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To ensure that more people will benefit from integrated care initiatives, scaling-up of successful initiatives is the way forward. However, new challenges present themselves as knowledge on how to achieve successful large-scale implementation is scarce. The EU-funded project SCIROCCO uses a step-based scaling-up strategy to explore what to scale-up, and how to scale-up integrated care initiatives by matching the complementary strengths and weaknesses of five European regions involved in integrated care. The purpose of this paper is to describe a multi-method evaluation protocol designed to understand what factors influence the implementation of the SCIROCCO strategy to support the scaling-up of integrated care.

The first part of the protocol focuses on the assessment of the implementation fidelity of the SCIROCCO step-based strategy. The objective is to gain insight in whether the step-based strategy is implemented as it was designed to explore what works and does not work when implementing the scaling-up strategy. The second part concerns a realist evaluation to examine what it is about the SCIROCCO’s strategy that works for whom, why, how and in which circumstances when scaling-up integrated care.

The intended study will provide valuable information on the implementation of the scaling-up strategy which will help to explain for what specific reasons the implementation succeeds and will facilitate further improvement of project outcomes.

The expected insights could be useful to guide the development, implementation and evaluation of future scaling-up strategies to advance the change towards more sustainable health and care systems.

In the rational model of the democratic governing chain, intervening spaces at all levels are neglected in relation to the policy process. An intervening space is a group of persons with the power and responsibility to interpret policy at their level in an organization. The research question is as follows: How are democratic policy ideas visible in the intervening spaces of a governing chain in public schools?

The study is based on two municipalities representing the 25 most populated cities in Sweden. The data are based on interviews with 66 informants with leadership roles on the district level and two schools in each municipality.

Leadership is obviously more than making decisions. It is also about facilitating and creating trust, engagement, motivation and willingness to take responsibility. In this process, intervening spaces are central. They exist at all levels from the national ministry to the classroom. The empirical examples show the importance and challenges in how different leadership roles, relationships and interaction transform policy intentions to practice on the local level.

The authors contribute by highlighting the parallel interpretation processes that take place at various leadership levels locally. There are possibilities and challenges in aligning the intervening spaces into a rational governing chain. The findings indicate that intervening spaces and policy drift is vital to support, control and use professional competence in the process to transfer political ideas to classroom practice.