In England, services addressing the complex needs of people with learning disabilities by integrating health and social care are currently designed in an ad hoc fashion. A structured approach has the potential to address variable levels of service provision and quality as well as provide clarity about the purpose and boundaries of the services. A design process is a series of steps taken to develop a product or process from initial needs to final design specifications and implementation. Currently no structured design process for these complex health and care services exists. Based on a literature review and an extensive set of interviews and observations carried out in a learning disability service we suggest a research framework rooted in engineering design to develop an appropriate design process. An existing model for design research forms the basis of an exploratory approach that allows for adaptation to different internal and external factors and constraints.