Informal leadership roles identified for interprofessional primary care teams

Interprofessional primary care teams that operate without formal management structures depend on informal leadership, according to a qualitative interview study published in BMC Primary Care. Researchers from the Netherlands interviewed ten healthcare leadership experts and distilled their insights into a new Framework for Informal Leadership in Primary Care, abbreviated FIL-PC, which describes four leadership roles that together support effective collaboration, shared responsibility, and ongoing learning.

The study was motivated by a demographic shift in the Netherlands: the growing number of frail older adults requires robust interprofessional collaboration in primary care to ensure person-centred, high-quality care. In teams that lack formal management structures, strong leadership is considered essential to support team development, coordination, and decision-making. Yet the authors note that there has been a lack of clarity about which leadership approaches are appropriate in such teams, and about the role the general practitioner should play within them.

To address this gap, the research team conducted semi-structured interviews with ten healthcare leadership experts. The data were analysed thematically using an inductive approach, meaning that the key elements of leadership were derived from the interview material itself rather than tested against a predefined theory. The stated aim was to explore relevant leadership theories and to examine the role of the general practitioner in fostering interprofessional collaboration in primary care teams serving frail older adults.

The analysis showed that interprofessional primary care teams without formal management structures require informal leadership. The proposed FIL-PC framework captures this in four key leadership roles: initiator, visionary, tutor, and overseer. Together, the four roles are described as supporting effective collaboration, shared responsibility, and ongoing learning among team members.

A central finding concerns the position of the general practitioner. According to the study, GPs are well-positioned to take on these informal leadership roles, but they may not yet fully recognize or embrace this potential.

The authors conclude that informal leadership is crucial for effective interprofessional collaboration in primary care teams without formal management structures. They position FIL-PC as a practical tool: the framework offers insights into the leadership behaviours needed and can guide teams in improving their collaborative practice. Because the framework was developed from expert interviews rather than tested in functioning teams, the researchers themselves frame it as a proposal that requires further validation in practice.

Accordingly, the study’s conclusion points to a clear research agenda. Future research should investigate the feasibility of the FIL-PC framework and explore educational strategies to support its implementation. Until such studies are carried out, the framework should be understood as a structured description of what leadership experts consider important in interprofessional primary care, not as a demonstrated intervention with measured effects on team performance or patient outcomes.

The study was published as an open access research article in BMC Primary Care on 24 October 2026, and is being shared early as a peer-reviewed, accepted version that remains subject to further editorial edits before the final version of record.

For primary care teams and the professionals who train them, the practical message of the study is that leadership in self-managing interprofessional teams need not rest on a single formal manager. Instead, the framework suggests that the functions of initiating collaboration, providing vision, tutoring team members, and overseeing the joint work can be distributed and enacted informally, with the general practitioner as one plausible carrier of these roles. How teams in practice adopt, combine, or divide these four roles, and whether doing so improves collaboration and care for frail older adults, remains a question for the follow-up research the authors call for.

Subject of Research: Informal leadership in interprofessional primary care teams serving frail older adults in the Netherlands

Article Title: Towards an informal leadership framework for interprofessional primary care: an interview study among healthcare leadership experts

Article References: Merx, L. M. H., van Dijk-de Vries, A., Veenstra, M. Y., Moser, A., van Rossum, E., Schers, H. J., & van Bokhoven, M. A. (2026). Towards an informal leadership framework for interprofessional primary care: an interview study among healthcare leadership experts. BMC Primary Care. https://doi.org/10.1186/s12875-026-03589-8

Image Credits: AI Generated

DOI: 10.1186/s12875-026-03589-8

Keywords: primary care, interprofessional collaboration, informal leadership, general practitioners, qualitative interviews, FIL-PC framework, frail older adults, team development, Netherlands, BMC Primary Care, Towards, informal