From leadership research to district action: School-Based Integrated Care Within Sydney Local Health District: A Qualitative Study About Partnerships Between the Education and Health Sectors

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Introduction: The unmet physical and mental health needs of school-aged children (5–18 years) in New South Wales (NSW), stemming from poor access and engagement with healthcare, can be addressed by school-based integrated care (SBIC) models. This research aims to understand why and how partnerships between the health and education sector, in SBIC models, are important in providing care for children, and to identify the facilitating factors and barriers for implementation. Methods: A qualitative study was conducted using semi-structured interviews and thematic analysis. The principles of the ‘Integrated People-Centred Health Service (IPCHS)’ framework and Looman et al’s (2021) implementation strategies for integrated care were considered. Results: Themes within IPCHS framework: Strategy 1: Engaging and empowering people and communities – community-driven models, improved access to healthcare, positive outcomes for children and families, ‘connection’, and service provision for marginalised populations; Strategy 2: Strengthening governance and accountability – system integration and developing evidence base; Strategy 3: Reorienting the model of care – shifting healthcare to schools reduces inequity and provides culturally safe practice; Strategy 4: Coordinating services within and across sectors – integrating care and stable workforce; Strategy 5: Creating an enabling environment: leadership, stakeholder commitment, and adequate resourcing. Discussion: Potential strategies for implementing SBIC models across NSW include community consultation and co-design; building multidisciplinary teams with new competencies and roles e.g. linkers and coordinators; collaborative and shared leadership; and alignment of operational systems while maintaining a balance between structure and flexibility. Conclusion: SBIC models require high-level collaboration across sectors and with communities to provide a shift towards child and family centred care that improves engagement, access and outcomes in health delivery. Keywords: School-based integrated care, Integrated People-Centred Health Service (IPCHS) framework, implementation of integrated care

Study methods

A critical realist-informed three-phase, sequential mixed method study was designed (Figure 3). Critical realism is a philosophical system where ‘realism’ describes a natural world that exists outside of our interpretations of it, and ‘critical’ refers to the study of science through the interactions of human language and social powers over time [17,18]. Critical realism is relevant to this research because SBIC has emerged as a potential solution for inequitable health, education and social outcomes observed within local communities. This study aims to understand the ‘nature’ or mechanisms behind SBIC models, particularly the facilitating factors and barriers to this process.

Limitations

SBIC programs within NSW have formed independently of each other and are small in number. This produces limitations in terms of the breadth of this research, which was optimised by including a COP in the study.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Santuri Rungan; Jennifer Smith-Merry; Huei Ming Liu; Alison Drinkwater; John Eastwood. School-Based Integrated Care Within Sydney Local Health District: A Qualitative Study About Partnerships Between the Education and Health Sectors. International Journal of Integrated Care (2024-04-01). https://doi.org/10.5334/ijic.7743

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.