Across the world health care systems are under pressure. Policy-makers and health and social care leaders are individually and collectively searching for approaches that can deliver better-quality, safer care and improved health at a reduced cost – the holy grail of health strategy. We have to rethink the way care is delivered, and improved co-ordination around the needs of the individual will almost certainly be part of the solution.
In England a cross-party consensus is forming around the concept of ‘integrated care’ approaches as the best hope for a sustainable NHS in the future (Goodwin et al 2013). There is general agreement that the goal involves more joining-up of services around the needs of individual patients and citizens. However, there is less agreement, and scant real evidence, about the best means of achieving this. The challenge to leaders in the health care system presented by this aspiration is immense as there are unlikely to be any ready-made formulae that can be easily applied. Leading across complex interdependent systems of care is a new and different role that needs to be undertaken alongside the already difficult task of leading successful institutions.
We believe that enough has been written to make the case for the need for a new style of leadership across health and social care systems (Ham and Walsh 2013; Goldsmith no date). The task now is to identify the skills, knowledge and behaviours that this new breed of system leaders will need if they are to be successful and to consider how such an approach to developing leadership – which is likely to be different to that found inside many of our institutions – can best be fostered.
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