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Role of medical leaders in integrated care systems: what can be learnt from previous research?
  1. Lorelei Jones1,
  2. Kirsten Armit2,
  3. Andy Haynes2,
  4. Peter Lees2
  1. 1Medical and Health Sciences, Bangor University, Bangor, UK
  2. 2Faculty of Medical Leadership and Management, London, UK
  1. Correspondence to Dr Lorelei Jones, Medical and Health Sciences, Bangor University College of Health and Behavioural Sciences, Bangor, UK; lorelei.jones{at}

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Integrated care systems are locality-based networks in England that bring together health and social care partners (including commissioners, providers and local authorities) to collectively plan services to meet the needs of the population. They are an example of collaborative governance, a governing arrangement that ‘brings public and private stakeholders together in collective forums with public agencies to engage in consensus orientated decision making’.1 One of the strengths of collaborative governance is the potential to include the perspectives and experiences of diverse stakeholders to generate creative, durable solutions to long-standing problems. In the case of integrated care systems, one of the key aims is to reduce the long-standing problem of fragmentation in care experienced by patients. However, decades of experiments with partnership working in health and social care have struggled with differences in culture, funding, timescales for decision making, and systems of accountability and regulation.

National policy identifies a key role for professional and clinical leaders in integrated care systems, building neighbourhood partnerships that span different services, and working with colleagues from different professions in designing clinical pathways across healthcare settings.2 Previous research suggests that medical leaders are well positioned to support collaborative governance. As hybrid medical managers, they are potential ‘boundary spanners’.3 Their membership of different professional communities gives them an understanding of different professional cultures, organisational politics and routine working practices; and helps with cross-boundary communication and engendering trust.4 They are also more likely than other professional groups to have ‘bridging’ relationships across organisations and professional groups, making them effective change agents.5

There is an urgent need to understand what makes collaboration between diverse stakeholders in publicly funded welfare services successful, and what medical leaders can do to support the collaborative process. Conceptual models can support leadership development and are valued by healthcare leaders. …

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  • Contributors LJ, KA and PL contributed to the design. All authors contributed to the analysis, writing and final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests KA, PL and AH are associated with the Faculty of Medical Leadership and Management which provides leadership development.

  • Provenance and peer review Not commissioned; externally peer reviewed.