Altought we have come a long way in being able to articulate the key building blocks of integrated care, the interplay between them is so complex and interwined that it seems an impossible challenge to create any simple implementation model. Yet, if integrated care is to advance, we must become better at smoothing over the many obstacles and challenges to implementation that have bedevilled the uptake and roll-out of even the most proven of integrated care interventions.

This is quite the “three-pipe problem” for integrated care since science has yet to make the real breakthrough to address how we might better understand the implementation and sustainability of complex innovations. Recent attems hace used a blend of realistic synthesis, behavioural theory and mixed-methods to understand implementation effectiveness.