Mechanisms for the integration of social services with health have come to dominate the debate on providing a more seamless provision of health and social care. Working together at the health and social care interface has been strongly promoted and endorsed in government documents since the late 1990s. Moves towards integration have been treated with suspicion and scepticism in the academic literature, with many authors highlighting the many barriers and challenges presented by this method of working. Yet these proposals do not represent a paradigm shift in culture in all parts of the United Kingdom, as Northern Ireland has had an integrated health and social care system for over thirty years. Based on an empirical study of senior health care professionals in Northern Ireland, this study identifies and discusses the key issues associated with integration. It concludes that the experiences in Northern Ireland have to date been overlooked or misrepresented and could prove extremely valuable in gaining an understanding of the challenges and benefits of integrated arrangements.