This programme implements and maintains secure, reliable, efficient, user-friendly IT systems for new and on-going clinical trials, observational studies and meta-analyses. The large-scale, often international, projects conducted by CTSU would not be feasible without sophisticated, bespoke IT systems. These are based on, and are enhanced by, our work in streamlining study processes, including innovative integration with measurement and data capture devices, and with routine health records. CTSU’s extensive IT experience greatly increases the speed of development: while many of the systems and much of the computer code can be used on multiple projects, changes are made to accommodate demands of new protocols, evolving technologies and changing regulations for security, privacy and data sharing. Long-term projects require long-term support with periodic upgrade or replacement of legacy systems. A major focus will be on the development of core systems to support (i) analysis, archiving and exchange of clinical trial data (meeting the requirements of the international Clinical Data Interchange Standards Consortium); (ii) key activities of the CTSU Wolfson Laboratory (particularly new analysers, quality control activities, long-term sample archive); and (iii) replacement and enhancement of legacy systems for coordination and analysis of long-term projects (e.g. the 20 year old Fortran-based systems that support the Early Breast Cancer Trialists Collaborative Group).