Bridging the gap between innovation and impact: Launching our Real-World Evaluation considerations

Philippa Darnton, Director of Insight at Health Innovation Wessex, and Andrew Walker, Head of Evaluation and Implementation Science at Health Innovation Network South London, introduce the network’s Real-World Evaluation Considerations.

Real-world evaluation of innovation is more important than ever in health and care because it bridges the gap between promising ideas and practical, scalable solutions that work in everyday settings.

As health systems face increasing pressure from rising demand, workforce challenges, and the need to reduce inequalities, it’s essential to understand not just whether an innovation works in theory, but how it performs in real-life contexts—across diverse populations, services, and geographies.

This need is underscored by the Government’s 10 Year Health Plan (2025), which sets out a bold vision for transforming the health service. To deliver these shifts at pace, the plan calls for a new operating model, a reshaped innovation strategy, and a culture of transparency and learning—all of which depend on robust, real-world evaluation.

Real-world evaluation provides the evidence needed to make informed decisions about adoption, spread, and investment. It ensures that innovations deliver meaningful outcomes for patients, staff, and systems. It also helps identify barriers, unintended consequences, and opportunities for improvement—making it a vital tool for learning, accountability, and continuous improvement in a rapidly evolving healthcare landscape.

How health innovation networks are leading the way with expertise in real-world evaluation

Real-world evaluation is a key priority for health innovation networks, forming a central part of our mission to support the spread and adoption of evidence-based innovations in health and care.

We bring together a highly skilled and multidisciplinary team, including mixed-methods researchers, analysts, clinicians, senior health and care managers, and specialists in areas such as commissioning, technology, and public involvement. Our teams are uniquely positioned to deliver robust evaluations by drawing on internal expertise across clinical, technical, and evaluation domains. We also leverage strong local networks across health and social care systems to enable rapid delivery and access additional expertise through partnerships with universities, NIHR Applied Research Collaboratives (ARCs), MedTech and In Vitro Diagnostics Co-operatives (MICs), and the national Health Innovation Network.

Our offer includes a wide range of support services: evaluation design and consultancy, capability building and training, and full evaluation delivery for service, pathway, and system-level innovations, including digital health technologies aligned with NICE evidence standards. We apply a broad mix of methods—quantitative and qualitative—including surveys, interviews, ethnographic research, social network analysis, economic evaluation, and participatory approaches such as evidence-based co-design. We also provide data analytics and insights reporting. Many of our evaluations are delivered collaboratively across regions and with academic partners, enhancing the scale, quality, and impact of our work.

A Practical Framework for High-Quality Real-World Evaluation

Across the health innovation networks we’re currently implementing a set of evaluation considerations—co-produced through our Evaluation Community of Practice—to guide our involvement in real-world evidence (RWE) generation. These considerations align with the NICE RWE framework and are designed to support high-quality evidence that informs decision-making within local health systems. They complement existing guidance, including the Network’s own RWE generation guide aimed at innovators, and are particularly relevant when working with partners such as NICE, NHS England, the Office for Life Sciences, integrated care boards, integrated care systems, and industry. The guidance also emphasises the importance of using a shared language across networks and stakeholders to ensure clarity and consistency in evaluation practices.

This set of considerations is not intended to be prescriptive or to replace established guidance or frameworks about how to undertake RWE. It aims to provide a set of considerations for each of the three stages of RWEs, as described within the NICE real-world evidence framework.

Key considerations at each stage of evidence generation

The evaluation considerations focus on three key stages of evidence generation: planning, conducting, and reporting.

Planning: Effective planning begins with clearly defining the purpose, audience, and evaluation questions, shaped by the needs of stakeholders such as service users, integrated care boards, and innovators. Evaluations should address health inequalities and consider under-served groups. Where appropriate, a programme theory—like a logic model or theory of change—should guide the approach. Feasibility assessments are essential, taking into account the innovation’s maturity, data availability, implementation timelines, resources, and stakeholder engagement. A full evaluation typically uses mixed methods to explore implementation, outcomes, acceptability, and value. Planning should also include a detailed evaluation proposal outlining the rationale, design, methods, and data collection strategies. Ethical practices, data protection compliance, and the use of evidence-based frameworks to understand implementation and adoption are also key considerations.

Conducting: During the conduct phase, robust governance and project management structures must be in place, including quality assurance for all outputs. Data collection should be high quality and relevant to the evaluation questions. The approach should remain agile and responsive to changing needs. Involving service users in the evaluation process helps ensure relevance and inclusivity. The evaluation team should possess the necessary skills and experience, including project and stakeholder management, and have access to appropriate analytical tools and data systems. Where needed, external expertise—such as from universities or research collaborations—should be sought.

Reporting: Reporting should aim to share insights that are applicable beyond the immediate context, especially those related to implementation. Evaluation reports must clearly describe the design, methods, and limitations to ensure transparency and reproducibility. They should also detail the innovation, its impact, and how it was implemented or spread, enabling others to assess its relevance to their own settings. Reports must present a balanced and independent analysis, including any unintended consequences or findings of ineffectiveness. If the same HIN provided other support to the innovator, this should be disclosed. Finally, there should be a commitment to making findings publicly available to maximise learning and impact.

Examples of our real-world evaluations

PlasmaTYPHOON+ Endoscope Drying System Evaluation: Health Innovation Wessex conducted an independent real-world evaluation of the PlasmaTYPHOON+ and PlasmaBAG system—developed by PENTAX Medical—between November 2023 and May 2024 in a decontamination unit in southern England. Using a mixed-methods approach, the evaluation explored energy use and plastic waste, stakeholder perceptions, and workflow assessment. PlasmaTYPHOON+ used 22 times less electricity than the existing storage cabinet. Staff found the system highly acceptable, with positive impacts on workflow, wellbeing, and financial efficiency. The system improved drying speed and operational flow. The evaluation also highlighted the need to update national guidance (HTM 01-06) to support standardised validation of drying cabinet alternatives.

South West London Cardiovascular Disease Prevention Decathlon Programme Evaluation: Health Innovation Network South London conducted a mixed-methods evaluation of the Cardiovascular Disease (CVD) Prevention Decathlon in South West London (SWL), which ran from August 2023 to July 2024. The ten-week programme was modelled on SWL’s Diabetes Prevention Decathlon and combined in-person educational and physical activity sessions to promote healthier behaviours and reduce CVD risk. The evaluation found that 75% of participants completed the course, with statistically significant reductions in cholesterol and blood pressure among those with elevated levels at baseline. Participants experienced moderate average weight loss (1.18kg, 1.5%) and reported highly positive experiences, particularly valuing the integration of classroom learning, physical activity, peer support, and expert facilitation. Survey responses, focus groups, and case studies highlighted the programme’s positive impact on participants’ health goals and knowledge, with many reporting lifestyle changes such as improved diets and increased physical activity.

Let’s lead the way

As health innovation networks we’re uniquely positioned to deliver effective and meaningful real-world evaluations, but that depends on all of us embedding this work in our day-to-day roles as part of the design and delivery of evaluations. The health innovation networks’ practical framework for high-quality real-world evaluation offers a clear, structured approach to generating meaningful evidence that supports local health system decision-making. Rooted in the NICE RWE framework, these considerations—spanning the planning, conducting, and reporting phases—emphasise stakeholder relevance, inclusivity, transparency and ethical rigor. Rather than replacing existing guidance, this framework complements it, promoting shared language and consistent practices across the health innovation landscape. By following these principles, evaluations can drive more effective innovation adoption and contribute to better, evidence-informed healthcare outcomes.

We have the tools. We have the expertise. Now let’s continue to use them together.

Access the RWE Framework and Resources.

To join the Evaluation Community of Practice, contact Philippa – [email protected] or Andrew – [email protected]