Purpose - Dysfunctional governance processes have contributed to catastrophic healthcare system failures due to discordance between clinical and corporate governance processes. The emergence of an integrated governance approach endeavours to overcome the traditional boundaries between corporate and clinical governance systems, to enhance understanding and transparency in the organisations approach to service provision. The purpose of this paper is to discusses the attributes of an integrated governance approach and its contribution to enhancing service delivery. Design/methodology/approach - The paper provides an overview of the governance approaches and the emergence of integrated governance to improve overall service delivery. Findings - An integrated governance approach erodes the traditional boundaries that exist within the complex healthcare system. This allows for a greater understanding of healthcare strategies and organisational objectives, and the dissemination of these throughout the organisation. Further, enhancing awareness within the clinical setting of the core attributes of the organisation and for the upper echelons of management to have a greater understanding of the clinical issues. Integrated governance acknowledges the contribution of all stakeholders including consumers in safe guarding the delivery of healthcare and its standards. Originality/value - This paper contributes to the discussion and debate regarding governance approaches and how these are situated in enhancing organisational performance.