Why Real‑World Evaluation Matters — And Why Stories Are the Missing Evidence

Across the health and care system, evaluation has never been more important. Rising demand, persistent inequalities and the pressure to innovate responsibly mean that commissioners and providers need credible, context‑rich evidence to make decisions that genuinely improve lives. Real‑world evaluation is now central to that mission.

The Health Innovation Network (HIN) South London captures this clearly in their first newsletter of 2026, with an article from Dr Andrew Walker, Insights and Evaluation Programme Director: meaningful change depends on understanding what works in practice, for whom, and in what contexts. Real‑world evaluation enables organisations to explore how innovations perform across diverse services and communities, going far beyond outcomes alone. It reveals implementation challenges, barriers to adoption, and opportunities for refinement — the practical realities that determine whether an innovation succeeds or stalls.

Real‑world evaluation: grounded in lived experience

Real‑world evaluation answers the essential questions:

• Does this innovation work in the complexity of everyday care?

• What helps it succeed?

• What gets in the way?

• How do people experience it?

  And crucially: how can we make it better?

Where narrative insight transforms understanding

This is where Akumen’s Narrative Experience approach becomes a powerful complement. For more than 20 years, Akumen has specialised in drawing insights from real‑life data — the stories people tell, the conversations they have, and the emotions they express. Few organisations have our depth of experience in extracting meaning from human dialogue at scale.

At Akumen we know that understanding the lived experiences of patients, service users and employees in healthcare settings is crucial to delivering patient centred care.

Narrative Experience combines advanced Natural Language Processing with a continuously updated healthcare ontology to identify themes, emotions and risks with precision. This approach allows for precise identification and categorisation of relevant themes, sentiments, and emotions within narrative comments and is validated by mental health professionals and data scientists to ensure insights are statistically significant and contextually meaningful. A human is always in the loop. Something which AI alone cannot achieve.

Why stories matter in real‑world evaluation

Stories reveal what numbers cannot. They surface:

• Emotional drivers behind behaviour

• Cultural and relational dynamics within teams

• Barriers that never appear in formal reporting

• Early warning signs of risk or inequity

• Opportunities for improvement invisible in quantitative data

  
  

This is why narrative insight is indispensable in real‑world evaluation. It helps organisations understand not just what is happening, but why — and it does so in a way that is accessible, human and grounded in lived experience.

Our approach provides deep qualitative insights, fostering a holistic understanding of the experiences of patients to enable patient centred care.

A safe, trusted partner for the NHS

Akumen’s credentials speak for themselves:

• Over 10 years of trusted partnership with the NHS

• 55 healthcare organisations relying on Akumen, including all of NHS Wales

• 10,000 patient comments analysed daily

• 180,000 words processed overnight, every night

  
  

These figures demonstrate not only scale, but reliability. Akumen is GDPR compliant, certified to Cyber Essentials Plus and NHS DSP, with all UK data held in UK data centres and access controlled by role and seniority.

Two decades of expertise in real‑world insight

Akumen has been working with real‑world data long before it became a system priority. There are very few topics you cannot illuminate through narrative analysis — from patient safety and workforce wellbeing to digital adoption, service redesign and community engagement.

Our partners say it best:

“The emotion analysis of responses enables very rich information… valuable insight into the experiences of patients and relatives.” — Swansea, NHS Wales

“An exponential increase in the level of understanding of NHS qualitative text data… a vital source of insight.” — Civica

These testimonials reflect what the system increasingly understands: real‑world evaluation is strongest when it includes the emotional, relational and experiential dimensions of care. Contact us to explore how we can help your organisation get to the 'why' within your data.