Researchers identify important leadership mechanisms to improve national health and social care systems

King’s College London

The NIHR-funded report will inform policy and leadership development and support improvements to health and social care systems nationwide.

Person caring for another

Researchers from King's College London and Kingston University have identified seven important components of leadership in integrated care teams and systems. These are released today in a study funded by the National Institute for Health Research (NIHR).

The identified components, referred to as 'mechanisms', will inform policy and leadership development and support improvements to health and social care systems nationwide. The seven mechanisms are:

  1. inspiring intent to work together
  2. creating the conditions to work together
  3. balancing multiple perspectives
  4. working with power
  5. taking a wider view
  6. a commitment to learning and developing
  7. clarifying complexity

The roll out of integrated care systems in England this year means closer collaboration between the NHS, social care, local authorities, and communities. However, little is known about how to develop and support leadership across these organisational boundaries. This study addresses that knowledge gap.

We are delighted to release this report on leadership in integrated health and social care teams and systems, which explores theories around leadership to discover what works, for whom, and in what circumstances. Our review is grounded in the reality of health and social care delivery, and addresses practice and policy changes throughout.– Ruth Harris, Professor of Healthcare for Older Adults at the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care

The study explored a wide range of evidence about leadership of integrated care teams and systems and used this to build a comprehensive description of leadership in action with all its associated contexts and outcomes.

This research offers a timely and unique perspective on leadership of integrated care teams and systems. All these systems are evolving now across the nation. In addition to examining research literature, we also explored the experiences of patients and service users, the public and other key stakeholders in integrated care. Our stakeholder group, consisting of integrated service managers, researchers and service users and carer representatives, was closely consulted throughout the process, and they helped shape the overall findings.– Jill Manthorpe, Professor of Social Work at the NIHR Policy Research Unit in Health and Care Workforce

In addition to identifying the seven leadership mechanisms, the researchers concluded that research into leadership of integrated care teams and systems is limited and underdeveloped, with ideas often based on outdated assumptions. By making explicit some of these assumptions, the review has generated new perspectives, which can be built on, developed and tested further.

We are proud to have contributed novel and valuable insights into the leadership of integrated care teams and systems and laid a solid foundation for future research and the courses and programmes that will develop leaders of the future. With the increased shift towards this model of working, we believe our findings will contribute to ensuring these systems always keep the public at the centre of service delivery.– Fiona Ross, Emerita Professor of Health and Social Care at the Faculty of Health, Social Care and Education, Kingston University

Findings from the study also formed the basis of a journal publication released last year, in the International Journal of Integrated Care.

Read the report

The full report: Developing programme theories of leadership for integrated health and social care teams and systems: a realist synthesis is available on the NIHR website.

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