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

Through the lens of systems thinking

The clients and their situation

It is 6 months since I was introduced to my clients. They are a mixed group from various public services who work in the same city together. To my delight, people with lived experience are included in the group working to enable systems change. They have been through an interactive programme together, introducing them to systems change and giving them the space and time to build some community together. They have some knowledge of systems thinking and I think they are ready for the next steps.

Their situation is one that many in public services are up against every day – multiple organisations trying to work together but working to different, and often conflicting, targets. Silos abound. Everyone seems to know each another but there is an elephant in the room. They always exist, right? They just aren’t talked about. Every group has their elephant, sitting silently in the corner.

Multiple and conflicting perspectives fly around like a hundred fluttering butterflies bouncing around in the wind, only these butterflies have teeth and take a bite at each other every now and then. Everything is interconnected and interdependent in some way, and power struggles are extremely evident. Those with lived experience are vocal about how services don’t always work for them. They are the recipients of the outcomes of overburdening bureaucracy and it hurts. It is destructive and breaks trust between the organisations and people in the community. My impression is that the focus is on the transactional, although there are pockets of innovation and everyone is dedicated. They are just constrained by the erratic complex, uncertain and ambiguous situation of which they are a part.

I see opposites – working together but power drives them apart, pulling in the same direction but bureaucracy throwing obstacles in their way like giant felled trees blocking a road. Sharing but lacking social learning. Can this complex situation challenge itself enough to enable people with lived experience to be seen differently, supported differently in the community and included in decision making in different and better ways? They are on their way, of that I am sure and over the six months I have known them I have seen admirable efforts to overcome long standing obstacles and challenges.

Let us begin…

They are ready now, I believe. We gather in a small room, conduct our ‘check in’ and I start the day with an interactive exercise based on viable systems. It is calming and aimed at easing people into the day in a relaxed way.

     

 

 

It is then followed by an exercise to start and lift the energy – an experience of complexity and what things might be ‘invisible’ to us yet undeniably there when we are together in a complex situation.

 

Our focus is now on the complexities of the situation and the complications that people themselves bring. Each one of us has our own epistemology, mental models, frames of reference and tendencies towards reaction rather than reflection. Are we adaptive to situations? Do we co-operate and reciprocate? Do we really see multiple perspectives, understanding that each of us will interpret the situation differently? We like to think that we do but in reality, we often do not.

Contextual awareness

Using their current situation as our context, together we start our journey of exploration. I introduce the Systems Thinking Change Wheel and share six categories that we can focus on that can, in different and complimentary ways, help us to create the conditions for change. The categories are based on work I have done over the last 10+ years using cybernetics and systems thinking to work with and in complex situations. We look at:

  • How self-organising or self-referencing teams might operate, including a focus on peer to peer collaboration and how groups might instigate and implement change within the boundaries of their autonomy
  • How the group can co-ordinate, collaborate and support across individual, team and organisational boundaries. We discuss internal system coherence within organisations and across organisational boundaries. Importantly, we include building community and networks and how co-production might be more effective
  • We move on to considering what resources are available, including the collective resources of their own experiences, skills and talents. How might some joint decisions be made when goals and expected levels of performance might be different for each organisation? Importantly, we discuss how this might be achieved at the same time as bringing the humanity back into everyone’s work and having some balance to avoid burnout
  • Of course, every ‘system’ needs some kind of monitoring, but we don’t talk KPIs and targets. We talk about conducting health checks on the system instead – is there congruence between the behaviour of the system and its vision? Is there a joint vision? Should there be? Or should there just be some element of similarity joining everyone together?
  • We then explore adaptability and how the group might change quickly enough to match changes and differing needs in the environment. We consider whether they could adapt to a sudden and unexpected change in circumstances and as I write this, I expect the group will have found their answer to this during the pandemic
  • We know there will never be a fully joint vision of the future, but the group do know that they have an element of shared purpose. The trick is in identifying that and using it to their advantage. They aim for some element of shared learning and shared meaning making. Alongside this, we consider how devolved accountability might work and highlight where there are commonalities in their identity and whether they want to create a shared identity as a group

 

Learning, change and adaptability are key throughout and using the above we move on to exploring actions within each section that can be undertaken to identify where the group are currently strong and where they need to focus more efforts, how they might synthesise their insights and move forward to co-create their future together.

Making the invisible visible

Every day people swim around in a sea of complexity that is evident, yet partially invisible to them. Events are easily seen, but the system structures, behaviours and individual differences driving the events are less obvious. Their impacts are felt but somewhere beneath the surface there is a fuzziness. They feel the waves, and often the tsunami, and yet it can still come as a surprise.

In this session we made the invisible, visible. We exposed that which we take for granted. We exposed it in understandable ways. The water in which people were swimming around in suddenly had some colour. They could see it, which meant that they now have more chance of working successfully with it and to change it, where necessary.

They were surprised by how much the session showed them. My response to that – it was already there. They already knew it. I just helped them to see it and work with it in a constructive way that they could understand. And now? Well now it is their turn to help others see the water they are swimming around in and work with it to start co-creating a different future.

The Systems Thinking Change Wheel and Creating the Conditions for Change – available as on site support or workshops (social distancing guidance permitting)

This narrative us intentionally anonymised to maintain client confidentiality