The NHS National Programme for IT in England is one of the largest information technology programmes in the world.1 The programme has been subjected to hostile media coverage in its four year history, and it has been difficult to know how much of this is justified. The publication of the National Audit Office report on the programme gives both supporters and critics food for thought.2 The audit office finds that elements of the programme are progressing well, but also points to key challenges over the next few years—in ensuring that the promised systems are delivered and that NHS staff are engaged with the programme.3

The report contains a wealth of detail, but doctors should pay particular attention to two issues. Firstly, the report notes that the Department of Health has failed to show benefits of the programme that will justify its …