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

The viable system model, relationship enablers and creating the conditions for change

‘There are 2 groups of people – those who want to fight with each other about who is right academically and those who just want help to translate the academics into practical application. Until we can all learn to talk to one another in a helpful way then we are never going to move forward, even if we want to use the methods. If the academics come at us with their harsh academic arguments, we just can’t handle that because that’s not part of our world and if we can’t get across to them our challenges and how we need help, without being put off by their harsh arguments, then we are never going to be able to transform the good stuff into something useable.’

These were the words spoken to me back in 2015 by the Chief Executive of a Clinical Commissioning Group. A year later I left their organisation to set up my own venture and as you will see, I never forgot her wise words.

I have a lot of successes in my work. People are often impressed by the quality and insights I can give, and my ambition has always been focussed on helping others to experience the real power of systems thinking. To that end, I have spent the last couple of years going back over my work and really challenging myself about, ‘what I do when I do what I do’ – a phrase used in the Open University systems thinking courses that makes you seriously reflect not just on what you are doing, but how you are actually doing it. I wanted to take what I was learning and pass that on to others and I wanted to give them something outside of the academics and textbook models and methods to work with.

I have captured my learning in my Systems Thinking Change Wheel, and a set of 100 action cards that underpin each section of the wheel, to give people insights into creating the conditions to support change and as I have found, this is particularly useful for system change.

Those who know me know that I use something called the Viable System Model (VSM) a lot. I don’t use it in it’s first order hard systems thinking way, though. I use it in a more qualitative way, which for me makes it much more versatile. The trouble is, when people see anything about the VSM they quickly turn the other way due to its complex diagram and over burdening academic narrative. In addition, some VSM lovers shudder whenever anyone tries to make its insights accessible to the masses. So what I’ve done is not regurgitated the VSM, but taken my learning from using it and translated that into something useable for people who may never have come across it before, but still deserve to have the insights from using it made accessible to them.

One of the most powerful learnings I have taken from my work is that where some would say exchanges of information are critical, I have found relationship to be even more critical. Importantly I realised that throughout all of my work I was building in ‘relationship enablers’ at every point. In many cases, the information people needed, contrary to popular belief, was there. The issue was that there was no relationship in place that gave the incentive for the information to be understood, acted upon and the outcomes fed back into the system to enable change/ improvement. I have many years of examples of building in relationship enablers and linking this to my other work with the VSM and other systems thinking I have developed a set of actions that sit under the sections of the wheel to help people create the conditions for change. Many of my other insights are captured in the cards and I am now using these to run workshops to help those wanting to apply systems thinking to their complex situations and particularly to enable system change. It isn’t the sections of the wheel that are the powerful thing, it is the WAY you enact them (‘it aint what you do, it’s the way that you do it’). This is critical and my action cards and my workshops go through a process of helping people to see the difference between what they do now and doing something that might sound very similar but enacting it in a way that might give very different results.

Please note that the Systems Thinking Change Wheel and associated text does not fall under the creative commons licence for this website, but is separately protected by UK Copyright.

NB: workshops can be run for min 10 people, max 20-25. If you are interested, please get in touch.