Health and social care professionals’ expectations for e-leadership in the digital transformation: a qualitative study

Health and social care are undergoing continuous transformation driven by increasing digitalisation. Ongoing changes place significant demands on professionals’ daily work and create new expectations for leadership. Previous research on leadership requirements in the context of digitalisation has predominantly focused on the perspectives and experiences of leaders, overlooking how professionals themselves perceive the leadership needed during this transformation. This study examined the needs and expectations of health and social care professionals regarding the e-leadership practices of their line managers as digitalisation reshapes work in the sector. We employed a qualitative approach and conducted eight focus group interviews with health and social care professionals (n = 33) using a nominal group technique. Data was collected from three Finnish wellbeing services counties between November 2024 and February 2025. Thematic analysis of professionals’ expectations for e-leadership by line managers was initially guided by a data-driven approach, followed by theory-based structuring using the three dimensions of leadership mechanisms: cognition (understanding professionals’ premises), affect (interpersonal engagement), and behaviour (leadership actions). Within the theme of leader’s understanding of professionals’ premises (cognition), line managers were expected to facilitate professionals’ competence development and to be well-informed about the principles and practices of digital work. Interpersonal engagement (affect) encompassed expectations for line managers to be accessible and supportive of wellbeing in digital and remote contexts, to consider equitable remote work practices that reflect professionals’ needs, and to support and encourage new digital initiatives. Under the theme of actions (behaviour), line managers were expected to recognise and set boundaries for digital workload, ensure supportive conditions for digital work, provide timely and accessible information and guidelines, and take responsibility for the development and evaluation of digital services. This study identified concrete expectations that can guide leaders in supporting health and social care professionals during digital transformation. Most expectations centred on leaders’ actions and interpersonal engagement and the results show that professionals value e-leadership that reflects the practical conditions and challenges of digital work. Line managers are expected to be both knowledgeable and supportive, facilitating environments where digital solutions respond to actual needs and can enhance everyday practices. Leading digital transformation should not be considered as a side task within everyday management but an area requiring intentional planning and allocation of resources.