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 na