As a result, several trusts expressed immediate interest in implementing AposHealth®.

What’s next?

We are now supporting trusts to:

• Develop business cases to implement AposHealth® within our NHS providers.
• Collaborate with stakeholders to review the actionable insights from our report such as co-produced patient education materials and enhancing clinical awareness and education.
• Monitor and evaluate AposHealth® outcomes using patient-reported data.

Most importantly, we are committed to continuing to listen. The insights framework is not a one-off, it’s a mindset for continuous improvement.

Final thoughts

Innovation is not just about new technology, it’s about improving lives. By using the ‘Patient Insight Framework’ to put lived experience at the centre of service transformation, we are helping NHS providers across Yorkshire and the Humber deliver more personalised, equitable, and effective knee osteoarthritis care.

As one participant told us: “Since I’ve given up nursing I feel like I’ve been put on the scrap heap. I felt old before my time. If APOS can help someone avoid that, it’s worth it.”

Let us keep making innovation work for the people it’s meant to serve and who need it most.

Download A-Framework-for-Driving-Innovation-Adoption-Through-Patient-Insight.pdf