Much of the debate about the NHS IT programme has been around process not outcomes. At this stage of climbing the mountain of implementation, people’s concerns understandably centre on costs, timing, security, resources, training, interoperability and process re-engineering. For the patient, though, there are wider quality issues about what quality gains an implemented system might deliver and what the vision of care might be. This paper examines diverse aspects of the NHS IT programme and discusses the patient benefits in primary care that may flow from the various initiatives. It evaluates which will be especially helpful and to whom. It also considers which initiatives at present seemin need of major development in order to realise the benefits for patients.