Service integration through medical leadership in England’s NHS

The purpose of this paper is to explore the current interest in leadership within the National Health Service (NHS), especially within medicine, as a solution to the slow rate of integration of health and social care services.

This paper is a conceptual analysis of policy documents and professional statements about leadership.

Leadership is a new common sense, promoted despite the limited evidence that it actually delivers. Leaders take risks, develop organisational vision and involve others in change using influence rather than hierarchic authority. They work together in ad hoc local networks, and, because leaders experience the work first hand, they are trusted by fellow professionals and bring to the organisation of work a flexible, immediate, policy-oriented dynamism and pragmatic adaptability.

This paper argues that the leadership movement represents a historic compromise between professionals (mostly medical) who want to shape decision making about service reconfiguration, and managers and politicians seeking ways to integrate health and social care services.

To the authors’ knowledge this conceptual analysis is the first to be applied to leadership within the NHS.