posted on 2025-10-08, 11:11authored bySam van Elk, Kirsten Armit, Juan Baeza, Alec Fraser, Ruth Harris, Lorelei Jones, Jessica Lubin, Gerry McGivern, Justin WaringJustin Waring
<p dir="ltr">Integrated Care Systems (ICSs) were created across the English National Health Service (NHS) to foster collaboration between health and care organisations within 42 geographical footprints. They were established, in part, to address significant financial and operational challenges, which had only intensified by the time ICSs became statutory bodies in 2022 [1–3]. Thus, ICSs find themselves attempting to foster collaboration amidst intense system turbulence, which is liable to undermine such efforts. Deemed ‘the makings of a sensible management structure’ by Lord Darzi’s recent review of the English NHS, ICSs show no signs of going away [4]. Accordingly, this commentary outlines a research agenda to explore whether and how ICSs can effectively collaborate in this turbulent context, and to support them in these efforts. This problem-driven research agenda does address leadership issues, but not exclusively, also calling for research on how ICSs can navigate competing goals and manage power within their systems.</p>
This article has been accepted for publication in BMJ Leader following peer review, and the Version of Record can be accessed online at https://doi.org/10.1136/leader-2024-001078. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/