Structure & Governance


The broad set of changes needed to deliver integrated care at a regional or national level presents a significant challenge. It needs multi-year programmes with efficient change management, funding and communications, and the power to influence and (sometimes) mandate new working practices. This means alignment of purpose across diverse organisations and professions, and the willingness to collaborate and put the interest of the overall care system above individual incentives. It also means managing the introduction of technology enabled care services in a way that makes them easy to use, reliable, secure, and acceptable to care professionals and citizens alike.

  • Enabling properly funded programmes, including a strong programme, project management and change management; establishing ICT or eHealth competence centres to support roll-out; distributed leadership, to reduce dependency on a single heroic leader; excellent communication of goals, progress and successes.
  • Managing successful digital innovation within a properly funded, multi-year transformation programme.
  • Considering the need to address the risk of health and social inequalities.
  • Establishing organisations with the mandate to select, develop and deliver digital services.

Assessment scale:

  1. Fragmented structure and governance in place
  2. Recognition of the need for structural and governance change
  3. Formation of task forces, alliances and other informal ways of collaborating
  4. Governance established at a regional or national level
  5. Roadmap for a change programme defined and accepted by stakeholders involved.
  6. Full, integrated programme established, with funding and a clear mandate.
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