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Abstract

Mega-programmes are prevalent across the world in areas of national importance, such as health, education, and security. In the United Kingdom, the National Programme for IT (NPfIT), coordinated by the agency ‘Connecting for Health’ (CfH), is one such example. This programme aims to transform the provision of healthcare through the creation of a new IT infrastructure connecting doctors, nurses and health care professionals across England. This network will support a range of online applications, for maintaining patient records, booking appointments, prescribing medication and transferring digital images. The vision of a fully information-driven National Health Service is attractive on many grounds, yet no nation has found it easy to realize. In this paper, we present four perspectives on the implementation issues surrounding the UK Programme, which address a cross-section of the expectations and anxieties of those involved, and the multiple outcomes achieved. We examine the tensions and opportunities in what is taking place, and draw out policy implications from our work.

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