How to find traction in complex health systems

You can’t influence a system you don’t understand.
Mapping it is the fastest way to find your real entry points.

Most innovators know their product inside out, but not the system it needs to move through.
And that’s where traction stalls.

Why It matters

In healthcare, adoption isn’t just about a single buyer.
It’s about how decisions, funding, and influence flow across organisations, networks, and people.

If you don’t see those flows, you’ll waste months pitching to the wrong audience.
If you map them, you’ll find your path of least resistance and your real opportunity for traction.

This framework can help you:

• Visualise the ecosystem you’re trying to enter.

• Identify the people and organisations that hold influence.

• Plan a targeted engagement strategy.

The health system mapping framework

Think of this as five clear steps to navigate complexity with confidence.

Step 1: Identify stakeholders

Map everyone who touches your solution, directly or indirectly incl.:

• Policy and oversight: NHS England, DHSC, NICE, MHRA

• Regional systems: Integrated Care Boards (ICBs), provider collaboratives

• Operational delivery: Trusts, primary care networks, community partners

• End users: clinicians, patients, carers

Example:
If you’re a digital diagnostics company, your users are clinicians , but your adopters are Trust medical directors, and your targets might be an ICB or a research partnership.

Step 2: Understand influence and interdependence

Not all stakeholders are equal. Some hold budgets, others set policy, others shape opinion.
Group them by influence level:

• Decision-makers can approve adoption or funding

• Advisors shape recommendations and evaluations

• Implementers integrate and deliver

• Champions trusted peers who advocate internally

Example:
In the NHS, an ICB’s clinical lead may not sign the cheque, but their support can make adoption inevitable.

Step 3: Map relationships

Draw how information, funding, and decisions flow.
Look for connections, dependencies, and clusters . For example:

• The ICB links multiple providers under one commissioning decision.

• A national initiative (e.g., digital diagnostics funding) can influence regional priorities.

Tip:
Use simple shapes: circles for organisations, arrows for flows.
The goal isn’t art, it’s insight.

Step 4: Spot leverage points

Ask: Where does one “yes” unlock many others?

• A pilot site that validates your impact

• A national programme aligned with your outcome

• A respected clinician who becomes your internal advocate

Example:
A mental health app gained traction by working with one ICB digital lead who then championed it to three neighbouring systems, faster than any cold outreach.

Step 5. Build a targeted engagement plan

Now that you know who matters most, plan your approach:

• Prioritise 5–7 key stakeholders

• Tailor your message for each

• Sequence your conversations to build momentum (from supporters to decision-makers)

Example:
Start with a clinical champion → share pilot data → move to ICB innovation lead → final discussion with procurement.

If adoption feels slow or uncertain, map the current first and you’ll find your path through it.