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Many observers and stakeholders mistakenly believed that implementing health IT would be a simple matter of technical change – a straightforward process of following a recipe or a checklist.

In fact, implementing health IT is one of the most complex adaptive changes in the history of healthcare, and perhaps of any industry.

This publication is available at https://uk/government/publications/using-information-technology-to-improve-the-nhs/making-it-work-harnessing-the-power-of-health-information-technology-to-improve-care-in-england ) to continue to provide a high level of healthcare at an affordable cost, it simply must modernise and transform.

In fact, cost savings may take 10 years or more to emerge (the so-called ‘productivity paradox’ of IT), since the keys to these gains are improvements in the technology, reconfiguration of the workforce, local adaptation to digital technologies, and a reimagining of the work.

While it is true that erred partly through overcentralisation, it is also important to note that centralisation sometimes makes sense, particularly in the context of a national health system.

While there is urgency to digitise the to digitise the secondary care sector in a staged fashion, in which trusts that are ready to digitise are prompted to do so, while those that are not ready should be encouraged and supported to build capacity, a process that will take several years.

While it is natural to seek a short-term financial return on investment ( is more likely to come in the form of improvements in safety and quality than in raw financial terms.