The goal of improving managerial effectiveness within the National Health Service has long been recognised as being inextricably linked to the improvement of information systems. However, recommendations concerning the latter have primarily concentrated on issues of capture and content of standardised information and not on the need for flexibility in the mechanisms by which this information is delivered to management. Such mechanisms must integrate rather than conflict with the diversity of the decision-making environment if information is to be used and therefore translate into improvements in managerial effectiveness. Thus there are several reasons why any information system within an organisation such as the Health Service needs to be a dynamic and responsive tool. Integration of data access with analytic power should allow requisite information to be derived and adjusted iteratively by managerial demand, rather than be standardised and pre-defined.This paper argues that more encouragement should be given to develop a variety of such 'Decision Support Systems' within the Service. Although the establishment of better base-line information throughout the organisation will extend the limits of what can be achieved with such systems, their justification is not necessarily contingent on developments in this area. It is suggested that local initiatives are possible and desirable using existing information sources. An example of one such system, developed to assist District management in planning and monitoring hospital inpatient and outpatient services, is discussed.