Collaborative Leadership in Integrated Care Systems; Creating Leadership for the Common Good

The COVID-19 pandemic has become a catalyst for change, but such change can only happen through collaborative leadership which maintains a focus on relationships and purpose rather than solely on outputs or outcomes. This conceptual article explores how health and social care integration has been offered as one potential solution to the challenge of health and social care transformation. Specifically, Integrated Care Systems in England are intended to provide regional governance, to provide public services in a coherent and robust way. We explore this development in relation to three key aspects: the macro-level global policy context; the meso-level organizational behaviour and culture; and the micro-level practice of individual leaders and managers. It is found that, whilst the organizational structure of Integrated Care Systems offers great promise, collaborative leadership is critical to realize truly resilient and sustainable collaborative relationships.

Primary health care case studies in the context of the COVID-19 pandemic

Overview

AICIC23 All-Ireland Conference on Integrated Care | 23 March 2022 | Dublin UCD

Skill-mix Innovation, Effectiveness and Implementation: Improving Primary and Chronic Care

What are skill-mix innovations and why are they relevant? This systemic analysis of health workforce skill-mix innovations provides an overview of the evidence and lessons for implementation across multiple countries.

The authors focus on six core segments of health systems: health promotion and prevention, acute care, chronic care, long-term and palliative care, as well as access for vulnerable groups and people living in underserved areas.

Building primary health care teams for universal healthcoverage in Africa

The Alma Ata Declaration on Primary Health Care (PHC) in 1978 defined PHC profoundly. Comprehensiveness and continuity of care, as well as coordination of referrals, were key attributes of integrated PHC. Unfortunately, African governments function with bureaucratic health systems, where top-down implementation policies, especially selective PHC vertical programmes driven by international agencies, create rigid, large, impersonalised units of PHC. Global agencies and country leaders must be challenged on this: what are they doing practically to build PHC teams for UHC in Africa?

Strengthening primary health care: contributions of young professional-led communities of practice

Health systems that have strong primary health care at their core have overall better patient outcomes. Primary health care is key to achieving Universal Health Coverage and the broader health-related Sustainable Development Goals by 2030. In 2018, at the launch of the Declaration of Astana, the World Health Organization formed the inaugural Primary Health Care Young Leaders’ Network. This paper aims to demonstrate the scope for young professional-led communities of practice in fostering support systems for young leaders and strengthening the delivery of primary health care at multiple levels.

Online Learning: Certificate in Integrated Care

The Certificate in Integrated Care has been designed using IFIC’s 9 Pillars of Integrated Care as a module based course of online learning. The accessible, high quality programme is offered through our digital, innovative and dynamic online learning platform. This comprehensive introductory level self-managed Certificate in Integrated Care accredited by CPD Standards UK delivered 100% online and in the comfort of your own home.

The course is based on The 9 Pillars of Integrated Care with the 5 modules as follows:

The Leadership of Co-Production in Health and Social Care Integration in Scotland: A Qualitative Study

The involvement of citizens in the production and creation of public services has become a central tenet for administrations internationally. In Scotland, co-production has underpinned the integration of health and social care via the Public Bodies (Joint Working) (Scotland) Act 2014. We report on a qualitative study that examined the experiences and perspectives of local and national leaders in Scotland on undertaking and sustaining co-production in public services. By adopting a meso and macro perspective, we interviewed senior planning officers from eight health and social care partnership areas in Scotland and key actors in national agencies. The findings suggest that an overly complex Scottish governance landscape undermines the sustainability of co-production efforts. As part of a COVID-19 recovery, both the implementation of meaningful co-production and coordinated leadership for health and social care in Scotland need to be addressed, as should the development of evaluation capacities of those working across health ...

The influence of nursing home managers’ leadership on person-centred care and stress of conscience: A cross-sectional study

Leadership and stress are common concepts in nursing, and this study explores empirically the connection between leadership and stress of conscience in the context of aged care practice. Previous literature has shown that when staff are unable to carry out their ethical liabilities towards the residents, feelings of guilt may occur among staff, which may be an expression of stress of conscience. Although leadership has been described as crucial for staff’s work perceptions of stress as well as for person-centred practices, the influence of nursing home managers’ leadership on stress of conscience among staff and person-centred practices is still not fully explored. This study attempts to address that knowledge gap by exploring the relationship between leadership, person-centred care, and stress of conscience.

What does Success Look Like for Leaders of Integrated Health and Social Care Systems? a Realist Review

Health and social care services in England are moving towards greater integration, yet little is known about how leadership of integrated care teams and systems can be supported and improved. This realist review explores what works about the leadership of integrated care teams and systems, for whom, in what circumstances and why. This review has generated new perspectives on the leadership of integrated care teams and systems that can be built upon, developed, and tested further.

Integrated Health and Social Care in England: Ten Years On

As part of major policy reforms begun in 2010, England introduced a wave of initiatives to encourage more integrated care between health and social care. These built on previous attempts which sought to achieve similar objectives through a focus on better partnership working. This article provides an overview and critical commentary on integrated care policy in England from 2010–2020. The experience of England suggests that greatest progress is made when integrated care focusses on tangible issues and when there is a clear understanding of how success will be measured. 

Balancing Pragmatism and Sustainability: A Case Study of an Interorganisational Network to Improve Integrated Care for the Elderly

Networks constitute a promising strategy for interorganisational collaboration, but may fail due to network tensions. By investigating the activities and internal dynamics of a voluntary meso-level network operating in the intersection of health and social care, this study aims to enhance the understanding of the relationship between pragmatism and sustainability and the role network governance plays in this respect.

The influence of leadership facilitation on relational coordination among primary care team members of accountable care organizations.

Teamwork is a central aspect of integrated care delivery and increasingly critical to primary care practices of accountable care organizations. Although the importance of leadership facilitation in implementing organizational change is well documented, less is known about the extent to which strong leadership facilitation can positively influence relational coordination among primary care team members.

The Odyssey of Integration: Is Management its Achilles’ Heel?

The importance of management to the implementation of integrated care is recognised in evidence and practice. Despite this recognition, there is a lack of clarity about what ‘good’ management of integrated care looks like, if the competences are different to management for ‘traditional’ care, and how such competences can be acquired.

Realising the True Value of Integrated Care: Beyond COVID-19

Stronger and more resilient care systems and communities are better able to cope, respond and adapt to new challenges and crises such as the current COVID-19 pandemic. They are able to quickly come together to ‘act as one’ and collaborate across disciplines and sectors towards a common goal. This is the essence of integrated care and this is what the International Foundation for Integrated Care (IFIC) stands for – creating a more connected health and care system.

Celebrating the 4th anniversary of the approval of the WHO Framework on integrated and people-centred health services: progress and opportunities ahead

This month marks the fourth anniversary of the approval of the Framework on integrated people-centred health services (IPCHS) and its accompanying resolution WHA69.24 (2016) on “Strengthening integrated people-centred health services” by the World Health Assembly. In May 2016, Member States showed exceptional support to these global commitments and requested WHO to help them implement, adapt, and operationalize this Framework. However, this was not the first time WHO recognized the relevance of health services being managed and delivered so that people, who are active participants of health systems, receive a continuum of care according to their needs throughout the life course. Other previous WHO global and regional commitments, including “People-centred health care: a policy framework” produced by the Western Pacific Region in 2007, the “World health report 2008 on primary health care: now more than ever”, and resolution WHA62.12 (2009) on Primary health care, including health system strengthening, had ...

Making Integrated Care Happen

IFIC Ireland will host and facilitate a series of 6 webinars throughout 2020 titled ‘Making Integrated Care Happen’ which forms one of the key delivery mechanisms enabling knowledge mobilisation across all stakeholders with an interest in developing and implementing integrated care within the healthcare systems on the island of Ireland.

It is important that those taking integrated care forward are enabled to share their experience, success and failures with others. Spread and sustainability can be accelerated if innovators and leaders are supported to work together in learning networks through which information and intelligence can be shared. This helps to avoid the same mistakes being made, can avoid unnecessary duplication of effort and can help build commitment and support by enabling leaders to work together in a community of practice.

Leadership for integrated care: a case study

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.

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

Towards integrated care systems (ICSs) Leading for integrated care

Leading across integrated care systems and integrated care partnerships (ICPs) requires a range of skills. These include being able to walk in other people’s shoes; having a constancy of purpose while retaining flexibility; and building the evidence base for change as a key tool for persuading the unconvinced of the need to redesign our model of care delivery.

Building on the recent report, "Leading for integrated care", this event will provide insights into the different leadership skills and behaviours needed to successfully secure more integrated care.

You will be able to hear from a range of different speakers from across the UK about how individual leaders from local government and the NHS are working in partnership to redesign services and in some instances place a greater emphasis on wellness.

Towards a theoretical framework for Integrated Team Leadership (IgTL)

This study presents a framework for the leadership of integrated, interprofessional health, and social-care teams (IgTs) based on a previous literature review and a qualitative study. The theoretical framework for Integrated Team Leadership (IgTL) is based on contributions from 15 professional and nonprofessional staff, in 8 community teams in the United Kingdom. Participants shared their perceptions of IgT’s good practice in relation to patient outcomes. There were two clear elements, Person-focused and Task-focused leadership behaviors with particular emphasis on the facilitation of shared professional practices. Person-focused leadership skills include: inspiring and motivating; walking the talk; change and innovation; consideration; empowerment, teambuilding and team maintenance; and emotional intelligence.

Clinical leadership and integrated primary care: A systematic literature review

As numbers of chronically ill patients with complex healthcare needs are increasing, primary care professionals will be challenged to deliver integrated care. Integrated care is about ‘delivering seamless care for patients with complex long-term problems cutting across multiple services, providers and settings.
Leaders are needed to address healthcare changes essential for implementation of integrated primary care. What kind of leadership this needs, which professionals should fulfil this role and how these leaders can be supported remains unclear.

The Governance of National Community Health Worker Programmes in Low- and Middle-Income Countries: An Empirically Based Framework of Governance Principles, Purposes and Tasks

National community health worker (CHW) programmes are increasingly regarded as an integral component of primary healthcare (PHC) in low- and middle-income countries (LMICs). At the interface of the formal health system and communities, CHW programmes evolve in context specific ways, with unique cadres and a variety of vertical and horizontal relationships. These programmes need to be appropriately governed if they are to succeed, yet there is little evidence or guidance on what this entails in practice. Based on empirical observations of South Africa’s community-based health sector and informed by theoretical insights on governance, this paper proposes a practical framework for the design and strengthening of CHW programme governance at scale.

Innovation of the governance of integrated care

Interest in integrated care is growing. This is reflected in the rising numbers of scientific publications, IJIC’s increased impact factor and the increasing number of participants at IFIC’s international conferences. It is stimulating to see that organizations like the World Health Organisation are developing conceptual frameworks that embrace integrated care. At the same time we know that integrated care does not become reality automatically; it takes a long timeframe. That can be conflicting with ambitions like ‘implementing good practices as fast as possible’ and with the pressure to deliver results in politically set tight time frames.

Talking leadership: clinicians leading transformational change

Taj Hassan, Consultant in Emergency Medicine at Leeds Teaching Hospitals NHS Trust, and President, Royal College of Emergency Medicine, answers some questions about how clinicians are contributing to transformational change in the NHS

Translating the Elements of Health Governance for Integrated Care from Theory to Practice: A Case Study Approach

Against a paucity of evidence, a model describing elements of health governance best suited to achieving integrated care internationally was developed. The aim of this study was to explore how health meso-level organizations used, or planned to use, the governance elements. 

Governing Collaborative Healthcare Improvement: Lessons From an Atlantic Canadian Case

The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) Quality Improvement Collaborative (QIC) in Eastern Canada provided an approach to spur system-level reform across multiple health systems for patients and families living with chronic disease. Developed and led by senior executives with a unique governance approach and involving clinical front-line teams, the AHC serves as a practical example of leadership creating and driving momentum for achieving success in collaborative health system improvements 

Project INTEGRATE: Lessons for Policy, Management and Implementation of Integrated Care in Europe

Project INTEGRATE aims to gain valuable insights into the leadership, management and delivery of integrated care to support European care systems to respond to the challenges of ageing populations and the rise of people living with long-term chronic conditions.

This project has already examined four case studies of best practices of integrated care in Europe, in the areas of COPD, Mental Health, Geriatric Conditions and Diabetes, that have had a proven impact in terms of improving patient experiences, generating better care outcomes and providing cost-effectiveness. The key aim of this part of the research was to define what constitutes good quality integrated care provision, and how integrated care systems can most effectively be built. In Phase 2 of the research, the project considered the cross-cutting themes process design, service delivery, skill mix, patient involvement, financial flows, regulatory conditions, and enabling information technologies in order to create connectivity, alignment and collaboration ...

Integrated care: better and cheaper

Integrated care improves health, increases quality of care and lowers costs. These three goals, this Triple Aim in other words, are achieved in many examples from all over the world: from Alaska to New Zealand, from Western Europe to South Africa. However, disseminating all these good examples is easier said than done, as nationwide implementation means the simultaneous realisation of the following six components of integrated care:

1. Multidisciplinary care pathways and decision trees

2. Patient self-management and shared decision-making by patients and professionals

3. Guaranteeing professional and patient- perceived quality

4. Population-based funding and shared savings

5. An Electronic Health Record and e-health

6. Servant leadership and a strategy for change management.

These are the conclusions Guus Schrijvers draws in his book Integrated Care: better and cheaper. His conclusions are based on more than 500 studies from the 1960s until mid-2016. In addition, he also draws on his own ...

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability. 

Effective Organizational Leadership in the Implementation of Integrated Care; Lessons from 9 cases in the iCoach Project

Policy makers in many countries are encouraging the development of integrated care strategies and the development of new models of integrated care. These new models require changes at a clinical or service level, organizational level and system level with strong leadership necessary at all three levels. Despite the key role of leadership in these efforts, there has been only limited study of what organizational leadership approach is successful in different contexts for integrated care. 

The Digital House of Care: Information solutions for integrated care

This paper draws on the recent experience of achieving large-scale data integration accross the boundaries of health and social care, to help plan and commission services more effectively. The purpose is to describe the development of a digital tool in an English county stiving towards a vision of integrated information that is used to underpin and increasingly integrated future of health and social care delivery. 

Barriers and facilitators to the implementation of person-centred care in different healthcare contexts

Background

Meet Integrated Care Pioneers in Edinburgh, Manchester and Wrexham!

Study tours offer a unique opportunity to meet integrated care pioneers in their natural environment and to experience and learn about integrated care practices from national and regional innovations. They are designed to support clinicians, managers and policy-makers with an interest and responsibility in the successful adoption of integrated care in policy and practice. Designed to be live case studies, the study visits offer the possibility to discuss regional and country-level strategies with the responsible decision makers, assess the barriers, facilitators and key drivers for integrated care at a regional and local level and reflect upon the transferability of lessons learned in moderated discussions and workshops.

The ICIC17 Three Country Study Tour will visit Scotland, England and Wales and seeks to examine the leadership and management of integrated care in these regions. Sessions will focus on the development of new models and approaches to care for older people with complex ...

The New Care Models for Integrating Health and Social Care through EHCH, PACS & MCP

This conference will look at how health and social care can successfully integrate through multi-speciality community providers (MCP), primary and acute care systems (PACS) and enhanced health in care homes (EHCH) systems, it is aimed at health and social care leaders involved in the planning of population based healthcare, a concept that should underpin services delivered via multi-speciality community providers (MCP), primary and acute care systems (PACS) and accountable care organisations (ACO) and focuses on how organisations can successfully integrate health and social care practices to give better continuity and consistence in care, reduce readmissions, save costs and improve patient experience. Through national updates and learning from vanguard case studies of new care models, delegates will receive practical information on how they can achieve a solid integrated system within their own organisation and workforce in line with the vision of the Five Year Forward View.

Self-perception of leadership styles and behaviour in primary health care

The concept of leadership has been studied in various disciplines and from different theoretical approaches. 

In the primary health care (PHC) setting, managers´leadership style is defined as a set of acttitudes, behaviours, beliefs and values. The objetives of this study were to describe and learn about the self-perception of behaviours and leadership style among PHC managers; to determine the influence of the leadership style on job satisfaction, efficiency and willingness to work in a team; and to determine the relationship between transformational and transactional styles according age, gender, profession and the type of organization. 

IHF 40th World Hospital Congress

The IHF 40th World Hospital Congress will be held 31 October – 3 November 2016 in Durban, South Africa with the theme: Addressing the Challenge of Patient-centered Care and Safety.

The World Hospital Congress of the International Hospital Federation (IHF) is a unique global forum that brings together key drivers of national and international policy, management, financial trends and solutions in healthcare management and service delivery. Through this forum multidisciplinary exchange of knowledge, expertise and experiences are facilitated, together with dialogue on best practices in leadership in hospital and healthcare management and delivery of services.

For further information please click here: IHF 40th World Hospital Congress

Integrated care: the importance of ICT in data sharing

In this post by Health IT Central it is analyzed how different experiences regarding people centered and integrated health systems have been developed across the world. Some studies have been able to identify what are the key elements to succeed when performing integrated health care; these factors are rethinking clinical models, achieving a cultural change, enforcing collaborative multidisciplinary working and improving the way patient information is shared. In this post, the author focuses on how important patient information sharing is to make integrated services experiences succeed, being a core factor in continuity of care and becoming a barrier when data sharing is not successfully achieved. According to the author’s opinion, the regulation recently approved by the European Union regarding data protection will make easier data sharing, allowing care to be delivered in a more effective and integrated manner.