Healthcare and IT are both knowledge-intensive industries with complex processes and high variability – every patient, every IT system is unique. Both professions are also continually evolving their bodies of knowledge with increasing sub-specialisation of practice. In addition to understanding this complex operating context, IHiS architects need to continually balance between national imperatives and local institutional needs. This talk shares how our Chief Architect’s Office is organised to guide enterprise IT at the portfolio and solution levels.