Change management in integrated care: what helps and hinders middle managers – a case study

There is little published research on the role of middle managers in the delivery of health and social care integration. Middle managers are critical to change management and require the skills to do this effectively. This study aims to explore what middle managers perceived as helping and hindering them in the delivery of change in one high‐profile integration project.

The study involved semi‐structured interviews of eight middle managers across health and social care organisations using a grounded theory approach.

Middle managers possessed good project management and staff engagement skills and understood the challenges of integration. Time and capacity, changes in senior leadership and lack of role clarity were significant hindrances. There were indications that informal networks had allowed them to progress the project.

This is a small‐scale study limited to one project. Although findings are supported by other published evidence, they may not be transferable to other settings.

Middle managers appear to possess change skills but lack understanding of how to apply them in complex environments. Dedicated time and awareness of complexity and leadership models may help middle managers to lead change within integration projects.

This study provides rich information about how middle managers perceive their roles as change agents within integrated working.