Background: Two UK academic centres were commissioned to provide a responsive rapid evidence synthesis service. The service covered topics identified by the National Institute for Health Research Health Services & Delivery Research (NIHR HSDR) programme as priorities for the National Health Service or to inform research commissioning. Aims and objectives: To describe and evaluate the review teams' interactions with the evidence users the programme aimed to serve, primarily NHS clinicians, commissioners and managers. We particularly aim to highlight the barriers and facilitators to the impact that this type of programme may have on the uptake and use of research evidence by decision makers. Methods: Narrative review of stakeholder interactions at different stages of the review process--prioritisation and defining scope; dealing with unexpected results; dissemination of findings; and measuring impact, illustrated by examples from the first three years of the service (2014-17). Conclusions: Timely production of high-quality outputs was facilitated by--initial mapping and scoping of the available published evidence; early engagement with stakeholders to optimise their involvement within limited time and resources; and willingness to consider creative solutions and different ways of working to overcome problems encountered in specific projects.