Successful integration is more likely with

• Demand from patients

• Commitment from high level staff in the conventional organisation

• Protected time for education and communication

• Ongoing evaluation of service (may help to defend service in the face of financial threat)

• Links with other conventional establishments integrating complementary medicine

• Realism and good will from all parties

• Jointly agreed guidelines or protocols between complementary and conventional practitioners

• Support from senior management or health authority

• Careful selection and supervision of complementary practitioners

• Funding from charitable or voluntary sector

Problems are likely with

• Financial insecurity

• Time pressure

• Lack of appropriate premises

• Unrealistic expectations

• Overwhelming demand

• Inappropriate referrals

• Unresolved differences in perspective between complementary and conventional practitioners

• Real or perceived lack of evidence of effectiveness

• Lack of resources and time for reflection and evaluation

List adapted from the report of the Delivery Mechanisms Working Party of the Foundation for Integrated Medicine