This initiative helps organisations within a large geographical area (in this case the South West) to smooth price differentials while maintaining choice for clinicians and focusing strongly on quality. This case study describes a collaborative approach across 10 interested NHS acute trusts in the region for procuring cardiology products. In the past the process for procuring cardiology products within the South West was fragmented, resulting in a wide range of prices for similar products. It was important that any savings be achieved with full clinical engagement in the process and without compromising clinical choice. In February 2009, a partnership agreement was formalised between the Peninsula Purchasing and Supply Alliance (PPSA) and the Avon, Gloucestershire, Wiltshire and Somerset (AGWS) Cardiac and Stroke Network. Successful collaboration across the South West has provided opportunities to exploit volume leverage within the cardiology market and created pathways to start improving the service provision at each individual centre. The collaborative approach ensures aggregation, and economies of scale are combined with a once-only approach to the supplier market. Clinical engagement and support is critical to promote innovative and cost-effective solutions across the AGWS Cardiac and Stroke Network. A band 6 category buyer is needed to support this procurement work. Building on existing relationships and having effectively introduced contracting control across the network, the longer term aim of the strategy will be to focus on service line costing of each tariff in line with the wider Quality and Productivity agenda.