Independent Consultant and

This report presents a case study of the emergency health care system in the United Kingdom. This is an intensely knowledge-driven sector that relies on public and private financing to provide outputs in the form of services that are widely perceived as ‘public goods’. The health care system comprises multiple knowledge-driven communities of professionals. This study examines their perceptions of transformations in the organisation and structure of emergency health care services from 1992 to the present. The results demonstrate that there are many discontinuities in the knowledge-driven activities within and between the health care professional communities. Important features of the transformation of the emergency health care system include: • the application of information and communication technology (ICT) systems that are insufficiently tailored to the requirements of their users. Many potential users lack the time and resources to learn to use them effectively or to maintain them. This is partly due to the turbulence created by constant change in the wider National Health Service