Purpose: The purpose of this paper is to describe the further development of the Koha 3.0 library management system (LMS) and the involvement of external software consultants at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper takes the form of a report based on internal documentation. Finding: Since its implementation in winter 2007/8 Koha has grown into an LMS that supports the wide-ranging needs of a busy and fast-growing specialist library. CAMLIS had Koha modules modified and added to meet its needs flexibly, using simultaneously both UK-based consultancy firms with Koha expertise. Originality/value: This is among the first implementations of Koha in the UK. Experience and conclusions from this installation might influence decisions at other libraries. (Contains 5 figures and 1 note.)