If Systems Thinking and Holism was an integrated and accepted part of our way of thinking as a nation, part of how government and the civil service think, and how we educate ourselves; then maybe this would happen differently. Perhaps we would:
- listen and accept, rather than analyse and differentiate.
- develop and open up, rather than entrench.
- look to the future, rather than just think of now.
- think of us, rather than think of me.
- enquire, rather than tell.
- all succeed, rather than compete to the top.
The Nations Health
In response to health, social, and community problems, we would have health services designed around the complex nature of issues that many of us face. Appropriate state or voluntary group support would be available, to prevent issues escalating to become bigger and more complex.
We would have local communities as a power-house of action.
Health staff would be in jobs that they could perform, and flourish as people.
Demands into the health services would be lower than today, as would be the cost of delivering those services.
Our relationship within Europe would have changed, to suit the different views in the country. We would have found ways to remain connected in Europe, and to be different.
We would never have had to go to the frustrated place we got to by the time Brexit was an issue, as issues with matter to people over the decades - in regard to immigration and national sovereignty would have been listened to, and the causes looked at.
Our understanding of the myriad of links that need to be made, to solve deep societal and person issues, would be such that we would realise that Homelessness is a symptom of a malaise with us as a nation. People would return to living a more balanced life.
We would have a reducing number of prisoners in our prisons, and a greater return of those people in prison back to a life away from crime.
Would our families and communities be structured in ways that promoted good living? Would we be less interested in consumerism, and have a greater range of interests that promote living a good life?
Education and Learning
Would we be helping children to become the adults they want to be, and take forward the principles that advance civilisation?
Would we be so much more aware of the true implactions of our lifestyle? So we would be creating a fairer world. Could we be reducing the impact of climate change at a pace that makes the future one that our children deserve?
Local government response to COVID-19 is giving us a glimpse of a new way of delivering our public services.
What can we learn from this, and make Working Smarter the new way of working?
We have all had to work differently, and to our surprise, it worked really well!
This write-up compares the current way that the public sector operates, with how we have rapidly redesigned ourselves to respond to the COVID-19 crisis. I will use experiences from various councils, to list down a series of actual changes that were made in both the services themselves, but more importantly, the way that staff and managers adapted to this change.
The New Support Hub
The typical setup was a group of front line officers in a large room together. Some of those with more experience were quickly appointed as leads. A facilitator was resident in the room three days a week for the first two weeks, and two managers had the job of ‘managing’ the team.
Lets look at various aspects of what we would normally do in these situations, and compare them with what actually happened
One; The Drive for change — the current approach
In both the private and public sector, pressures are what creates new activity and change — regardless if we want it or not. In fact, we generally prefer to retain static workplaces, but pressure drives us, kicking and screaming into doing something.
Local government in the UK has been in austerity now for over 10 years and the impact of this pressure has, according to most comentators, to simply cut rather than improve. In terms of outcomes from the perspective of those who need support and help to live their lives, the impact has seen them struggle more, and generally get into greater difficulty in their lives. And ontop of that, we have failed to tackle the waste in the way we do things. Austerity is a major pressure, but that pressure has come from where? It is from central government funding, and that is what we reacted to.
Drive for change — the new approach
The pressure from COVID-19 came from our community, an external pressure, and it has been very different to that from central government. Firstly it came very quickly, no time to have meetings and plan endlessly. No reports! But more importantly, what is the driver? The driver is in the local need, the need that is on the doorstep, and in the urgent phone calls. So, dealing with this problem means that we then deal with the actual need in-front of us, rather than a man-made initiative.
The basic design of the new way of working consists of three main things;
We observe that:
The impact of reduced central funding, drives us to cut activities and non-essential services.
The impact of being confronted with real problems, drives us to support people to get them back to supporting themselves.
A brief comment about urgency — it is a driver for change that is often needed to bolster us into action. That pressure creates speed, and drives the activity and solutions that we use to address that change. And the quicker the speed of the problem, the more rapidly we need to respond.
An Example — One hospital Chief Exec sent an email to all staff, congratulating all staff on moving a haemoglobin ward. It was completed in two weeks, rather than taken two years!
Two; The redesign — the current approach
How we redesign in the public sector needs no introduction here. Most of us can make a list of ‘cures’ for our woes that we have seen over the years. The main characteristics of such change might be something like:
The redesign — the new approach
It started with an email to a group of front line staff from different departments, to meet in a room, scratching their heads and wondering what to do. A facilitator was there in the room that had the ability to go and fix things. We engage the public online with a form, and via the phone. Most people preferred to call, as they wanted to discuss things. The council office was closed to visitors, but there were a few people with no working phone or internet who needed immediate help — we helped them, despite it being not what we ‘officially’ meant to do.
The facilitator watches as calls begin to come in, and the staff work out how to deal with them. Once a call is complete, they put the phone down, and talk with their fellows in the room and discuss how to take this forward. The conversations are not planned - they emerge, people feel they can contribute and are listened to.
The manager is outside the room most of the time, and has regular zoom calls with the team. There are flip charts of diagrams and lists going up on the walls, as we figure out what we are doing.
An Example — There was a question about food bag volunteers not having food safety training or certificates, we went upstairs to talk to the environmental health expert, and we got a pragmatic and immediate reply that did not slow us down. It took 10 minutes.
What are they doing that is different?
We had plenty of data to analyse, so we analysed it… It was interesting. And we waited for it to actually direct us to do something that we could not do without it. What we found is that technology was essential, it was critical to helping us to retain knowledge. But, when there was a question, when there was complexity to resolve, invariably a person was the key to answering it, not the data.
Three; The change framework— the current approach
We have experts who have big brains, who know everything. They tell us what we have to do to comply, or else we will incur the wrath of the Daily Mail. We add in lots of checks and management approvals to the procedures, and the experts threaten us with inspections. Risk is defined by the worst case scenario, events that will rarely happen. Our power comes through compliance, for instance GDPR.
Those experts define the how we do the change, and that ultimately defines what becomes the overarching focus of the change. The real reasons for the change become lost to these pressures.
The change framework — the new approach
The experts connect with what the team are doing in their operations room, and they observe. The facilitator then discusses how they can help the team to ensure they do the right thing. The experts realise that by sitting on one room, engaging with staff, ensures flexibility of governance at the right level. Risk is balanced and learned from the actual activity being carried out, rather than fearing the worst case. Checks and balances are part of the discussions with the team who then modify their workflow diagrams.
GDPR was not allowed to become a barrier, it was used to adapt and alter the design of what was needed. The experts' role includes to actually resolve the issues the team encounter, and allow the team to do what they need to do unhindered.
Four; Measures — the current approach
Measures are a managers way of understanding performance and indicates what is happening in the work. Typically, what matters to the manager gets measured; how many, departmental costs against budget, how quickly can we process, government returns, etc. Managers react to those measures.
The staff respond to the measures by artificially improving them, and this creates departmental silos, hiding the real issues, and their purpose becomes ‘hit the numbers’. Measures are often compiled into reports, discussed at meetings, and hidden from the front line. After careful massaging, top management receive a watered down version of what others want them to know.
Measures — the new approach
The numbers are written up at the end of the day on a flip chart on the wall. If anyone wants to know outcomes, they have to come to the room, where someone from the team will explain the measures, and have a discussion as to the implications. No numbers are allowed to be emailed out of the room! This causes other managers and finance to engage directly with the team.
The measures are used in discussions in the team to alter what they do; they learn from them. It is up to the manager to go into some individual cases to understand the causes of costs, and then to formulate the cost model away from the team.
The operations room becomes the place to go to for managers.
Five; Management— the current approach
The management approach in the public sector is born from bureaucratic and administrative foundations. Rooted in the logic of Taylorism, designing the organisation like a logical machine. Then add in the myriad attempts to bring in private sector techniques and wider ‘best practice’ initiatives, and we get to where we are now. In times of pressure, we tend to behave as our masters expect us to, and that is almost always responding to the person with the purse strings.
Management — the new approach
Let’s look at what organisations do when they liberate themselves from the confines of so many conflicting pressures, and instead focus on what we are here to do — purpose as defined by those we are here to support. This greatly simplifies our focus, and directs the organisation to do the right thing. Moving away from the machine paradigm, replaced by an adaptive and emergent way of working that requires a shift in the way we manage.
This table attempts to highlight some of the main management approaches and behaviours that emerged, contrasting between the current and new way of working.
How do we move forwards, learning from this?
One way is to set up a series of change initiatives, and then plan the living daylights out of them. That's what we have been good at doing, but now we want to do better, we need to do this differently.
The crisis has taught us one really important lesson, that has made us very uncomfortable, but is true.
We reacted immediately, and became person centered by default.
We were thrust into uncertain territory, that was actually not that frightening
One thing to note, is that this way of working does not just happen. The new services did not just happen. There were many issues that needed resolving, where the cause was; people not being team players, dominance, lack of communication, top down management decisions, silo mentality.
Community groups are the place where the complexity and solutions meet. In one area of the borough, there was almost no demand. We heard nothing. We discovered that it was because there was a robust and well operating set of volunteers operating in that area. We had little idea what they were doing, but were on hand to support them when needed. The end to end workflow, includes groups, neighbours and family as the true enabler of support.
The development of new approaches like this requires conscious leadership decisions to be made. It requires the managers to become both managers and the facilitators. This is primarily dealing with demand that is complex — uncertain and changing; therefore the management approach needs to adapt to that environment. We need to ask ourselves about the fundamentals of what we need to put in place, to ensure that we enable our organisation to work this way.
The challenge of service designers wading through the field of systems thinking, and how to prevent getting stuck at the first hurdle
Systems thinking with regard to organisations is conceptually very simple;
it is a wholistic way of looking at the organisation, its environment, customers, and its place in the industry it is in, and everything that it is a part of it.
When people start to percieve their organisation and role with this mindset, they gain a perspective that leads them to understand how that organisation can work in a fundamentally different way to traditional mechanistic reductionist principles that operate today. However for the curious, if you begin to search for what Systems Thinking is to then apply it, it often ends up creating more confusion than it solves.
The more difficult part of understanding Systems Thinking, is a cognitive one; getting to that place of removing our dependence on reductionism and learning to think systemically. Unfortunately there are no clear ways of doing that, and I have come across many weird and wonderful interpretations of how to get there. In this blog I will use Design Thinking as an analogy, because there are similarities with Systems Thinking (ST) due to the fact that they are both ways of seeing and understanding that are more fundamental than logical analysis. They both can underpin how we percieve nad interpret what we see and understand. They are both 'thinking' things.
Design Thinking was coined in the 20th century. It became the subject of ‘papers’ and then become increasingly recognised through very practical and successful product development. Then, others came along and made some significant and new strides in the direction of service design based on Design Thinking. An interesting characteristic about Design Thinking is the reluctance for those operating in that field to strictly define it from an academic persective, and more importantly to resist attempts to standardise and codify it. And, acording to many practitioners, the day that happens will probably be the day it begins to die.
Section by Stefanie di Russo
We have come to realize that we do not have to turn design into a limitation of science, nor do we have to treat design as a mysterious, ineffable art. We recognize that design has its own distinct intellectual culture; its own designerly ‘things to know, ways of knowing them, and ways of finding out about them’ (Nigel Cross 1999, p. 7)
Schön aggressively refuted the idea that design needs to ground itself in science to be taken seriously. Like his peers, he made an attempt to individualise design as a unique practice through cognitive reflections and explanations on its process.
Schön’s main approach on design practice was not focused on analysing the process but rather framing and contextualizing it. He describes the idea of ‘problem setting’ as a crucial component that holds together the entire process. The point of focusing on this was to allow designers to best understand how to approach the problem before they go about processing how to solve it.
Let us search, instead, for an epistemology of practice implicit in the artistic, intuitive processes which some practitioners do bring to situations of uncertainty, instability, uniqueness and value conflict (Schön 1982, p. 49)
The Reality of Design and Systems Thinking
So, we’re all doing some 'Design Thinking' out there, and we all have slightly different approaches and ways. We are learning from each other, and learned from when we didn't do it very well. In the last 15 years Design Thinking has made a significant impact in modern business. And perhaps an attribute to this success is what Design Thinkers are not doing, and that is to create academic works that define it.
Design thinking has always been around well before it was named some decades ago. It is when we define it, name it, and then attempt to codify it does it then lose what it actually is. For those involved, you will know what I mean through the excellent book Design Thinking Doing that reflects this approach.
Systems Thinking on the other hand, seems to have been defined early on by different groups who were primarily academically focused. While there is nothing wrong with that, much of what we call Systems Thinking still seems to be defined more by those who have focused on the academic aspect almost exclusively.
Therefore at fist glance, it may be difficult for some curious people to get appropriate help in understanding the first rungs of the ladder of Systems Thinking, if they think that you need to plunge into the theory. For me, this seems to be a hangover of its history; starting in the realms of engineering, systems thinking written concepts appear to be rooted in theory through analytical analysis, rather than practical evidence and holistic understanding. However, this is not quite true. If we examine the lives of those known system thinker creators, they often had deep conceptual and holistic thinking. And it is this that is often hidden by academic writings.
On the other hand there are many who use Systems Thinking more connected to the workplace, and less connected to the theory, who are successfully developing. But they have no united voice or way to group together as a community that Design Thinking has. And is this practical version still Systems Thinking?
Learning Systems Thinking? It’s not so Straightforward, lets ask Russ Ackoff
So I want to seperate Systems Thinking from systems theory. They are different but yet related. Many will first meet with systems theory when embarking on this journey of learning and discovery. Or they might stumble across open-ended systems thinking discussions that has little associated theory.
I want seperate the two because Theory itself by definition is a rational, scientific and reductionist way of looking at anything. Academia primarily engages in theory and research analysis. Systems theory, when compared to Systems Thinking in action is by conceptual definition different. But are obviously directly linked.
As an example, when we use a model to describe something, we are not describing that thing directly. The model is and always will be an artificial construct that we create to help us understand. And often the model is a poor relation to the real thing, in that we have to embellish or move away from the model when applying it. We use models and theories to help us analytically to understand Systems Thinking, and for some this is the ideal route for them. But for others it could also confuse and only teach us about structured constructs and models, if we limit ourselves to this approach. Looking at Systems Thinking through a holistic lens, we would never reduce it to its component parts and then ‘teach’ those.
Ideally, systems theory and practice should inform one another, Prof Mike Jackson OBE
So, for some it is far better to explore and experience Systems Thinking in action.
We need methodologies to help others in organisations to learn, but that methodology is not or ever will be Systems Thinking itself. The methodology or approach anyone takes is their way of undergoing a journey of Systems Thinking learning or application.
What is an Organisation Understood as a System?
What is an organisation as a system? Simply put...
The core of a system is an interconnected set of people that are coherently organized in a way that achieves something. Donella Meadows
A system is just a concept, something that people have understood as long as people have understood anything. ... It does not really help much to have a systems awareness up here, it all comes down to what we do, how we think and act. Peter Senge
So What is Systems Thinking?
To combine with Design Thinking, for the purpose of service design, Systems Thinking is the way of thinking that incorporates both theory, concepts, and practice.
And if anyone now wants a definition of Systems Thinking that makes any sense in the real world, listen to Ackoff talking about systems thinking, and how it fits into Design:
And here is a definition that I like:
Systems thinking is a 'mental model' of how we see and talk about our realities that help us to better understand and work with 'systems' that influence and shape the quality of our lives, Gareth Evans Msc.
I would expand that definition to ensure that it operates at the level of mindset or paradigm, as we naturally operate within a rational and often reductionist environment. So many of the greats of systems thinking express themselves through a paradigm related to how we percieve the world of work, that is for them a fundamental part of systems thinking.
Navigating the Systems thinking Environment
Focusing on the the correct definition of theory above all else can sometimes be characterised by people expressing particular behaviours, especially visible on social media. I have found that these not only hinder learning, but often do not help others to learn. Examples are:
If you go to the world of systems thinking and cybernetic groups you will find that they are very often antagonistic. Its not necessary to behave in that way, its juvenile.
...We should curate our different modes of thinking, rather than moving towards uniformity. Ranulph Glanville
The splintering of the systems movement into warring factions championing soft systems thinking against hard systems thinking and critical systems thinking against soft systems thinking may provide amusement to academics but is alienating to practitioners. Prof. MICHAEL C. JACKSON OBE
If you go to the world of systems thinking and cybernetic groups you will find that they are very often antagonistic. Its not necessary to behave in that way, its juvenile...
In contrast, and that the world of Systems Thinking can learn from, is the approach of Design Thinkers - free from historic trends, allow for the refreshing of the definitions, and be what they decide they want to be, free of judgement.
When applied to organisations, Systems Thinking should be reversing the impact of reductionist thinking, Taylorism and rigid mechanistic thinking; it should be pointing us to novel ways of seeing and managing through people, that results in positive outcomes for the organisation, and for the staff themselves. It could be heralding new horizons that coincide with Design Thinking and its associated mindset and culture; Design Thinking and Systems Thinking should go hand in hand. For me, part of the beauty and power of Systems Thinking is its inclusion of everything that incorporates all aspects of organisations, especially the recognition that people are at the core of this.
And as for my journey, I was lucky enough to meet some people who have spent much time analysing theories and creating approaches, but more importantly, learning from the reality of current organisations and how we operate within them. Putting that theory into practice. For myself, the understanding and application of Systems Thinking has developed through experience, a mindset of learning, and the application of ideas and concepts to discover their impact. Design Thinking could have gone down the same sorry path as Systems Thinking, but it luckily got led by those who were open, flexible and understood emergence of knowledge and learning through experience.
Service design underpinned by system thinking
The diagram above is but one view of a framework to developing a successful systems thinking based methodology for service or organisation design, applicable for practitioners within organisations. It also brings with it knowledge from various specialisms.
A particular aspect of this framework that is worth noting, is that feedback from experience in organisations is the primary way that this model develops into a successful methodology. It is no coincidence that the Experience & Learning bubble is the largest.
Looking at this framework, it does demonstrate something, that different routes taken by different people will create different methodologies, and that we should recognise this difference as positive and providing necessary comparison to learn from.
Design Thinking has mushroomed because its fertile ground is a myriad of service design agencies, operating within various industries. And I continues to evolve. Contrast that with Systems Thinking and the fear that consultants will push it into the realm of a fad.
The quote below is one that has transformed my fundamental attitude from one of talking and arguing, to one of doing and being open to learning. For me, doing is the core that drives the model above.
"What you’ve achieved is what matters, not what you’ve suggested or said." - Taiichi Ohno
What do I suggest for others to move forward? I am not exactly sure, and I would welcome proven suggestions. Certainly I would encourage learners to seek out those who they resonate with, and reject those who they don't. Read, connect, visit, and work with those you find attracted to, and move away from those who you find express behaviours and attitudes that repulse. Thats what I did, and it has helped me. Oh, and the most important thing, practice it, do it, make mistakes and apply and learn.
I have found that Systems Thinking that is published is often applied to world problems, social, or natural systems, or derived from the early days to Engineering. If we look at the models and concepts that are created to communicate that type of application of Systems Thinking, I find that they can be often unhelpful to learn from, when we are focused on services and organisations. I sometimes fail to recognise the relevance that an organisation has, with a natural element like a cell or a human body. And as such perhaps be courageous enough to create your own understanding of organisations when helping yourself to think more systemically, especially in the light of organisational trends as described by Frederic Laloux in the book Reinventing Organisations.
The way I understand how able someone is to see an organisation through a Systems Thinking lens is to have a conversation with them, and listen to how they see and therefore describe about that organisation. Their concepts and how they express them will link to their thinking.
Complexity & Grint
Complexity, it messes with our rationality. Let go of that rationality as a cage and allow complexity to become normal.
Understanding complexity, and therefore moving away from my prevailing and rational mindset, has helped me to understand why I often failed to sustain much of what I was trying to achieve in the past, with managing operations and people, implementing change, creating and implementing IT systems. I, like so many others, have looked back and seen the frustration and struggle to ‘get things to stick’ and how I used to blame others for that failure.
What I now realise, apart from a different style of management in general, is that the mechanisms (control, skills, behaviours, etc) that are required to operate with complexity, need to be quite different to the mechanisms that are needed to dealing with complicated but rational services and problems.
Understanding when to use a particular approach, helps managers to understand why sometimes their efforts are successful or futile.
In both the public and private sectors, managers that I see assume that their learned understanding of management is rooted in those derived from complicated rational systems. Especially those based on the Command & Control paradigm. There are many resources now available at the click of a button to help us to understand complexity and how to deal with it, so I wont go into details here, but I have found the simplicity of Grint a very helpful starting point.
Using Different Approaches
Systems thinkers can collide because they see the world in different ways, or they can see this as essential. We should examine the different ways they see the world rather than argue about the way the world ‘actually is’. In some circumstances one viewpoint will give you the traction to bring about improvement, in others a different viewpoint is needed. You can make an informed choice of which viewpoint ( and associated systems approaches) to start with but you will never really know until you are engaged in the process of using it. And you should be ready to switch as a project progresses. Best is to have a variety of viewpoints (and associated systems approaches) at your disposal. This ‘second-order’ thinking - concentrating on the nature of the systems approaches and what they can achieve, rather than pinning down what the world is like - is called critical systems thinking, perhaps most well defined by Prof Michael Jackson, OBE.
My Experience of Outcomes of Good Service Design
As an exercise, which I do not know if has any value out not, I have decided to write a first draft of a set of Good Service Design principles. (I was inspired by Rams the product designers principles). Any feedback would be welcome, as I expect these principles to change significantly:
The Foundations of what I do
These are some of my Systems Thinking & Complexity principles listed, that I use as a foundation to what I do.
I hear things, and I forget them. I see things, and I remember them. I do things, and I understand them. Confucious
this is primarily about human beings working together to solve the problems of other human beings.
Digital Design then follows from this Service Design, after the human and formal interactions that are created.
It is easy to remember theory with the mind; the problem is to remember with the body. The goal is to know & do instinctively. Having the spirit to endure the training & practice is the first step on the road to understanding.
Qualities Required to Learn about Thinking things
This quote by Tim Brown recently describes the shift in Design Thinking activity with organisations that is happening worldwide. The shift is from the initial concept of product design and fitting that into a stable organisation. Now, service designers are increasingly called to integrate their work within the business itself. In his quote Tim Brown specifically refers to the design of the underlying end to end service. For those seasoned practitioners who have been working in Service Design, this should come as no surprise, as it is becoming an increasing reality in our work.
Is this good? The impact this is having on service designers is less about theoretical discussions about being right or wrong, it is driven by the market demand. And it is being driven by the market because Service Design is maturing into he next stage in its development; it is moving from an innovative and dynamic start-up, to a more accepted mature methodology, slowly becoming integrated into businesses. That in itself is very interesting, as it is another indicator that proves the worth of Service Design through its acceptance by mainstream businesses. So, it perhaps has to be accepted as a positive milestone on the path to providing greater value.
What approach and skills are needed to fulfil this shift? The question has been bounced around conferences and discussion in the last few years, and is being currently tested by those in the thick of the service design workplace. From recent observations with that work that is published and has demonstrates proven success, these are some of the points that are surfacing:
1. Familiarisation with business concepts and skills have to be present when undertaking service design in a business context.
2. Service Design and business transformation skills and methods have to go hand in hand at various points in application of Design Thinking, and the relationship with the client.
3. Design Thinking has specific unique principles and characteristics that are central to its definition, and traditional methods of transformation are mostly not aligned to these principles. Therefore additional transformation disciplines have to become realised through approaches and mindsets like Systems Thinking, Teal, and other modern concepts. This will allow Service Designers to leverage their new approaches into business services efficiently and effectively. In fact, efficiency and effectiveness need to become part of Service Design.
How to do this. These three points do not mean that all service designers have to become proficient in them, but designers will be increasingly co-designing their services in collaboration with like-minded team members who have got that proficiency. They have to work with those who share their principles of working and culture. Service Design agencies are already sourcing those contacts into their work.
The Role of Digital. Lastly and perhaps most striking, is that if Design Thinking has to include truly redesigning services, designers have to be able to wean themselves off the single minded focus on Digital as being the only means by which to achieve transformation. The transformation of services is far more about people, behaviours, purpose, and the workflow, than it is about any one specialisation. Why do I say that Digital might have to be not the only design specialism? Well, I deal with plenty of complexity with some services. This is particularly relevant in the public and health sectors, where as soon as we move away from the most simplistic services, we land right in there middle of complexity. And in service design, complexity is often not the best way to deal with that complexity. In England we have plenty of examples of that. If that is widespread, that will certainly push Design Thinking into wider contexts!
A recent example I saw recently, in a London Borough Council, was a new customer system for helping people walking in. It was for Housing. It went like this;
In the week I was there someone was so shocked by the service they were getting and they were in such a mess, that they took an overdose whilst sitting talking to the housing officer. They were in hospital for two days. And no, they did not have severe mental health issues. That same week, in another housing department in the country, a person set themselves alight in the same situation.
Whoever designed that Digital service has lots to learn about SD
Having just got back from a public sector conference, looking over the day and asking myself the question as to whether or not these gatherings help? The answer is yes, many people discussed good things that teams are doing, and agreeing what we should be doing. But one phrase from the conference really did trouble me;
We now know what we need to do to make Transformation work’
And then someone reminded me of something. They showed me a report with this great list of innovative health & social care working principles:
Now imagine the The Health Minister agreeing the above and stating in Parliament;
The theme of the plan is to harness the efforts of the community in both the statutory and voluntary sense. That is very much in line with the Government's view.
Well, this list and this quote is from the Secretary of State for Social Services in 1982! The realisation that dawned on me that we have been there before, and we’ve revisited this several times in the last decades, was a jolt.
Does anyone reading this recognise that those wanting the job to transform health & social care, where after several decades, realise that their work has made no meaningful impact? They all seem to be doing good work, but with almost no real lasting difference.
We try and make improvements, but what about those who work there? What can it be like for them? Imagine that when an NHS nurse gets to work starting their shift, that their manager slaps them in the face, then later on the manager sticks a pin in their leg, so it bleeds. Then at lunchtime, the manager hits the nurse over the head and causes a headache. What would we think of the behaviour of that manager?
Obviously this account is ridiculous and would never be acceptable. But if so, then why do we accept this behaviour when the abuse does not lead to any obvious physical damage? We encourage nurses and social workers to train, and encourage them to accept low pay with the promise of having a job that really matters. And then, when they start the job, we ensure they can never do a job as they were trained to do, because there is not enough time. And we command them to stop using their brain and follow simple and stupefying instructions, so that they cannot really help the patient in the promised way. And we treat them to the point where they often cry with frustration on their drive home. How have we come to accept this abuse?
This mindset that we have developed leads to ridiculous accepted conclusions;
1. What is one of the problems of the NHS? We don’t have enough nurses.
The root cause of the symptom of not enough nurses is that the nurses we train, start work, get abused by the NHS system, and leave. We have always had plenty of nurses being trained, we simply throw the opportunity away, and damage careers in the meantime. Can it be morally right to convince, train and then give someone a job that is not possible to be morally fulfilled?
Taking the same situation but with a plasterer who plasters the walls of old properties, the result of this situation for the plasterer would be a poorly and partially plastered wall. Would anyone simply accept that? Imagine thousands of new houses with partially plastered walls, is a ridiculous outcome to contemplate. But why do we accept this in our public services? Is it because plastering is physical that we can see it so obviously?
Management of Public Services
Managers in the public sector are not one homogeneous mass, but they do seem to behave in a similar way. Whether managing nurses, council officers or road repairs, their answer in a situation where a member of staff cannot complete the task given to them for that day is in many cases a shrug of the shoulders. The one time that a manager has to use their ability to lead and manage operations, they abstain in the worst possible way.
Managers are paid more, and part of their role is to manage and maintain the operations and delivery of services funded by the public for the public. One hundred years ago the Suffragettes managed to get 50,000 people to march to London; before phones and the internet. They were showing the world that the situation had got to the point that it desperately needed to change. What should our leaders in the public services be doing to highlight an impossible and abusive situation? Certainly not simply shrugging their shoulders - why can't they sit on the steps of Whitehall for a day in demonstration. NHS leaders are somehow subservient to their hierarchical masters, but surely their job is also to push upwards to their bosses? Public sector leaders have a duty to highlight and ensure critical aspects of the organisation, not simply to act as top down mouthpieces. The Windrush issue is an example of managers having to follow and not react to bad culture.
Lastly, what of the impact on the most important group of all - those the services are helping - Us, the public? This could be the subject of another article - but what of those millions of interactions since 1982, that could so easily have different outcomes.
At times, managers can and do get dismissed from their job because they say something that is overheard, published and deemed racist or suchlike. But when managers ignore and take advantage of their staff, there is no public outcry - they carry on with their job. Are a few misplaced comments far more important than peoples livelihoods?
The Cause of the Problem
Enough wringing of hands, and bemoaning the lack of political will. Moving past despondency and looking for hope, lets look for the systemic cause of the problem. Why after 35 years can we not implement real transformation? For me, the answer emerges surprisingly quickly and clearly.
Those who Govern the System
Elected politicians, MPs, on election day are suddenly pushed behind a desk and have to run the public sector. They have to oversee a hugely complex and large organisation. Would they know if Universal Credit is a good idea? You can ask this question to people whose job it is to deliver benefits and half will say yes, and the other half say no. It is a complex issue that can only be answered by understanding the whole system, and how people truly interact with it - understanding it as a real behavioural set of individual workflows. Imagine MPs attempting to make clear judgements in the middle of the myriad of conflicting pressures that they face daily. Its not heir fault, its the situation they find themselves in - needing to make policy decisions before the next minister arrives.
The direct imposition of short term political decision-making on the long term nature of public service is an ill-matched structure of control or governance. Politics is an emotional and illogical maelstrom of ideology and decision making, and these characteristics are the opposite of the characteristics required by the structural nature and purpose of the public sector services we expect politicians to be able to oversee. We watch as expectant policies are kept out of the meandering reach of decision-makers; lost opportunities for key decisions, indecision, and fear of election consequences - demonstrating clearly that those decisions that are needed are simply too large and complex for the political environment at that time. MPs or councillors do not control public services, but they do create the environment and governance by which those services operate. A good example of this is how the imposition of austerity has driven the public sector recently. Also, central government has an important task in defining elements of the wider system - like management competence, digitalisation, etc.
So, if it is so difficult to know what to do in the face of a barrage of conflicting information, it is the height of irrationality to expect MPs and the collection of those who report to them, to effectively oversee such complexity. And no, the Civil Service cannot do it either - they are good at bureaucracy and administration and maintaining control, not managing complexity.
If this was a large private sector multi-national, the CEO would put in plans to change the structure and replace leaders with ones that have the correct competence. It could be completed in six months. There is no practical reason why this cannot start to happen in the public sector, if the will was there. And it would free up politicians to do the job that they are good at doing - from a distance.
It seems Incredibly Difficult to Achieve
When I work with managers they are quick to explain the a number of reasons as to why a particular change cannot happen. It is the nature of the culture that we see that the public sector is full of barriers to moving forward. However, when working with certain senior managers it can be demonstrated, and to their great surprise, that these barriers can be overcome. When working with teams to develop new approaches, there always comes a time when making forward progress, the team realise that they have broken the public sector spell of continually struggling in decision quicksand. From that point forward, the team move into a new decision-making paradigm, and we move into new territory of true change.
What is the Root Cause?
We actually know how to run public services well, there are islands of examples using innovative methods that have demonstrated a transformation from the old style public sector administrative master-servant relationship. We have seen that services can be transformed so people in need can be guided to get their lives back on track, and communities can rediscover their strength. Many times these fledgeling examples are caught up in larger pressures, that then throttle their existence; they need to have the appropriate underlying long term alignment across the public sector to continue and thrive to other areas.
Most of the truly transformative change I have been a part of has reverted back to 'normality' due in all cases to new managers taking over the service, and bringing their old management style and behaviour with them.
What is a Solution?
There are people who know how to understand, and then manage operational complexity. And there are also clever people who can make things happen. Find those with both attributes, and put them in a room together, that also spans a cross-party political landscape - ideology has to take a back seat here. That group then leads that part of the public sector - they decide the structure, what methodologies are most valid based on evidence, manage transformation through proven prototypes, and ensure the appropriate leadership competence is promulgated throughout the sector. So that the transformation can emerge to all parts of the sector.
Their strategic vision will span 25 years. They could plan for changes in technology and demand, tackling preventative longer term solutions to impact on problematic root causes. And their appointment to the group is neither as elected officials or private sector capitalists. They would be a unique group whose selection has to be decided with caution and transparency.
Using the example of the problem of ‘not enough nurses,’ that group could ensure that nurses are able to do their job by ensuring a minimum number of nurses in given situations, and that the nurses are treated with a level of management attention and approach that is now expected in any other industry. They would define management competence and ensure management suitability to those competencies. Most importantly, they would understand the core journeys service users take through the NHS, and they would ensure the structure and services are designed to match those user journeys.
Political (public) oversight must still be in place, with the ability to ensure that the public leadership group is doing the right job.
So is the systemic answer is that we need a different governance structure?