NHS Senior Leadership Onboarding and Support

Collaborating and systems leadership for all

Group of 4 people chatting

Collaboration has always been at the heart of great care. The transition detailed in the Long Term Plan assume further developments in ways of working across the NHS, local authorities, third sector and private organisations. The resources on this page seek to recognise the changing landscape of systems working and the changing relationships which will deliver the best care for patients in such a way that those receiving services don’t perceive organisational boundaries.

There are specific resources via the buttons below for leaders in emerging system architecture. However, it is anticipated that all leaders will benefit from all elements on this site.

These new partnerships and ways of working challenge the development of skill sets around:

  • Thinking in a systemic way while balancing existing organisational demands
  • Being able to work with what emerges as well as what is planned
  • Seeking multiple perspectives and walking in each other’s shoes
  • Developing solutions through compromise
  • Building relationships with a system focus
  • Being self-reflective 
  • Being a supportive peer across a system

This theme supports development in the ‘Partnership’ domain of the Chair competency framework.

The resources below may support you as a board-level leader in any organisation to collaborate with others in the system. In addition there are some specific resources for Integrated Care System and Sustainability and Transformation Partnership leaders and Primary Care Network Directors, roles which are emerging in the new systems architecture:

Case Study: Frimley’s collaborative leadership programme – this case study provides information on how the Frimley Health and Care System 20/20 leadership programme helps to improve collaborative system working.

Research: A summary of national and international research into Systems Leadership which goes into six key dimensions of Systems Leadership behaviours and links to longer, underlying research, including literature reviews and in-depth interviews. There’s also a helpful infographic on the back that plots external environmental issues against aspects of Systems Leadership approaches that are especially applicable. Virtual Staff College, October 2013.

Report: ‘The Revolution will be Improvised II’ gives stories from places around the country that have looked to use Systems Leadership to make progress on knotty and complex issues – not just the successes but the hurdles that people have overcome and what’s happened as a result. There are some brief case studies in there as well. The Leadership Centre, 2015.

Publication: ‘The Revolution will be Customised’, looks at using Systems Leadership approaches in introducing and sustaining digital innovation. The lessons learned and the factors involved are very interesting, including in relation to the leadership that made for success. The Leadership Centre, 2018.

Publication: The Art of Change Making – a compendium of models, theories and approaches drawing on what the Leadership Centre considers Systems Leadership Enablers. The chapters on adaptive leadership and complexity have been highly recommended. The Leadership Centre, 2015

Short paper: By Sue Goss, Senior Principal at Traverse, ‘Systems Leadership: A View from the Bridge’ 2015. Sue’s personal account of what she has been learning and how to make systems leadership work in practical terms.

Blog: ‘Hello my name is Steve…’ Steve Russell CEO of Harrogate and District NHS Foundation Trust reflects on his first 100 days in his new role as a CEO.

Report: By the NHS Confederation – ‘Best Job in the World?’ outlines the views of new NHS chief executives on the changes in leadership approach and style that they believe will be required if the NHS is to meet the ambitions of the Long Term Plan. NHS Confederation, June 2019.

Blog: John Coutts, Policy Advisor – NHS Providers ‘Public involvement, councils of governors and system working’ In a world of systems working, how do NHS Provider organisations and Councils move forward together? NHS Providers, June 2019.

Publication: ‘Building healthier communities: the role of the NHS as an anchor institution’ The Health Foundation, August 2019

infographic from the Health Foundation Article on the NHS as an anchor institution

Toolkit: NHS NWLA Citizen Leadership Toolkit. The Citizen Leadership programme was developed to activate community citizenship, empowering and enabling communities to mobilise their assets and apply leadership capabilities to engage decision makers in their localities. The resources required to deliver a programme in your locality are available to download for free online


  • Always start with common purpose – what is the issue that you all have most to gain from improving? This will also help you know and understand the pressure points for the other people round the table
  • Connect with system leaders early on and if possible, prior to your start date
  • Work on building relationships and trust, rather than on strategies and plans.
  • Be curious, think beyond me and my organisation, broaden your horizons and walk the shoes of a citizen, colleague and partner
  • Invest in and nurture relationships with your system partners, including your staff, colleagues and local communities
  • Acknowledge that you’re working in complexity – it will take longer than you think and be harder than you think, allow for clumsy, emergent solutions – small incremental changes will have a big impact over time.
  • Sharing timely good quality risk information across collaborating organisations can support building trust, transparency and understanding.
  • Network and become a valuable member of face to face and social networks – undervalued resource on tap! – Twitter, LinkedIn, groups, platforms – make an effort!
  • Actively seek networking opportunities and support from peers outside the organisation; your Local Leadership Academy may be able to assist with this.