ISSN 0004-0894 © Royal Geographical Society (with The Institute of British Geographers) 2003 Area (2003) 35.1, 74 – 83 Blackwell Publishing Ltd (Re)surveying the uses of Geographical Information Systems in Health Authorities 1991–2001 Darren P Smith*, Myles I Gould** and Gary Higgs† *Department of Geography, School of the Environment, University of Brighton, Brighton BN2 4GJ Email: D.Smith@Brighton.ac.uk **School of Geography, University of Leeds, Leeds LS2 9JT Email: m.gould@geog.leeds.ac.uk †GIS Research Centre, School of Computing, University of Glamorgan, Pontypridd, Wales CF37 1DL Email: ghiggs@glam.ac.uk Revised manuscript received 3 October 2002 This paper provides a comparative analysis of two separate national surveys of the uptake and use of Geographical Information Systems (GIS) by Health Authorities (HAs) in England and Wales. The surveys were undertaken at two different time points (1991 and 2001), and the intervening period has been characterized by major (and continuing) health sector restructuring. The substantial number of HA mergers between 1991 and 2001 provide a methodological challenge in attempting to make comparisons. A pragmatic approach is adopted and the presentation of results has to be restricted solely to English and Welsh HA data. Our findings show that there has been a considerable increase in the use of GIS since the early 1990s, and there is some evidence of more sophisticated uses for a wider range of policy-related and application tasks. However, we conclude that there is still considerable scope for the wider uptake and use of GIS within the NHS. In addition, our findings provide a baseline with which to monitor the impacts of future organizational restructuring on the uses of GIS within the NHS. We suggest that this is important given the replacement of 95 English HAs with 28 new Strategic HAs (StHAs) from April 2002, and the repercussions of the anticipated shift in GIS responsibility to Primary Care Trusts. Key words: England and Wales, GIS, NHS, Health Authorities, organizational restructuring, temporal change Introduction This paper explores the contention that Geographical Information Systems (GIS) have now ‘come of age’ within the health care sector, and considers the changing role of such technology in enabling the exploitation of spatially referenced digital data within Health Authorities (HAs) in England and Wales. Recently, Higgs et al. (2003) have provided a detailed discussion of the current role of GIS within all HAs/Health Boards and Trusts in the United Kingdom, as part of inter-organizational collaborative ventures and geographical data exchanges. Drawing upon findings from national questionnaire surveys, conducted during June–July 2001, Higgs et al. demon- strate the potential of GIS to address health concerns which cross institutional boundaries, and suggest that this could help facilitate ideas of joined-up government