Despite the overwhelming evidence of the effectiveness of the individual placement and support (IPS) approach to vocational rehabilitation for people with mental health conditions, there is very limited evidence of implementation in the UK. Both government policy and national clinical guidelines have set out a need for the availability of this effective approach in favour of other approaches, yet implementation appears to be an exception rather than a rule. This paper sets out four key challenges to implementing the IPS approach within mental health services in England: fear on the part of professionals, individuals and their families; a culture of low expectations; a failure to provide the support that we know works, and the global 'credit crunch' recession. Using a framework from implementation science, this review identifies the key features of implementing IPS within routine clinical practice from the experience of two large mental health NHS trusts in England.