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The National Health Service (NHS) in England is the largest organisation in Europe, with over 1.3 million people working in it, and serving the needs of some 50 million citizens. The NHS is halfway through a ten year plan to implement the National Program for IT, the largest civilian IT project in the world. It is intended to bring the benefits of advanced information technologies for the maintenance of integrated care records to every public healthcare facility in England. Clearly there is a need for a great deal of education and training for such a large deployment, and a national strategy has been developed to use the same technology to deliver large-scale e-learning to hundreds of thousands of end-users, thus realising what has been dubbed a 'double dividend' from the national program. Indeed, the benefits of using the technology to support learning do not end with learning about the national program, because once the infrastructure is in place, it can be used for other information and learning purposes as well. Thus, technology which is originally being deployed for clinical and management purposes, is also at the same time subtly changing the 'learning landscape' for the people who work in, with and for the NHS. This presentation will explore several major aspects of how technology is being used to deliver work-based e-learning, to provide electronic performance support, to allow access to information resources and communities of practice, and even to allow for the collection and sharing of data in real-time for both diagnostic and research purposes. The presentation will consider the challenges of working with a large and geographically distributed workforce, with very different levels of technological skill and confidence, and how learning at work can connect, on the one hand, with formal learning in universities and colleges and, on the other hand, with informal and self-directed learning in the home or community. The presentation will also consider how- digital technologies not only have the ability to supplement face-to-face learning in a range of blended approaches but, because of their immense storage capacities, can in fact expand or amplify the human capacity for learning.