Delivering an integrated care systems approach for speech and language therapy head and neck cancer services in the UK: service development and redesign in Cheshire and Merseyside.

Purpose of review: The purpose of this review is to share the implementation of an integrated care systems approach for head and neck cancer speech and language therapy services. Facilitating factors and barriers to change are highlighted and links to relevant literature are indicated. The intention is that this paper will provide a 'non blueprint' for others embarking on large scale integrative change.

Recent findings: Integrating health and social care provision across organizations is necessary for improving outcomes for people, reducing health inequalities and improving efficiencies in care. Whilst recognizing this intention, the current structure for providing care in NHS organizations does not foster cross-organizational working.

Summary: Integration enhances patient centred care, however implementation of change across organizations is challenging. Managerial support is pivotal and differences in organizational culture need to be acknowledged, respected and overcome. A clearly defined vision, to which all staff are committed provides an anchor in challenging situations. Transformational change is iterative and cannot always be predetermined. Success is possible; tenacity, flexibility and agility are key.