While workforce development activity can improve the knowledge, skills and capabilities of staff, organisational development supported by skilled leadership is vital. Without skilled leadership effective integration of services is unlikely. For this reason, this guidance includes indicators to support leadership, recognising the critical role of those who are in a position to influence and shape the structure, culture and climate of the primary or community health setting. It is acknowledged that this can extend beyond those in formal leadership roles.
The challenges for leadership include resolving many of the systemic issues that are known to create barriers for integrated service delivery. These include siloed funding arrangements, inadequate technology, lack of clarity about roles, confusion about the model of integration, poor understanding between different services and a lack of cultural leadership.