NHS Managers Closely Observed: Some Features of New Technology and Everyday Managerial Work. Karen Clarke 1 , Mark Hartswood 2 , Rob Procter 2 and Mark Rouncefield 1 1 CSCW Research Centre, Department of Computing, Lancaster University 2 Institute for Communicating and Collaborative Systems, Division of Informatics, University of Edinburgh 1 k.m.clarke|m.rouncefield@lancs.ac.uk 2 mjh|rnp@dai.ed.ac.uk Introduction: new technology and organisational life in the NHS. This paper presents some preliminary findings from our ongoing ethnomethodologically informed ethnographic studies (Hughes et al 1994) into managerial work and hospital information systems in everyday use. Our focus is the everyday work of various managers - Clinical Directors, Nurse Managers, Service Managers and Information Managers, and how people, systems and enterprises interact and collaborate. This involves shadowing various hospital managers - usually for a week at a time - documenting and tape-recording their everyday, practical activities moment-by-moment as they occurred (Clarke et al 2001). Our paper reports on some of the complexities involved in the use of Information and Communication Technologies (ICTs) in the provision of information, the production and utilisation of that information in everyday managerial work, and the variegated skill and trust factors relevant to information use in managerial working practices. It documents the articulation in practice of the cultural, organisational and technical arrangements for the use of ICTs in managerial working across organisational boundaries. This paper's interest in new technology and managerial work in the NHS is part of a more general concern with the ‘future of work’ and its relationship with technological change. This interest has developed against the background of major transformations in the social and economic environment. (Lash & Urry 1994) and the emergence of an ‘Information Society’ or ‘Informational Economy’ (Castells 1996) where a particular emphasis has been accorded the role of IT in supporting skill and knowledge and facilitating the coordination and control of work (Zuboff, 1988) as collaborative work becomes increasingly electronically supported (Grudin, 1990). In common with other large-scale, distributed, organisations the NHS is experiencing enormous growth in ICT deployment, intended to ‘reconfigure the organisation’ through its application in data analysis and processing, communication and decision support (Scott Morton (1991). This is recognised within the NHS itself: "We certainly use IT as an explicit catalyst for organisational change, especially the design of working practices" (in Doherty et al. (1999)) and recent reports, such as 'Building the Core,' continue to argue the importance of IT as an intrinsic part of the agenda for change. Healthcare institutions are particularly information intensive and IT increasingly plays an important