The progression of implementation of an information systems strategy in a UK acute hospital is described. The case study describes the IS strategy, the conditions that led to its development and its content. It then follows the progression of attempts to implement the strategy over five years. At the end of five years, little of the strategy has been implemented. Reasons for this are discussed structured around the following questions: Why was the IS strategy produced? What external environmental changes influenced implementation?, How did internal organisational change affect implementation? In what ways was the IT strategy naïve? Was the IS strategy exercise at the hospital of any value? Lessons for both researchers and practitioners are presented. It is concluded that, far from being a irrelevant exercise, the development of the IS strategy at the hospital provided a catalyst for organisational learning and culture change which enabled the hospital to avoid some IT investment mistakes which other hospitals did not.