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

Creating the conditions for System change

Change isn’t all about going in and ‘doing something’ to someone and then leaving them to it. To be effective, it is a whole lot more than that. Building the conditions for change is as important as the change itself. But, what do I mean by that? Well, you can ‘diagnose’ a situation and discover what is not working so well. There are many different approaches for doing that, all of which might uncover similar things about the situation. But there’s another piece of work required and that is helping people to build the conditions that will allow changes to be made not just now, as you need them at this point in time, but on an ongoing basis, in a co-evolutionary way. One off change often doesn’t ‘stick’. You might get a financial saving, economies of flow and organisation but unless you have created the right conditions for the thinking that crated the change to flourish on an ongoing basis, your ‘win’ may be short and sharp and it is likely that the situation will, at some point, rebound right back to where it started.

Some of my work lately is around ‘system change’ and for system change is it important to create the conditions for change. In my newly developed training, I take people through the following questions:

  • How might you engage in peer to peer collaborations?
  • How might you instigate and implement change yourself, within the span of your autonomy;
  • How can you strengthen community, develop networks, collaborate and work together with people outside of your own team on an ongoing basis (particularly bringing in the voice of lived experience);
  • How can you contribute to internal system coherence;
  • How can you bring humanity and balance back into the work;
  • How do you make joint decisions, decide upon joint goals and decide what level of performance is reasonable;
  • How do you ensure effective system characteristics;
  • How do you ensure congruence between the system and its vision;
  • How do you build external relationships and gather intelligence about the world around you;
  • How do you ‘pivot’ and change quickly enough;
  • And how do you get that joint vision, meaning, purpose and identity?

These are some starting questions I use to help those who are trying to create the conditions for System change. I use my Systems Thinking Change Wheel to highlight and explore these questions and then bring in a set of Action Cards to help people take the thinking and make it into a reality. I don’t ‘do to’ people, I help them think about the situation themselves, create their own meaning, identity and purposes and then work with them by supporting them to start developing the conditions that are required. It isn’t an easy journey or a quick one. You need to be in it for the long haul and that is why it is important that you engage in systems and complexity thinking for yourself. No one can do it for you, even if they lead you to believe they can.

Creating the conditions for change using systems and complexity thinking. Spoiler alert….it’s down to you! (with other people’s help to get you started and occasionally to keep you on the right track).

If you are interested in a training session (as a group) then please do get in touch