Challenges Faced by the Leaders in Integration

Abstract

The structure of health and social services will be reformed in Finland so that the reform will enter into force on 1 January 2020. This means that responsibility for providing public healthcare and social services will be assigned to autonomous regions that are larger than municipalities. Healthcare and social services will be brought together at all levels to form customer-oriented entities, and basic public services will be strengthened. The existing multisource financing will be simplified and customers will have more freedom of choice in the services. The objective is to reduce inequities in wellbeing and health between people, and to manage costs. The reform will help to bridge a large part of the sustainability gap in general government finances. The Government's aim is to save EUR 10 billion, of which approximately EUR 3 billion should be covered through the reforms in the branch of government of the Ministry of Social Affairs and Health. Besides structural reforms, the steering and operating models in healthcare and social welfare will be thoroughly modernised. The aim is to achieve better services that are not only more customer-oriented, effective and cost-efficient than before but also better coordinated. The purpose of this study is to examine the challenges faced by the leaders, when integrating health and social care. The research material was gathered from Master's degree students in the autumn 2017 in the University of Applied Sciences by method of empathy-based stories. One third of the students worked as a leader and the others in other responsible positions. We received a total of 32 stories. Through categorization of the data various forms of challenges of leadership are revealed. The research material raised the challenges of the change process. It is important to see a common goal, an up-to-date flow of information and a sufficient time resource for all actors to create new types of services. Consideration of emotions raised up to be very important in the passage of change eg resistance to change, uncertainty, well-being at work. The inefficiency of hierarchical interfaces administration – political decision-makers – leaders - employee - clients was raised in the material, creating a picture of the differences in the realities of different hierarchy levels. The key is to form a sufficiently similar reality in which the main goal would remain the same throughout the organization. The activity of the leaders with employees was supported by a positive atmosphere in which everyone has a common goal, bold networking inside and outside the own working area, increasing multi-professional co-operation and transparency of work, and a joint debate focusing on the opportunities created by change From customers' viewpoint important was experienced of customer orientation, customer involvement and service guidance, and high quality services The change challenges the skills of the leaders in many ways. They need to keep up-to-date on change-related issues, work transparently and maintain trust in both customers, employees and strategic management. Theoretically, research engages in discussion about change management, ethical leadership, inclusive leadership, and lean thinking.