Applying systems thinking to commissioning: what can the viable system model bring to the party?

I first met the viable system model (VSM) in 2006, when I embarked upon my systems thinking journey with the Open University. Admittedly, it wasn’t an easy introduction. There it was, in the corner of my change management party, staring at me like a monster never to be approached. But, me being me, I couldn’t resist poking it with a stick a little bit, just to see how it would react.

I guess it confused me, at first, because I was never quite sure if it was about ‘an organisation’ or ‘organisation.’ This was mainly because the text I was learning from used both phrases/ words so very closely together that I sometimes mixed the two up. I wasn’t the only one either, a number of other colleagues made the same mistake too. It wasn’t long though before I realised it was about organisation (be that ‘an organisation’ or any other kind of system) and then we soon learnt to get along.

Managing complexity and being adaptive is key in the public services in which I have worked and therefore the VSM has been an ideal model to apply because the five systems that exist in the VSM have that purpose in mind. Maintaining a system in a state of homeostatic equilibrium is no easy task but the VSM encourages and supports the learning, adaptation and evolution required to do just that.

When I look at public services I look to see what makes them breathe, what makes their heart beat, what conditions have to exist to enable them to live, what makes them die? I look at how they interact with their environment and within elements of themselves. I look at what interdependencies exist, or don’t exist but should or could. I look to see what the drivers of both internal and external complexity are and are they being absorbed/ matched/ batted away or simply ignored? I look for the energy levels in my system – are people and processes energised, frantic? Are they stressed, fearful or in despair? Or are they asleep, calm, laid back with not a care in the world? I don’t just consider, ‘What is this thing?’ I consider, ‘What does it do?’ These are all clues you see, and when you can spot them and apply them to the VSM you get to know exactly where things are going right or wrong.

The VSM’s party trick, well one of them anyway, is to encourage you to identify if there are any variety imbalances driving disorder in your system and if there are, from where do they originate? Is it the workload between the environment and the operational units of your system that is causing a problem? Is there disorder between the operational units themselves? Could it be that there is an imbalance between the autonomy required to innovate and the cohesion required to maintain your identity? Is the rate of change causing a problem; is there an imbalance between changing at a pace to match the environmental variety and yet maintaining the current status quo?

Looking for requisite variety in all of these areas of potential critical variety imbalance has been a very powerful approach for me in my work. I am able to recognise the resource conflicts and the turf wars between clinical teams, indicative of issues in co-ordination mechanisms (knows as system 2 of the VSM). I am able to identify if there is a common sense of purpose, what the structural couplings are and what kind of identity this creates. I know what pathologies to look out for, for it is the pathologies that indicate that my system is sick.

We can only manage organisation if we know how it works. The VSM helps us to understand how it works. It guides us to consider what value our system provides to its environment and the things it does to keep itself in existence. It helps us to decide if primary activities are split by: task, customers, geography or time. It guides us in explicitly identifying mechanisms that enable primary activities to run smoothly. It gives us a platform from which to examine resource bargains and identify control dilemmas. It allows us to understand the type and nature of monitoring loops that are effective and those that break the bond of trust. It encourages us to link performance measurement in a meaningful way. It encourages us to gather intelligence from outside of the system and guides us in making better decisions.

I have used it, in combination with other systems thinking methods and concepts, to identify and reduce quality incidents in health services, to redesign pathways, to identify where and why services have been underperforming and help them improve,  to evaluate strategy and to form strategy, to decide whether to re-commission or decommission and to build new services from scratch.

So, after a tentative introduction to each other, the VSM and I get along just fine nowadays. In fact, I believe it is one of the single most powerful models I have ever used to help me understand a situation, diagnose weakness in a situation or design something from scratch. It gives me the skills to make better choices. It helps me understand why a situation is like it is, taking away any preconceived ideas and prejudices. It makes me feel at ease working with large, messy social situations and supports me in identifying problems and opportunities. VSM is no longer standing in the corner of my party…’s dancing, right in the middle of the floor!

 “… vision without systems thinking ends up painting lovely pictures of the future with no deep understanding of the forces that must be mastered to move from here to there.” Peter M Senge, The Fifth Discipline.

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