Product value to pathway impact: What the CVD Modern Service Framework means for pharma
pharmafile | August 9, 2026 | Feature | | Cardiology, Cardiovascular Health, Diagnostics, Hospital Management, Modern Service Framework, NHS
By Sabina Syed and Ewan Maule
The Cardiovascular Disease Modern Service Framework1(CVD MSF) begins with a familiar problem at a much greater level of urgency. The NHS already has many of the interventions needed to prevent heart attacks, strokes and premature deaths, but too many people still remain unidentified – treatment is started late, evidence-based targets are not met, or the benefit of treatment is lost because care is fragmented. This costs lives, widens inequalities and creates avoidable demand for NHS services.
The CVD MSF responds with 12 immediate priorities for the next three years, alongside a 10-year direction for cardiovascular-kidney-metabolic (CVKM) care. Six of those priorities sit under “driving treatment to target”. They include improving uptake of SGLT2 inhibitors, treating hypertension to target, optimising lipid management, completing the nine diabetes care processes, managing blood pressure and cholesterol in people with established CVD, and rapidly increasing four-pillar therapy for heart failure. The significance of the CVD MSF is not that it changes what medicines are needed, in fact they remain central to its delivery; but it does change what value the NHS will increasingly expect from industry,
Additionally, the MSF is explicit that failure to reduce variation can amount to failure of delivery, even where headline performance improves. Integrated Care Boards (ICBs) will be expected to allocate resources proportionate to need and use targeted approaches for underserved populations.
For pharma, the CVD MSF presents an opportunity to support the patient pathway beyond the current value proposition of their medicine. Whilst product evidence remains essential, NHS decision makers will also want to understand the size and distribution of unmet need, where patients are lost from the pathway, what service capacity is required, how treatment will be sustained, and which outcomes will demonstrate impact.
So how should pharma be re-imagining their approach?
A two-tier strategy that considers a differential approach to stakeholder planning, engagement and demonstrating value
1] As strategic commissioner, ICBs will set outcomes, determine priorities, allocate resources between competing needs and oversee delivery, quality and equity. The CVD MSF gives them priorities, but the likelihood is that implementation will be expected with no additional funds. Planning needs to begin with a clear assessment of current performance. The priorities can then be translated into commissioning intentions, affordability-centred business cases, pathway specifications, contracts and measurable provider expectations. For pharma, an ICB value proposition needs to be a strategic case that takes into consideration a whole ICB population and budget, grounded in evidence and support with insights and tools to aid decision making. Context will be key and tailoring to local needs critical.
2] Providers: The new population-based delivery models2 will shape how this work is organised in the NHS. Single and multi-neighbourhood providers are intended to bring services together around defined populations. Under the emerging Integrated Health Organisation model3,4,capable providers may hold a whole-population budget and take greater responsibility for planning services, allocating resources and redesigning pathways. Providers will have greater scope to decide how outcomes will be achieved. For pharma, a pathway delivery strategy must work for the providers, practices, pharmacies and neighbourhood teams responsible for reaching patients and changing care. Whilst product evidence remains necessary, competitive advantage will increasingly come from pathway implementation support, behavioural insight into patient and communities, forging different relationships with patient groups, supporting pathway improvement centred around quality and equity of care and business cases that enable CVD MSF priorities to be resourced appropriately.
Key questions pharma should be asking themselves during brand and account planning cycles:
Is our value proposition still centred on just the medicine when the NHS is increasingly focused on outcomes? How do we need to change this?
- How well do we understand the operational realities of delivering CVKM transformation locally?
- How well do we understand NHS funding, contracting and payment mechanisms across our CVD pathways of interest?
- What evidence & support services can we provide that helps systems improve equity, uptake and treatment optimisation?
- What capabilities are we developing beyond product promotion?
- How do we need to engage with stakeholders differently, so we are viewed as partners or solution providers to realise the ambition of the CVD MSF?
- Could we become a partner in implementation rather than simply a supplier of treatments?
At a time of great change within the NHS, industry-supported programmes will be more useful when they help systems understand who is missing from care, reach people through trusted routes and report outcomes by population group.
The strongest industry-NHS partnerships will remain transparent, properly governed and led by NHS priorities. Pharma contribution may include pathway analysis, implementation support, workforce development, patient insight or real-world evidence. Value will depend on whether pharma builds local capability, engages effectively and supports measurable, sustainable improvement across pathways.
Pharmaceutical companies that thrive in this environment are unlikely to be those with the strongest clinical story alone. They will be those that can help systems identify unmet need, redesign pathways, improve treatment to target goals identified in the CVD MSF and demonstrate outcomes.
References
1. Department of Health and Social Care, NHS England. Cardiovascular disease (CVD) modern service framework (MSF): a cardiovascular-kidney-metabolic approach – the strategic vision and delivery model. London: Department of Health and Social Care; 2026.
2. NHS England. Fit for the future: towards population health delivery models. London: NHS England; 2026
3. Department of Health and Social Care. Fit for the Future: 10 Year Health Plan for England. London: Department of Health and Social Care; 2025.
4. Alderwick H. Government’s 10-year plan for the NHS in England. BMJ. 2025;390:r1396. doi:10.1136/bmj.r1396.
For further information or simply a chat to see how we can help, please drop a line to info@visions4health.com
Sabina Syed is Managing Director of Visions4Health
Ewan Maule is Clinical Director, Chief Pharmacist (NENC ICB) and Honorary Professor at Teesside University
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