Innovation
Primum Digital Health - CrossCover
Competition
Competition 17 - Urgent and Emergency Care
The Challenge
CrossCover is a comprehensive Clinical Pathway Development and Operations Platform that optimises healthcare delivery across the NHS. It addresses fragmented care by connecting primary care, secondary care and patients throughout the entire patient journey, regardless of specialty.
The platform tackles several key NHS challenges:
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Disconnected systems: Bridges siloed primary and secondary care through interoperable technology, enabling seamless information flow
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Referral inefficiencies: Streamlines the referral process with integrated management systems that connect to NHS Mailbox and e-RS
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Variable clinical practice: Ensures standardised, evidence-based care through customisable clinical pathways and decision support
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Carbon footprint: Provides real-time carbon impact analysis, helping reduce unnecessary patient journeys and resource use
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Patient engagement gaps: Facilitates active patient participation through digital forms, notifications and shared decision aids
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Measurement difficulties: Delivers comprehensive analytics on outcomes, budget impact and carbon costs
The platform's flexibility enables deployment across any clinical specialty, fundamentally transforming how integrated care systems work. By optimising both clinical and clerical workflows, CrossCover helps the NHS deliver more effective, efficient and environmentally sustainable healthcare.
The Innovation
CrossCover is a UKCA-marked Class 1 Medical Device software platform designed to help clinical teams design, build, test, deploy and monitor clinical pathways. It combines:
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AI-assisted Clinical Pathway Development System
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Referral Management System with NHS Mailbox and e-RS integration
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FHIR interoperability with Primary/Secondary Care EPRs
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Patient-facing app for digital forms and communications
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Real-time carbon impact analysis dashboard
Patient population: The platform can be used for any clinical specialty across any care setting (pre-hospital, primary, secondary care).
Development stage: Fully implemented and operational (TRL 9). Compliant with ISO13485, ISO27001, DCB0129/0160, NHS DTAC requirements, and registered with the MHRA.
Cost model: Software-as-a-Service annual subscription based on population served, number of referrals processed and the volume of consumables used, such as SMS sent
Available on the G-Cloud 14 Digital Marketplace- https://www.applytosupply.digitalmarketplace.service.gov.uk/g-cloud/services/346319149229322
Implementation requirements: Requires clinical leads to sign off pathways, IT integration team, and designated project manager. Training provided for pathway editors and users.
Market approach: Annual subscription with unlimited users and usage (subject to fair usage policy).

Impact
Currently deployed across over 50 NHS Sites with evidence of reduced unnecessary referrals and improved clinical effectiveness.
Environmental Impact
CrossCover reduces carbon emissions by 18% (22.5kg vs 18.28kg CO2e per patient), as calculated by YHEC using ISO Standards and Greenhouse Gas Protocols across primary care, prescribing, referrals, and patient travel.
Financial Benefits
The system achieves 11% reduction in pathway costs for elective pathways (£73 vs £65 per patient), potentially freeing £3.9M in GP time annually per ICS. For emergency pathways a UEA study in the South West showed the platform has been evidenced to save £100 per patient. (https://drive.google.com/file/d/12xBD4nf5Fc8eTxN-QaDZnomlMIl06Yv_/view)
Clinical Evidence
Keele University's RCT demonstrated doubled best practice adherence in primary care, 40% reduction in routine referrals from primary to secondary care, and decreased prescribing (2.1 vs 1.79 per patient). The system maintained excellent safety with no high-risk issues identified. (Unpublished findings)
Implementation & Behaviour Change
Successfully deployed across Birmingham and Solihull ICS and multiple NHS Trusts including Cornwall, CrossCover has transformed clinical practice through standardised referrals and doubled self-management support (28% vs 17%).
Patient Experience
Patients benefit from increased self-management resources, efficient consultations (system requires <3 minutes), and "right person, first time" care that reduces unnecessary appointments.
Future developments
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The AI pathway building wizard transforms static guideline documents into interactive decision support flows within minutes. The technology is being used to enable rapid expansion across multiple clinical specialties.
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The referral management system is being extended into ophthalmology and dental spaces.
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A version of the CrossCover platform is being developed specifically for individual consultants to manage their private practice. This will provide solo practitioners with the same powerful tools currently available to large ICS and hospital deployments, improving care quality and efficiency across the healthcare ecosystem.
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CrossCover are launching Voxtor, an ambient clinical Scribe and an NHS App-integrated Patient Pathway application, creating a seamless digital journey for both clinicians and patients.
"OrthoPathway was extremely helpful. It streamlined the pathway. There’s less intervention or the intervention is different and earlier" General Clinician
"It’s very good for making decisions. It’s very systematic because it goes through the examination of findings you should look out for and then it goes to the decision that needs to be taken based on what you find on the x-ray and the client’s examinations, so it’s very good, I find it very useful." General Clinician
"I can make decisions faster on who needs to come in and who needs to go based on what I see from OrthoPathway" General Clinician
"Guides Junior Doctors who are new to Orthopaedics and gives them confidence" General Clinician

Date Published
June 2025