ABSTRACT
This chapter considers the four very different approaches to systems leadership in health and social care developed in the four parts of the UK – Scotland, Northern Ireland, Wales and England. From around 2000 the NHS in Scotland has pursued an approach of increasing collaboration, partnership and integration, both within health care but more particularly between health and social care. Leadership development support for systems leadership comprises two complementary programmes which are offered as a joint partnership between the special Health Board, NHS Education for Scotland, the Scottish Social Services Council and the Royal College of General Practitioners, Scotland. Northern Ireland has had a structurally integrated system of health and social care since as long ago as 1973. It was created as a result of a local government reorganisation when social care was completely divested from local authorities and transferred at that time to four area Health and Social Services Boards.
