DescriptionWhat does success look like for leaders of integrated health and social care systems? A realist review.
Background: As health and social care in England move towards more integrated models of working with increasing cross-sector and interagency collaboration, leadership is becoming more complex. While there is much
descriptive research on leadership and leadership development within health services, there is little understanding of what the mechanisms are for effective leadership across integrated health and social care systems,
the contexts that influence good leadership, or the nature of the resulting outcomes.
Aims: To identify and refine the programme theories of leadership of integrated team-based services in health
and social care, exploring what works, for whom and in what circumstances.
Methods: A realist synthesis was undertaken. Databases were searched for published and grey literature. In
line with realist synthesis methodology, each study’s ’fitness for purpose’ was assessed by considering its relevance and rigour. A stakeholder group of integrated service managers, researchers and patient/service user
and carer representatives was closely consulted and helped shape the overall findings.
Results: Thirty-six papers were included generating evidence for seven potentially important components or
‘mechanisms’ of leadership in integrated care teams and systems. These were: ‘inspiring intent to work together’; ‘creating the conditions to work together’; ‘balancing multiple perspectives’; ‘working with power’;
‘taking a wider view’; ‘a commitment to learning and development’ and ‘clarifying complexity’. No research
evidence was found for an eighth mechanism, ‘fostering resilience’, although our stakeholders felt that this was
Discussion: Research into the leadership of integrated care teams and systems is limited, with ideas often
reverting to existing framings of leadership, where teams and organisations are less complex. Research often
focuses on the importance of who the leader is rather than what they do.
Conclusion: This review has generated new perspectives on the leadership of integrated care teams and systems that can be built upon, developed, and tested further.
|Period||6 Sept 2023|
|Location||Manchester, United Kingdom|
|Degree of Recognition||International|