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At the macro and meso level of health care delivery, it is important that health system development be coordinated with areas of development, such as social, economic and environmental development.
Moreover stakeholders from the micro and meso level of chronic care organisation in Belgium, identified the lack of integration of care as one of the biggest weaknesses of today's healthcare system, along with the unclear definitions of the roles and functions of health professionals involved in care processes [ 32].
Less attention has been paid to the meso level of interaction within and between scientists and the institutions they work in.
The meso level of understanding provided by including the key informants highlighted the wider contextual issues along with the nature of the work required to implement user and carer involved care planning.
Local leaders and champions of quality and their perceptions of the receptiveness of the meso level of the organisation to quality improvement will be a particular focus of our investigation.
The researchers behind this study have previously undertaken a survey of patient safety officers in the county councils, i.e. the meso level of Swedish health care, to identify factors they believed to be of relevance for improved patient safety [ 13].
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This feedback loop could be a way to connect the macro and meso levels of priority setting with the micro level.
In April and May 2012, four focus groups, two per language group, were organized with stakeholders from the micro and meso levels of chronic care.
Micro and meso levels of health care are based on the WHO-definition [ 16].The meso level comprises the health system at both the local and the organizational level, such as hospitals.
The perception of the members of the North West London CLAHRC of how the programme was framed at the macro and meso levels shaped their understanding of what they were meant to be implementing.
Across the macro and meso levels there are strong indications of a shared understanding.
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