Local healthcare technology assessment (LHTA) is a multidisciplinary systematic process that identifies the benefits associated with the adoption and application of healthcare technology to meet the clinical needs for a healthcare facility. The aim of this study was to explore the option of locating an intraoperative MRI scanner in our future 22 theatre Department. Following a series of engagements with relevant stakeholders, including patients, carers, surgeons, radiologists, radiographers and anaesthetists, the needs and requirements for the patient journey were evaluated. This was achieved using a LHTA tool to incorporating a workflow analysis informed by these engagements. As such, the process was holistic in its approach while maintaining a patient centred focus. The tool allowed additional value to be demonstrated with the reconfiguring of the four safety zones and access points so that the scanner could be accessed and operated safely both intra-operatively and independently from theatre as required. This allows the scanner to be used to its full capacity scanning both theatre and ambulatory patients. The final outcome is an exemplar design of an MRI in a theatre department integrating the patients’ priority needs, safety and clinical efficiency. It gives access to imaging at the right time and place, resulting in the best potential outcomes for all.