Making Systemic Governance Practical for Integrated Care: Co-Designing What Works Across Boundaries and Contexts

Abstract

Background: Integrated care depends on governance that connects leadership, resources, and accountability across organisations and professions. Yet in most systems, planning still happens in silos – strategic intent at the top rarely matches operational decisions below. This workshop explores how systemic governance can help integrated care work at scale. Using Singapore’s Hospital Governance Operating System (HGOS) as a live case, facilitators will share how a hospital system clarified four levels of organisational leadership roles, owners, and decision forums across six planning dimensions – work planning, budget, manpower, learning, informatics & IT, and risk.   Participants will then co-design and co-learn how governance might look and function in their own contexts: hospital networks, community systems, or integrated care partnerships. The aim is not to adopt HGOS, but to test together what principles and structures make governance truly enabling for integrated care at scale.   Audience: Leaders and practitioners from ministries, health authorities, integrated care systems, hospital and community providers; and colleagues in quality, workforce, finance, digital/data, and risk who must act together to plan, prioritise, and govern integrated care.   Approach: This 90-minute workshop blends short framing segments with highly interactive group work. Opening (15 min): Quick polls to surface participants’ governance challenges, followed by a clear, non-technical overview of HGOS and how it has been used to join up planning and accountability across a hospital system.   Breakout 1: Mapping systemic governance (30 min): Tables co-create a “Systemic Governance Map” to identify who and how each level of leadership owns the various dimensions of integrated care planning (services, manpower, budgets, learning, IT, risk), where they connect, and which platforms or forums bring them together.   Breakout 2: Making systemic governance work (30 min): Groups discuss what it takes for systemic governance to function effectively in practice. They identify the organisational / integrated system capabilities, behaviours, and change conditions that make joined-up governance work – such as collaborative leadership, open decision-making, learning culture, and consistent follow-through. Each table synthesises observable “signs of good governance” and the enablers needed to get there (e.g., leadership routines, organisational capabilities) Synthesis & reflection (15 min): Participants share key design insights and note personal actions to take home. More than half the time will be devoted to interactive group work and cross-learning among participants from different systems.   Outcomes: Participants will leave with: A shared understanding of what systemic governance means and how it enables integrated care at scale. A Systemic Governance Map showing how planning roles and decision forums connect (or can be better connected) in their own settings. A structured list of practices, behaviours, and organisational enablers that make systemic governance work day-to-day. Practical insights and peer-tested ideas for strengthening governance coherence and leadership capability across integrated care systems. Facilitators will also capture participants’ reflections to refine HGOS as an adaptable learning and design tool for integrated care governance internationally. Preferred duration of 90 minutes Speakers / facilitators: A/Prof Ng Yeuk Fan, Dr Lim Ther, Dr Justin Lee