Real world evaluation: Bridging the gap between innovation and impact

Real world evaluation of innovation bridges the gap between promising ideas and practical, scalable solutions that work in everyday settings. Philippa Darnton, Director of Insight at Health Innovation Wessex, and Andrew Walker, Head of Evaluation and Implementation Science at Health Innovation Network South London, explain how it’s done, and why it is more important than ever before.

As health systems face increasing pressure from rising demand, workforce challenges, and the need to reduce inequalities, it is 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, which sets out a bold vision for transforming the health service. To deliver the three 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.

Leading the way with expertise

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 highly skilled and multidisciplinary teams, 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 our expertise in the adoption of innovation and in 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).

Our offer includes a wide range of support services: evaluation design and consultancy, capability building and training, and full evaluation delivery of 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 rapid insight generation. 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

The health innovation networks are implementing a set of evaluation considerations—co-produced through our Evaluation Community of Practice and through our Collaboration Agreement with NICE —to guide our work 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 our RWE practical guide for 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.

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.

Looking ahead

At the Health Innovation Network, we believe better care starts with better evidence. We must move beyond asking if an innovation works, to understanding how it works in real-life contexts. Our framework for real-world evaluation supports innovators, policymakers, commissioners, and providers to generate meaningful insights – ensuring that innovation leads to genuine impact for patients, staff and systems. We invite you to explore our approach and work with us to turn bold ideas into everyday improvements, where they’re needed most: on the ground.

Our Insight team work with a range of partners and clients in primary, secondary (hospital trusts, clinics) care, community settings and the voluntary sector. We also work with innovators to provide evidence for scaling up innovations.