Making sense of systems
Thinking afresh as to how to support new ways of thinking and working
The NHS in the UK faces many challenges and at the same time, is guided by an ambition to reform itself to become more geared towards – and responsive to – the needs of the population.
However, there is limited time and space for those who work in the NHS to think creatively about how to respond to these circumstances. The service is extremely busy and it feels as though staff – particularly those responsible for managing and leading – are caught up in a permacrisis, which limits their capacity to think differently and to test out new ways of doing things.
This has led to a fresh corporate imperative for people to embrace systems thinking – and, in practice, to apply the precepts of systems leadership. However, this raises a crucial issue: there are myriad approaches to business leadership these days, as a cursory glance at the groaning shelves of the Airport Academy demonstrates, which can sometimes make systems leadership feel like yet another fad.
As with all fashions, of course, people are sucked into it, partly out of a personal fear of missing out and partly because everyone around them seems to be saying that it’s a trend into which they need to buy.
Current systems thinking
However, approaching the challenges and ambitions of health and social care systemically makes absolute sense. It is a perspective that acknowledges that the whole is greater than the sum of its parts and that a system relies upon meaningful connectivity between agencies – and individual agents – to maximise that effect.
All of which has led to a busy market of workshops, courses, and programmes that aim to induct people into systems thinking. However, these tend to take place at a distance from the practicalities of what it is like to make sense of systemic working in practice and to navigate it in a positive fashion.
There is a paradox at the heart of this. The busyness that managers and leaders in the NHS face at this time denies them the headspace to think systemically in the context of their systems. They are frantically doggy paddling in order to keep their heads above water, which prevents them from learning in the pool the swimming strokes that would make the situation smoother and easier.
On the other hand, there is an effort to teach people about systems – but this is taking place away from the practicalities of work in a quite abstract fashion. It’s as if people are stepping out of the pool to sit in a classroom to be shown the theory behind other swim strokes that might support them better in the water.
Crisis and leadership
Why is proximity to practice so important in this instance? Primarily because our organisational focus in most instances is on structure: we focus constantly on the scaffolding that envelops the work that we are asked to do. Yet the latter occurs systemically, with a passing relationship to the structure but in many ways independently of it.
Importantly, it is arguable that recent experience shows us that systems become apparent, and we are better able to acknowledge their presence, at times when we face crisis. There are examples cited by Rhiannon Firth in her book Disaster Anarchy – for instance, the aftermath of Hurricane Sandy in the US – where disasters outstripped the state’s capacity to respond, due to its structural emphasis, but out of which arose mutual aid arrangements, which were systemic responses.
A clinician with whom I spoke at the peak of the Covid 19 pandemic explained that it used to take her at least three days to organise a patient transfer. Invariably, to action it, she would need to involve people above her in the hierarchy. However, with the arrival of coronavirus, she found it necessary to step into leadership – and she quickly found that she could network with opposite numbers in other agencies at a grassroots level…and suddenly transfers could be achieved in around half a day.
This is important learning about how structures can often constrain innovative approaches to getting things done – and that an experience of crisis can create a tendency for systemic working to come to the fore. The challenge, however, is to preserve that learning about systems that arises out of difficult practice, when organisational elasticity tends to see things snap back into place, with bureaucratic structure reasserting itself.
Learning about systems from systems
Over the course of the past six months, I have been in conversation with my colleague and co-thinker Eitan Reich as to how best to help people with systems thinking and practice. This piece is a summary of a longer and more detailed white paper, which can be accessed HERE.
We have generated several foundational precepts in terms of thinking about this challenge:
- Crises tend to cause structures to buckle, which has the positive effect of allowing the systemic underpinning of the workplace to become more apparent – and hence more widely applicable.
- Seeking to “teach” people about systems at a distance from the systems is too abstract an approach – which will make it feel like an imposition for many leaders.
- A useful starting point is to explore people’s recent experiences of crisis, in terms of what they saw happen; what they initially considered doing, and what eventually emerged as a way forward, which may well have been wholly unexpected but needs now to be acknowledged as a different way of working.
- Knowingly engaging with the experience of working systemically that arises inadvertently out of extreme circumstances will give people the permission to unlearn traditional leadership thought and practice and to allow a new way of being and doing at work to emerge. For example, the structural mindset requires us to think about directing: to embrace a systemic perspective means that we focus instead of finding ways of connecting.
Next steps?
Eitan and I are now extremely eager to identify a couple of partners who are interested to work alongside us in collaboration to continue this exploration and development of a way of helping people to think and practice more systemically in the public sector. If this is something that you might be interested to discuss with us, please drop us a line at radicalod@colefellows.co.uk and we’ll schedule an exploratory call.
Email: radicalod@colefellows.co.uk
Website: www.markcole.org
Blog: www.radicalod.org
X: @reflectservices
