Integrated care systems and nurse leadership

The number of people in England with two or more chronic conditions is expected to double to nearly 10 million over the next 20 years, increasing the demands on health and social care services (Kingston et al, 2018). The vast majority of this care for older people with multiple morbidities takes place in primary care and community settings. As well as having two or more chronic conditions, many older people have other impairments, such as declining cognitive ability or sensory losses, making it more challenging for them to navigate complex and fragmented care provided by multiple organisations. The NHS Long Term Plan (NHS England, 2019b), published in January 2019, and the associated NHS Long Term Plan Implementation Framework (NHS, 2019a), published in June 2019, set out clear expectations that local NHS organisations will increasingly focus on population health and local partnerships with local authority-funded services through new integrated care systems (ICSs). The Implementation Framework states that the emerging ICSs will be clinically led, and David (2019) makes the case for nurses to play substantial roles in providing advice and leadership within these emerging systems. This article explores two models of integrated care from the Netherlands and asks whether there are lessons to be learnt from these models, as well as what the leadership implications might be.