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People with intellectual disabilities are high users of acute hospital care. Given their varied and often complex health-care needs, they often experience health inequalities and inequities, contributing to poorer health outcomes. As nurses are the largest health-care workforce with a patient-facing role, they have an important responsibility in meeting this populations health needs. The purpose of this paper is to explore key issues relating to the role nurses play in providing equitable health care for people with intellectual disabilities.

This service feature draws upon relevant literature to examine key contextual issues highlighting the importance of nurses in providing equitable health care for people with intellectual disabilities.

The findings from this service feature highlight the importance of nurses taking a leadership role in advocating for, and actively supporting the health needs of people with intellectual disabilities. Nurses’ leadership role, along with implementing reasonable adjustments, should be underpinned by education and training relating to the bespoke health needs of people with intellectual disabilities. This should help nurses promote the health and well-being of this population.

Addressing this populations health needs is a collective responsibility of all nurses. There are many examples of how nurses can be supported through policy, education, training and advocacy and this needs to be considered by key stakeholders and addressed as a matter of priority.

Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.

The purpose of this paper is to explore the dynamic relationship between formal and non-formal processes of accountability in a public services context.

The paper presents a case study of the impact of the Health and Social Care Act (2012) on the practices of Health and Wellbeing Board (HWB) members. It draws upon multiple data sources, including in-depth interviews with the members, comprehensive archival data published by the HWB (2011–2019), and observations of HWB public meetings. We utilise the concept of dynamic duality (Li, 2008) to further theorise the relationship between formal and non-formal processes of accountability and how they mutually transform one another.

The case illustrates the role of formal and non-formal processes of accountability at a HWB in England. Moreover, the case study reveals the relationship and interaction between the formal and non-formal accountability processes and how they change and transform each other over time. We find that whilst non-formal accountability processes were strengthened by a historical legacy of partnership working, over time the dynamics at play led to the development of formal accountability processes through more sophisticated performance systems, which in turn transformed non-formal accountability processes.

The paper presents a more holistic conceptualisation than articulated in prior accountability literature, dynamic duality, on the relationship between formal and non-formal accountability processes. Through application of this conceptualisation to a HWB in England, the paper spotlights the inter-relationship between formal and non-formal processes of accountability, and how they have the potential to transform each over an extended time-period.