dive-running
Hey Dave, using the same setup here, but I am not sure if I can be of any help, as most of the time it works for me flawlessly.
Sometimes there are periods when a new run is not synched automatically (never found a pattern when it does and when it does not), but then still I can manually synch the activity by clicking on the three dots "..." on the upper right corner of the respective training session and chose "Export" Also, in this menu, there is an option called "Export Verlauf" (in my german version), i'd assume that is the option mipapo is talking about.
But coming back to the automatic synching, I can only suggest checking Profil / Runalyze and see if both Synching Health data and Synching Training Session is set to "Automatic" with the two sliders.
Hope that helps, as in general this setup with AppleWatch, Healthfit and Runalyze is just great for me.
Alex