The Health Service Executive (HSE) was established in 2005. This merged a number of different Health Boards and organisations. To enable this change and achieve its objectives, the HSE launched The HSE Transformation Programme (2007-2010) consisting of 13 programmes with 119 projects. In parallel, the HSE established a National Programme Office (NPMO) with the responsibility to implement a standard Project Management Methodology and approach for the management of the 119 projects. Following the implementation of the HSE, there were many different methodologies and styles to project management as each of the 11 areas were independent organisations up until then. This paper describes how the NPMO developed a standard methodology and implemented it for the Transformation Programme. It begins with a review of the process in operation and identifies the weakness in the adopted methodology and approach. In addition, the paper includes an outline of the challenges that faced the HSE and the NPMO to develop an alternative approach for the management of projects, one that had better buy in and effectiveness. Futhermore, the paper discusses the process undertaken to develop a revised approach to project management resulted in the development of HSE Project Management LITE. The roadmap in developing this approach is outlined together with the key principles adopted to implement Project Management LITE.