Systems Leadership

Systems Leadership is a practice, not a product. We define it as “the collaborative leadership of many people at different places in a system, in order to achieve a shared purpose.”

We recognise that, in comparison with traditional ways of understanding leadership, systems leadership “…involves shifts in mind-set, behaviour and leadership practice” for health and social care leaders. This is because leaders are applying the principles of systems thinking to the kinds of intractable, wicked issues they face in increasingly complex health and care systems.

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Learning from leaders: What does leadership look like in a health and social care setting?

Professor Jon Glasby, Head of School of Social Policy at the University of Birmingham, discusses the importance of health and social care leaders working across systems to deliver joined up services.

Learning from leaders: What does leadership look like in a primary care setting?

Sarah-Jane Marsh, Chief Executive at Birmingham Children's Hospital NHS Foundation Trust discusses her experience of leading in health and social care and the importance of systems leadership. 

Prof Jon Glasby discusses the importance of health and social care leaders working across systems to deliver joined up services
Sarah-Jane Marsh discusses her experience of leading in health and the importance of systems leadership

Why systems leadership?

As a collaborative partnership between key departments in the College of Social Sciences, the Centre for Health and Social Care Leadership is ideally placed to develop our understanding of what systems leadership means in health and social care, and the potential for this different way of thinking about leadership.

Systems leadership is not a new concept in health and social care but it has become increasingly important since the publication of the Developing People-Improving Care Framework in 2018 which aimed, inter alia, to equip leaders to develop high quality local health and care systems in partnership, collaborating across organisational, professional and geographical boundaries to build relationships and achieve shared system goals.  Discussion around the development of systems leadership has also acquired momentum in recent months because of the NHS Long-Term Plan and its emphasis on Integrated Care Systems (ICSs), whose precursors were the 44 Sustainability and Transformation Partnerships formed by collaboration between local councils and NHS organisations. ICSs will “…take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve”.  ICSs will thereby, according to the guidance, enable better local delivery of joined-up services, improve working lives for staff who must collaborate across organisational and professional boundaries, and facilitate the sharing of data on which new models of care will be based.

The Long-Term Plan is built on systems leadership, but this is not an uncontested concept and clarity is needed. 

In this context, our work at the Centre has three main areas of focus:

  1. Evaluation: Exploring how Systems Leadership approaches are being adopted and the extent to which this is proving effective in changing the way health and care services are designed, commissioned and delivered.
  2. Development: Understanding the essential components of leadership development for collaborative leadership at all levels in complex systems of health and social care and designing interventions which incorporate these approaches.
  3. Research: Investigating the ways in which systems leadership in health and social care compares with systems leadership in other sectors – education, business, development – and with other approaches to leadership in the public sector. 


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Systems leadership viewpoints

Discussion relating to system leadership


Leadership Programmes are designed on systems leadership principles:

  • The 21st Century Public Servant Leadership programme for Aspiring Directors of Public Health (2017 -2020)
  • Leading D!fferently: a programme to develop systems leadership in 3 localities in Cornwall County Council (2018 – 2019)
  • PHM support to core leadership teams in 7 Midlands STPs in partnership with the Strategy Unit (2019 - )
  • Systems Leadership modules for the Copenhagen healthcare region (2018 – 19)
  • Integrated Teams Pilot Programme 2016/17 for HEE in the West Midlands
  • Systems Leadership Masterclass series 2016/17 for HEE in the West Midlands

In development:

  • Systems Leadership development programme for senior public sector leaders
  • Evaluation of the 21C ADPH programme


Report on the development of systems leadership for the NHS LA (embargoed)

Evaluation of the Bristol Mental Health Systems Leadership model (K. Newbigging & B. Weir, 2017)