Paradoxes of multi-level leadership: Insights from an integrated care system

Bolden, Richard; Kars, Selen; Jarvis, Carol; Sheffield, Rob

Abstract

In this paper, we draw on systems leadership, complexity and paradox theory to elucidate the tensions that organisational actors experience when practising multi-level leadership. We explore these issues through a study of the perceptions and experiences of stakeholders within an Integrated Care System (ICS) in England. Employing a collaborative inquiry approach, data were collected via 19 narrative interviews with participants in key leadership roles across ICS partners and nine co-creation workshops with a total of 86 participants from different parts of the ICS. Findings highlight that in developing multi-level leadership practice, leaders experience contradictory expectations and outcomes, including paradoxes of identity, place, purpose and change. We conclude by suggesting that leadership in multi-level contexts requires oscillating between competing polarities in a dynamic equilibrium with attention to localised interactions.

• Journal Article Type: Article
• Acceptance Date: Jun 20, 2023
• Online Publication Date: Jul 13, 2023
• Publication Date: 2023
• Deposit Date: Jun 29, 2023
• Publicly Available Date: Dec 7, 2023
• Journal: Journal of Change Management
• Print ISSN: 1469-7017
• Electronic ISSN: 1479-1811
• Publisher: Taylor & Francis (Routledge)
• Peer Reviewed: Peer Reviewed
• Volume: 23
• Issue: 4
• Pages: 337-357
• DOI: https://doi.org/10.1080/14697017.2023.2234388
• Keywords: Systems, complexity, paradox, multi-level leadership, health care, public services
• Public URL: https://uwe-repository.worktribe.com/output/10897290