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

Introduction: 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. Methods: A realist synthesis approach was undertaken in 2020 to explore English language literature on the leadership of integrated care teams and systems, complemented by ongoing stakeholder consultation. Results: Evidence was identified for seven potentially important components of leadership in integrated care teams and systems: ‘inspiring intent to work together’; ‘creating the conditions’; ‘balancing multiple perspectives’; ‘working with power’; ‘taking a wider view’; ‘a commitment to learning and development’ and ‘clarifying complexity’. Discussion: Research into the leadership of integrated care teams and systems is limited, with ideas often reverting to existing framings of leadership, where teams and organisations are less complex. Research also often focuses on the importance of who the leader is rather than what they do. Conclusion: This review has generated new perspectives on the leadership of integrated care teams and systems that can be built upon, developed, and tested further.