ABSTRACT
The challenges facing the provision of healthcare are shared, and well known, across many economies. Demand for services outstrips supply, and there is a workforce crisis, especially notable in General Practice (Britnell 2019; Owen et al. 2019). People are living longer with multiple and more complex health needs. Yet at the same time, social care and community care budgets have been reduced (Humphries et al. 2016). There are large, unwarranted, variations in practices and outcomes, rising costs and numerous examples of failures (Porter and Teisberg 2006). There are fragmented services and poor communication between the component parts (National Collaboration for Integrated Care and Support 2013). International studies of healthcare based on systematic reviews of available evidence across multiple countries find some common patterns in the contemporary challenges facing leaders and managers. These include rising demand, epidemiological shifts, performance issues, and resource and workforce issues. These challenges are met with health sector reforms built on innovation attempts and collaborative initiatives (Senkubuge et al. 2014; Figueroa et al. 2019). Likewise, the leadership and management challenges arising out of the severe workforce shortages globally have been well recognised (World Health Organization 2016).
