The importance of effective collaboration between health and education professionals is widely recognised (e.g. Edwards 2011, Frost et al 2010). In considering the question ‘how can extended services be changed in order to improve access and inclusion’, Frost et al identified three key themes: • Organisational culture and philosophy • Sharing knowledge and skills • Policy, commissioning and funding. In this paper we consider issues relating to each of these areas that arose from research visits to Italy, Japan and Norway, in the context of the relationship between health and education. The continued need for better communication between health and education professionals was highlighted by our research, but we were also able to explore some emerging initiatives and roles that attempt to straddle the divide between the two areas. A key theme arising from each of the case studies was the suggestion of a shift of paradigm across professions, whereby teachers engaged with health professionals are primarily concerned about how interventions from health relate to what goes on in the classroom.