Waring J, Bishop S, Clarke J, Exworthy M, Fulop NJ, Hartley J, et al. Healthcare leadership with political astuteness (HeLPA): A qualitative study of how service leaders understand and mediate the informal 'power and politics' of major health system change. BMC Health Services Research. 2018;18(1)
The implementation of strategic health system change is often complicated by the informal politics and power of health systems, such as competing interests and resistant groups.