This case study looks at how the NHS assessed its portfolio, programme and project management at a time of organisational change. AXELOS’ P3M3® Model was used to evaluate organisational ability, highlight areas for development and strategise for an improved approach. As the largest publicly funded health service in the world, the National Health Service (NHS) is going through a period of change and reform. It faces the challenging task of delivering transformation while protecting quality, the effective use of resources and continuing productivity. The NHS needed a framework to manage and control the delivery of change across portfolio, programme and project management. It wanted to build its capabilities to manage the implementation of transformation objectives effectively and efficiently.