15. Coherence, Alignment & System Integration

Lens: Check whether parts of the system pull in the same direction.

• Policy coherence: Alignment (or conflict) among financing, workforce, digital, and clinical policies.
• Vertical & horizontal integration: Coordination across care levels (primary–secondary–tertiary) and sectors (health–social care–public health, etc.).
• Alignment of incentives with purpose: Do financial, professional, and organizational incentives support the transformation’s stated goals?
• Interface management: Management of key interfaces (hospital–primary care, health–social care, health–education, health–justice).