Zoom out from the service

Taking the System Thinking Change Wheel into a different context took me to an area of familiarity – the NHS. Leadership development is always on people’s lips and in their thoughts, it seems, at the moment.

For this session I used a case study example of something I have worked on to run a workshop. It was a complex NHS service that, like most, was interdependent with a number of other health and care organisations and services. Nothing is stand alone in the NHS. Just about everything is a complex web of interconnectivity and interdependence, including multiple organisations and a multitude of people and processes.

Knowing about systems thinking is one thing. Knowing enough about it to be able to work effectively with it, without having to spend a long time studying about it, is another. Clients usually want to jump straight in and get to grips with the complex situation they face.

I sometimes find that people’s default position in the NHS is to try and improve the processes in a service, rather than zooming out to see the wider picture and think about the wider system aswell. This means that options for change and improvement are limited and an easy way out is to blame staff for poor performance of the service. But there is another way to expose more about the situation, leading to a wider range of opportunities for change and improvement.

The workshop

We start the day by exploring the biggest challenges people have whilst trying to make change and we have some discussions around what makes systems viable. It is an interesting and enlightening session with lots of interactive exercises and moving around. Ideas are flowing and people are engaged.

Then, we move quickly into a case study – no time to lose. After a short run through of the case study the room is split into groups and each group is given a section of the Systems Thinking Change Wheel to consider. Without considering any actions at this time, each group are given a different set of questions about the situation to discuss. More information is available to help discussions along, but only if people request it. It helps those in the room think about what information they might need to understand why the situation is like it is.

Bringing all of the discussions together exposes a tangled web at many levels of organisation – an individual level, a team level, an organisational level and at a wider system level. The information in the room is rich and enlightening.

 

 

 

 

We move on to using the action cards – a different set for each group. They get going, identifying areas where there is strength in the situation – where things are going really well. Then, it is on to the areas that need more work. Finally, the groups are given tokens that represent resources – money, people, equipment, innovation, training etc. They are challenged to show where they would invest time/ effort/ money and why. Not surprisingly, this does not go on blaming staff or just telling the service to ‘do better’. They don’t know it, but they have just done quite a sophisticated diagnosis of the situation. The levels in the situation are easily visible, the imbalances creating havoc are visible and they have identified many areas for improvement.

 

 

 

 

 

 

The benefits

The groups discussed, supported each other, considered the wider picture, motivated each other, challenged, contextualised and shifted each other’s perspectives several times. It was a joy to watch.

Using insights that I brought from the actual situation I had worked on, we shared stories and feelings and insights. We looked at things from several angles and quite unbeknown to them, they were collectively ‘systems thinking’. They were also co-creating a potential way forward. The vibe was high energy and I even heard the words, ‘oh, this is fun’ at one point. We explored the balance between autonomy and control, empowerment, adaptability, trust, power and enabling structures.

We explored the role of managers, flexibility, pivoting and the balance between generalist and specialist roles.

There were a few shifts in thinking that day and an assuring buzz in the room. We were focussing on how to ‘Create the Conditions for Change’, rather than focussing on individual ‘do this’ ‘do that’ actions. Each situation requires actions that are contextually specific. The trick for me is to guide people in the right direction and then encourage them to decide on those context specific actions themselves. No ‘lift and shift’ answers here.

Creating the Conditions for Change Workshop – available face to face when distancing guidance permits and very soon to be available as an online session

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