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    I disagree - as Sarah has said, it is almost impossible to evaluate the total effect until the practice is up and running. There are windows built in, as far as I can see, to enable tweaks and reviews. Any good business has those features. The NHS is Too Too huge to be able to properly assess the impact of everything on everything else - best guesses and professional estimates running alongside risk assessments (and registers) and effective project plans are the best that can be done - and that applies to all businesses and large organisations!

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