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Journal article

Leadership for integrated care: a case study

Abstract:

Purpose

Integration of health services involves multiple interdependent leaders acting at several levels of their organisation and across organisations. This paper aims to explore the complexities of leadership in an integrated care project and aims to understand what leadership arrangements are needed to enable service transformation.

Design/methodology/approach

This case study analysed system and organisational leadership in a project aiming to integrate primary and specialist care. To explore the former, the national policy documents and guidelines were reviewed. To explore the latter, the official documents from the transformation team meetings and interview data from 17 health-care professionals and commissioners were analysed using thematic analysis with the coding framework derived from the comprehensive and multilevel framework for change (Ferlie and Shortell, 2001).

Findings

Although integration was supported in the narratives of the system and organisational leaders, there were multiple challenges: insufficient support by the system level leadership for the local leadership, insufficient organisational support for (clinical) leadership within the transformation team and insufficient leadership within the transformation team because of disruptions caused by personnel changes, roles ambiguity, conflicting priorities and insufficient resources.

Practical implications

This study provides insights into the interdependencies of leadership across multiple levels and proposes steps to maximise the success of complex transformational projects.

Originality/value

This study’s practical findings are useful for those involved in the bottom-up integrated projects, especially the transformation teams’ members. The case study highlights the need for a toolkit enabling local leaders to operate effectively within the system and organisational leadership contexts.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1108/lhs-09-2019-0066

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
RDM
Sub department:
OCDEM
Role:
Author


Publisher:
Emerald
Journal:
Leadership in Health Services More from this journal
Volume:
33
Issue:
2
Pages:
125-146
Publication date:
2020-02-03
Acceptance date:
2020-01-06
DOI:
ISSN:
1751-1879


Language:
English
Keywords:
Pubs id:
1085077
Local pid:
pubs:1085077
Deposit date:
2020-02-06

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