As Brexit drew ever closer, NHS England set up an ‘operational response centre’ to support trusts struggling in the event of a no-deal or hard exit from the EU. Meanwhile, the Department of Health and Social Care published the so-called Kark review into the fit and proper persons test that is applied to members of NHS boards; and then largely ducked the question of whether senior managers should be better qualified and regulated. The NHS in Scotland issued a GP IT framework. And David Hancock from InterSystems continued his series of blogs on interoperability by addressing some of the project management issues that are needed to make big change projects a success.