In this insightful discussion, Phil Moore, Insight's innovation lead, and Hammond Reddie, University Hospitals Birmingham's CTO, delve into the complexities and future of healthcare IT systems. Hammond emphasizes the importance of collaboration with service owners to drive progress, despite there being occasional areas of friction. Hammond highlights the challenges posed by the numerous interdependent systems within healthcare, noting that changes in one system can significantly impact others. He underscores the necessity of understanding the infrastructure at a granular level, revealing that their Trust manages between 600 and 700 systems, and sometimes ownership and accountability is unclear. This lack of clarity can hinder effective management and innovation. Hammond advocates for a methodical approach to evaluating and implementing changes to avoid unintended consequences. The conversation sheds light on the critical role of IT in healthcare and the need for strategic planning and collaboration to navigate its complexities and drive future advancements.