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Integrated care system leadership: a rapid realist review

Knight, L, Neiva Ganga, R and Tucker, M (2024) Integrated care system leadership: a rapid realist review. Leadership in Health Services. ISSN 1751-1879

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Purpose Given the complex nature of Integrated Care Systems, the geographical spread, and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper presents novel findings from a rapid realist review of Integrated Care Systems (ICS) leadership in England. The overall review question was: how does leadership in ICSs work, for whom, and in what circumstances? Design/methodology/approach Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of (i) a review of ICS strategies and guidance documents, (ii) a scoping review of the literature, and (iii) interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, 6 CMOCs were extracted from 18 documents. The study design, conduct, and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong, Westhorp, et al., 2013). Findings The review informed four programme theories explaining that leadership in ICSs works when i) ICS leaders hold themselves and others to account for improving population health, ii) a sense of purpose is fostered through a clear vision, ii) partners across the system are engaged in problem ownership, and iv) relationships are built at all levels of the system. Originality This review will be of relevance to academics and healthcare leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature, and informing leadership practice and healthcare systems.

Item Type: Article
Additional Information: This author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BY-NC) licence. This means that anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. If you wish to use this manuscript for commercial purposes, please contact permissions@emerald.com
Uncontrolled Keywords: 1117 Public Health and Health Services
Subjects: H Social Sciences > HF Commerce > HF5001 Business
H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Liverpool Business School
Publisher: Emerald
SWORD Depositor: A Symplectic
Date Deposited: 26 Jan 2024 11:52
Last Modified: 12 Feb 2024 16:15
DOI or ID number: 10.1108/LHS-12-2023-0092
URI: https://researchonline.ljmu.ac.uk/id/eprint/22450
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