NHS ICS Leadership Development

Building resilient leaders for integrated care systems across the NHS

Introduction Leadership Challenges Key Competencies Development Programmes Emerging Trends Resources

Introduction to NHS ICS Leadership

The NHS is undergoing significant transformation with the establishment of Integrated Care Systems (ICSs). These systems bring together NHS organisations, local authorities and other partners to take collective responsibility for planning services, improving health and wellbeing, and reducing inequalities within a geographical area.

This fundamental shift in how health and care is delivered requires a new approach to leadership development. Effective ICS leadership demands collaborative skills that span organisational boundaries, strategic thinking that integrates health and wellbeing, and cultural competence that respects diverse community needs.

This page explores the specific leadership challenges facing ICSs, outlines key competencies needed for success, highlights existing development programmes, and identifies emerging trends in healthcare leadership.

Leadership Challenges in Integrated Care Systems

The transition to integrated care systems presents unique leadership challenges that require new approaches and skills:

System Thinking: Moving from organisational-specific to system-wide perspectives, balancing the needs of individual organisations with collective system goals.
Collaborative Working: Leading across traditional boundaries between primary, secondary, and tertiary care, as well as between health and social care sectors.
Cultural Integration: Building a shared culture and identity across multiple organisations with distinct histories, values, and ways of working.
Resource Allocation: Making difficult decisions about limited resources across a broader range of services and providers.
Data and Information: Leveraging data across multiple systems while navigating complex governance arrangements.
Stakeholder Engagement: Managing increasingly complex relationships with patients, communities, regulators, and government bodies.

            Key insight: Effective ICS leadership requires balancing leadership across three domains: personal, organisational, and system-wide. Leaders must be comfortable operating in all three spheres simultaneously.        

Key Leadership Competencies for ICS Success

Research and practice have identified several key competencies that distinguish effective ICS leaders:

System Leadership

The ability to think and act beyond organisational boundaries, understanding the broader system and how different parts interact and influence each other.

Collaborative Influence

Building alliances and partnerships across diverse stakeholder groups, navigating power dynamics without formal authority.

Sense-making

Making sense of complex, ambiguous situations and helping others understand the bigger picture and potential implications.

Innovation Management

Creating an environment that fosters innovation and improvement across system boundaries, learning from both successes and failures.

Equity Focus

Embedding health equity considerations into decision-making and prioritisation processes, addressing systemic inequalities.

Resilience Building

Fostering adaptive capacity at personal, organisational and system levels to manage uncertainty and rapid change.

NHS Leadership Development Programmes

The NHS offers a range of leadership development opportunities specifically designed for those working in integrated care systems:

Systems Leadership Development Programmes: Intensive courses that bring together leaders from across systems to develop collaborative approaches to complex challenges.
Breaking Boundaries: A programme specifically designed to help healthcare leaders develop the skills needed to work across organisational boundaries.
Graduate Management Training Scheme: Offering structured development for early-career healthcare professionals with leadership potential.
Elizabeth Garrett Anderson programme: Developing senior leaders with a focus on whole-system improvement and change.
Nye Bevan programme: For those in senior leadership positions, focusing on leading transformational change across healthcare systems.
Executive Coach Network: Providing one-to-one coaching support for leaders facing complex system challenges.

            Emerging Practice: Many ICSs are now developing their own context-specific leadership development approaches that combine formal programmes with experiential learning, coaching, and peer support networks.        

Emerging Trends in ICS Leadership Development

The field of ICS leadership development continues to evolve, with several notable trends:

System-wide approaches: Moving beyond organisation-specific development to create shared system leadership capabilities.
Place-based leadership: Focusing on the development of leaders who can integrate services at local community level.
Peer learning networks: Creating cross-organisational communities of practice where leaders learn from each other's experiences.
Leadership diversity: Emphasising the importance of diverse leadership teams that reflect the communities they serve.
Data-driven leadership: Incorporating health intelligence and analytics into core leadership development curricula.
Civic leadership: Developing leaders who can engage effectively with civic infrastructure and democratic processes.
Community engagement leadership: Building capabilities in authentic engagement with patients and communities as partners in care design.

Resources for ICS Leadership Development

A range of resources are available to support leadership development for integrated care systems:

NHS Leadership Academy: Provides extensive resources, toolkits and programmes for NHS leaders at all levels.
Health Foundation: Offers research and practical resources on healthcare leadership and system improvement.
King's Fund: Produces insightful analysis and practical guidance on leadership in integrated care.
Imperial College Health Partners: Provides leadership development programmes with a focus on implementation science.
NHS Confederation: Offers resources and networking opportunities specifically for system leaders.
Local Government Association: Provides development opportunities for those working at the interface of health and local government.
NHS England & Improvement ICS Support Framework: Provides practical resources for those establishing and developing ICSs.