Complexity and its implications for health systems implementation

The National Programme for IT in England is an ambitious programme comprising a variety of systems from the tried and tested to the new based on new government policy that is being implemented at the same time. For such a large and complex programme, it is not surprising that there are a variety of outcomes emerging. While there are many successes, there are also delays and concerns. This paper looks at two very different systems in the programme (Choose and Book and PACS). It compares and contrasts their implementation within a health community and identifies implications, based on complexity theory, this has for the choice of approach to implementation of associated change.