Report on Leadership in Integrated Care Systems from SCIE
The Social Care Institute for Excellence (SCIE) is pleased to announce the publication of a new report in its Future of Care series, entitled “Leadership in integrated care systems (ICSs)”. This paper, prepared for the NHS Leadership Academy, is aimed at chief executives, directors and senior managers from the NHS, local authorities, housing organisations and voluntary and community sector; it is based on findings from interviews with systems leaders and a review of the literature. The NHS Leadership Academy commissioned SCIE to undertake this research to further expand the understanding of systems leadership and leadership of integrated care systems.
Key findings in the report include the following:
- Integrated care systems (ICSs) are a critical part of NHS England’s strategies, which arethe biggest national move to integrating care of any major western country.
- With no basis in law, ICSs are entirely dependent on a collaborative approach to leadership and a willingness on the part of the organisations involved to work together.
- Leadership in ICSs is very much a form of systems leadership, but with new and unique challenges, such as the need to exert influence across an even larger range of organisations and co-produce services with people who use them.
- Effective systems leadership relies on a composite set of capabilities and behaviours, which can be grouped under the following four domains (NHS Leadership Academy Systems Leadership Framework):
- innovation and improvement
- relationships and connectivity
- individual effectiveness
- learning and capacity-building.
- Leaders in ICSs need to be skilled at:
- identifying and scaling innovation (e.g. from pilots)
- having a strong focus on outcomes and population health
- building strong relationships with other leaders, and often working with them informally to develop joint priorities and plans
- establishing governance structures which drive faster change, often going where the commitment and energy is strongest
- setting the overall outcomes and expectations on behaviours, but handing day-to-day decision-making to others
- supporting the development of multidisciplinary teams (MDTs)
- designing and facilitating whole-systems events and workshops to build consensus and deliver change
- understanding and leading cultural change
- building system-wide learning and evaluation frameworks
- fostering a learning culture across the whole system.
- Leaders told us that they would welcome support in the following areas:
- skilled external facilitation, to help deliver complex programmes
- the creation of ‘safe spaces’ for leaders to meet with peers and share problems and solutions
- more opportunities to learn from other professions and sectors
- systems leadership development for middle managers across the system
- masterclasses on:
- co-production theory and practice
- finance and risk-sharing
- scaling innovation
- understanding local government and social care
- large-scale and large-group facilitation
- working and influencing across multiple layers of governance.
The entire report can be read here as a webpage, or you can download directly as a PDF after setting up a free user account on the site.