In Finland, a major health and social service system reform was implemented in 2023. The reform introduced macro-level organizational integration of health and social services as the responsibility for organizing the services was transferred from c. 300 municipalities to 22 well-being services counties which get their funding from the state. The purpose of this study is to describe different leadership actions to promote integration at the meso- and micro-levels of the service system after the macro-level organizational reform.
The qualitative study utilized semi-structured interviews (n = 25) collected from the upper-level leaders of the well-being services counties. The study participants represented 11 well-being services counties in Finland. The data were collected in May–August 2023. Inductive content analysis was used for data analysis.
Four leadership actions to promote integration at the meso- and micro-levels of the service system were identified: (1) service user-based leadership actions, (2) partnership-based leadership actions, (3) service system-based leadership actions and (4) knowledge-based leadership actions. Most of the interviewees combined several different leadership actions in their recount.
The study highlights important information of the focus points set for leading integration in the unique context of reforming health and social services. With this paper, we provide a new way of comprehending integration from the leadership point of view. The conceptualization through the different leadership actions may facilitate forming a shared vision for integration among leaders and managers.
