For me, banging the drum, pots, pans and anything that makes a noise about how great the NHS is, is easy and for the most part, spot on. Being proud of NHS services, while understanding the weaknesses, is not mutually exclusive and although I am not qualified enough to talk about daily clinical issues, patient outcomes or front-line staff challenges evident in some, if not all Trusts – I feel I can provide a point of view about the daily IT challenges that get in the way of enabling NHS outcomes. As an ex-NHS employee, and having worked with the NHS in one capacity or another for around 15 years since then, I’ve seen there is a malignant issue that mirrors the points in the newspaper article. The timing of Sunday’s article was uncanny and followed close on the heels of one of those ‘putting the world to rights’ conversations with a close friend of mine who happens to be a CTO within a large NHS Trust. Given our relationship, we regularly enjoy long rants to each other about our respective worlds of work. At this point, he and I are locked in a repeating cycle of mutually assured destruction, as we both know each other’s views and opinions on everything. However, beyond sharing (or oversharing) our rich opinions on most things, we ended up talking about technology, which is the thing we feel passionately about – and incidentally pays both our mortgages in one way or another. On this, a wet and cold Monday, the specific frustration that landed on both of us was the lack of reality – or acceptance of reality – we see in our peers across the NHS. The NHS is amazing at publicising each and every quick win, such as a major clinical system procurement or deployment, but I rarely see honest reflections from across the NHS about the overall state of technology and technology platforms. We have both attended meetings feeling as though knowledge is not power but a curse – and that counteracts the messages of positivity shared by our peers and colleagues. We consistently hear leaders in technology across the NHS talk about how good things are due to a singular project or technology area, while knowing full well, that other Trusts (in some cases the same Trust) have had major cyber security issues; or are still running a sizeable proportion of services on Windows 7; or have limited backup and DR capabilities or… the list goes on.