In achieving the vision, leaders need to foster participation and involvement through developing trust. Being
transparent about difficulties and failures is part of the trust-building process. Resources need to be allocated
consistent with the vision. Leutz's10 second law of integration is perhaps the most important for any change
process: it costs before it pays. Leaders need to employ a rigorous project management approach to
implementing change which clearly identifies the costs and risks, as well as the benefits.
Health service integration has the potential to address issues of access, patient satisfaction, better use of the
diminishing health labour force and more effective use of financial resources. This case study demonstrated that
managers and clinicians agree on its desirability. The issue is implementation through effective change
management, not just good intentions.