“Dark days before Christmas,” my Mother says. It may be those short days just after the winter solstice that are dulling my mood while I look back on my time in healthcare IT. How much has changed and how much have we learned? Not nearly enough.

Darkness hangs over the NHS National Programme for IT (NPfIT) as we end the year. Accenture has left and the future of software supplier Isoft is unclear. Progress on the core cross-organisational National Care Records Service—for me the Programme’s essence—is also well behind schedule.

But shafts of light pierce the dark. NPfIT’s PACS deployments have progressed well. Though an easy win, they are nonetheless an important one because they highlight the benefits of sharing electronic patient-based information. Also, Cinderella sections of the NHS like Community and Mental Health are benefiting from the deployment of new systems.

My mood has also been lightened by the number of young clinicians, especially doctors, excited by the possibilities of information technology. I have recently met several—some working with Professor Sir Ara Darzi’s unit in London, which looks at the integration of technology into medicine.

At this time of year the days lengthen slowly with the darkest hours just before dawn.