Since the National Health Service reforms were introduced, the NHS has moved towards a greater emphasis on accountability and efficiency of healthcare. These changes rely on the swift delivery of IT systems, implemented into the NHS because of the urgency to collect data to support these measures. The case study details the events surrounding the introduction of a patient data management system into an intensive care unit in a UK hospital. It shows that its implementation was complex and involved organisational issues related to the costing of healthcare, legal and purchasing requirements, systems integration, training and staff expertise, and relationships with suppliers. It is suggested that the NHS is providing an R&D environment which others are benefiting from. The NHS is supporting software development activities that are not recognised, and the true costs of this task are difficult to estimate. It is also argued that introducing PDMS crystallises many different expectations making them unmanageably complex. This could also be due to PDMS being a higher order innovation that attempts to integrate information systems products and services with the core business.