Case study: Evaluating what drives change
in the SW Digital Neighbourhoods Programme

Background 

How can digital tools help neighbourhood teams spot who needs help before a crisis hits? Technology and teamwork can make care more proactive – as the South West Digital Neighbourhoods Programme  has shown. 

Since 2023, teams have been implementing Brave AI – an AI risk assessment tool helping healthcare professionals identify individuals who are at risk of going to hospital next year but who may otherwise go under the radar.

Those people can then be contacted and invited to take part in a conversation about their health and wellbeing, so that local, integrated neighbourhood teams – made up of a range of health and care professionals – can work with patients to develop a personalised care and support.

Future Care Capital’s evaluation helped to uncover what really drives change with these digital tools.

What we set out to learn

In the Autumn of 2023 Future Care Capital (FCC) undertook an early process evaluation to understand not just what happened, but why and how change was unfolding as the programme rolled out. We focused on the programme at the time, looking at how implementation unfolded, and the context that shaped it, rather than on outcomes.

 

What we did

• Implementation of core components. The process evaluation examined how key elements were being put in place – most notably the formation of Integrated Neighbourhood Teams (INTs) and the deployment of the Brave AI risk-stratification tool – along with factors that helped or hindered delivery (e.g., workforce readiness, technology integration).
• Focus on ‘how it’s working’. Using the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), we explored questions about engagement, use, delivery and sustainability – i.e., how the programme is being delivered and what enables or blocks progress.
• Methods in brief. A qualitative process evaluation (interviews and focus groups) with an analysis of themes was used, preceded by a formative exercise to surface the intended mechanisms of change of the programme. We didn’t treat qualitative feedback as anecdotal, but as a crucial form of evidence.
  

What our work shows – and why it matters

• Depth is valuable alongside surface metrics. Whilst quantitative metrics are undoubtedly an important part of driving and evidencing digital transformation, they don’t tell the whole story. Our qualitative, process-focused lens showed how implementation really worked in practice – how people interpreted data, adapted workflows, and collaborated across boundaries. This helps others replicate what works, not just report it.
  
• Talking to people leads to person-centred action. Brave AI generated signals about people who might benefit from support. Yet the impact comes from how teams adapt to these signals. By focusing on the people rather than the technology we produced insights that are more likely to lead to change. This is because AI and digital tools add value only when integrated into everyday clinical workflows and serving programme goals.
• Formative work is critical. It’s easy to start with the assumption that everyone’s on the same page on what’s being evaluated – in reality that’s rarely the case in any programme. Our initial work with the delivery team brought all parties together and developed a shared understanding that streamlined the evaluation process whilst also supporting programme delivery. It’s a win-win situation.
• Good evaluation takes time to brew. The best insights in life often come from reflection. Our approach to this evaluation; talking, reflecting, refining meant that our findings were grounded in the context of the whole programme rather than individual discussions with selected team members. A little more time and reflection lead to far richer insights.

Context and experience make data more actionable

The evaluation approach we use at FCC shows how moving beyond surface-level metrics can reveal the underlying dynamics of change: not just what happened, but why and how. It looked at how digital tools, data and relationships came together to improve proactive, person-centred care across the South West, showing that understanding context and experience is as valuable as counting outputs. 

If you’re planning or delivering an innovation programme, we’d love to explore how an evaluation like this could help you learn and adapt. Get in touch with Andy Jones at andy@futurecarecapital.org.uk .