Five areas where the current knowledge base has limited or no coverage, prioritised by currency of change and degree of gap.

19 councils, £50,000 each — what the first wave of NHS Digital's Social Care Digital Innovation Programme taught us about digital change in social care.

The £480m Palantir-led platform — the largest single test of the platform hypothesis in the NHS, and what its adoption difficulties reveal about the Complexity Challenges.

The strategic arc from 2014 to the present — escalating ambition, £8.1bn in investment, and a persistent gap between targets and delivery.

A £1m SBRI-funded platform for people with learning disabilities — 164 people supported across five geographies, combining video, health monitoring and outcomes tracking.

A telemedicine service for renal replacement therapy patients at Lister Hospital — 40 homes connected, 13 clinics replaced, 84 hours of patient travel saved.

Applying the platform model that transformed banking, retail and travel to care delivery — and why it requires more than technology.

The evidence base for video in care delivery — clinical outcomes, deployment challenges, and the structural barriers to scale.

Why conventional stakeholder analysis fails in care — and how the Gateholder model and Intervention Space provide a better framework for digital change.

Why RCTs fail for complex digital care interventions — and how a sociotechnical, action-research approach generates better evidence.

Practice, Outcomes, Technology, Evidence — a four-dimensional iterative framework for co-developing technology and practice in complex care settings.

Four recurring complexity challenges — Hubris, Sustainability, Collaboration, and Context — explain why digital health programmes fail, and what to do instead.

Why digital change in health and social care consistently fails to deliver on its promise — and what the evidence says about when it succeeds.

Technology and the social systems within which it operates are inseparable. Outcomes arise from their interaction — not from either alone.