Business & Service Design using Systems Thinking

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.

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?

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?

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 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

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.

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 take a demand, and we deal with it in the way that makes most sense to us.
• From our knowledge on the ground, we predict a problem and then plan to resolve it from occurring.
  
• We design the steps of this end to end service workflow as we take the demands.
  

We observe that:

The impact of reduced central funding, drives us to cut activities and non-essential services.
vs
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!

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:

1. Top down designed and driven change.
2. Planning, discussions, governance, oversight, budget, permissions, risk analysis; all lead and define the change that we intend to do. Communication is via report templates and email.
3. Front line staff do not like change, therefore we need to communicate it to them.
4. Change takes a long time, and we know that lasting outcome is often a fraction of the original intended improvement.
5. Digital and IT always makes things better doesn’t it? It is a magic wand. Digital by default.
6. We replace one set of procedures, with a new set. We still retain a standard service, designed against best practice. ‘Customers’ slot into categorised demands and follow our standard process.
7. ‘We’ create our services, that we then impose on the public. We have the power; parent-child relationship. We deliver and give to the needy.

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?

1. The workflow is driven by the demand, and that demand shouts out the purpose to the team; ‘help me to help myself in the current crisis’.
2. The facilitator has an eye on what is happening, and highlights potential issues to the leads in the room. Working with them to resolve them.
   
3. The front line staff are designing the workflow, every day they discuss the learning from the day before and modify what they do. The facilitator and manager support the team and ask them what they need resolving to make this work.
4. Change takes two weeks at the most, it is iterative and uses prototypes to learn what works.
5. We learn that it is people that make a difference and make things occur, the technology should support that, not drive it. The public choose how they want to engage with us, regardless of our technology.
6. We create a rough set of flow diagrams on the wall. We all know what we are doing, and how flexible we have to be to do the right thing. We deal with people by listening and talking to them, and our actions are guided by what matters to them.
7. We recognise that, by engaging with people directly, that the power relationship is mutual. Our role is not to deliver, it is to facilitate and support.
   

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.

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 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.

• Our measures record departmental costs and targets, and we pay attention to central government metrics.

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.

• We primarily measure purpose; the time to help people, against their real need, and keep the measures visible to all.

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.

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.

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.

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 were thrust into uncertain territory, that was actually not that frightening

• Everyone involved focused on one thing; delivery against purpose, driven by the real needs. We became person centred in the true sense of the phrase. Staff were responsible for the end to end flow of each case.
• We recognised how the end to end service includes communities, so staff collaborated with community groups in ways that were appropriate to each situation.
• Decision-making has to be local, based on the real situation on the ground. Managers understand that and support those decisions.
• Managers ‘allowed’ the design of how we deliver to emerge, by designing it together with those in the front line.
• The communication channels were direct, and based on a network of contacts that briefly emerge to solve particular issues.
• The values, leadership and behaviours we need are different; based on collaboration, focus on the workplace, achievement, learning, and systemic.
• We still understand our constraints, but instead of focusing on cost, we focus on the causes of cost and act on them.
• We are in this together, and we achieved speed through collaborating and learning from each other’s organisations.
• Digital has helped, but it is not the answer. The real value is in the staff and bringing their whole selves with them.

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.

What is an organisation as a system? Simply put...

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:

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

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.

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 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.

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;

1. you walk in,
2. queue, and the person shows you that you have to go to the computers and register. So,
3. you are presented with a few pages with simple questions and you have to supply your NI number and email.
4. You then have to verify your email address.
5. Then, you can select the option to make an appointment with a housing officers and if you are lucky to get one the next day. OK, that is possible for many of us.
   

But what about the people who are in most need? I watched as homeless people turned up, wandered around and got help on the computer. Had no idea as to their NI number and could not verify their email. They left and returned several days later, in a much worse state than before, with a volunteer to help them - to then get an appointment the next day.

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; 

And then someone reminded me of something. They showed me a report with this great list of innovative health & social care working principles:

• Holistic approaches and co-production
• Devolved responsibility for decisions about resources to local level with real accountability to families and communities 
• Community work, engaging with the strengths and talents in the neighbourhood and nurturing local voluntary organisations and associations – “helping communities be strong and resourceful”
• Undertaking local social care planning on an inclusive basis

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 Structure
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.

​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.
​
An Example
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?

Interesting to read this article in the guardian that the issues with the NHS are not just about ‘fixing people’ when they are unwell. But that loneliness has a large impact on people well-being, demonstrated in the figures for 50% less life expectancy to those that are lonely.  

Analysis
When I did some work in the NHS, and we looked at the demand into hospitals and also helping people in the community - going to the GP, or after they have left the hospital. Something about what we were learning about the demand seemed to need further analysis. It is easy to treat different types of demand as common categories - broken leg, diabetes, etc. But when we looked at the time taken to help people get back to a normal life, there was great variation in the resources and time used with the same category.

Complexity
We discovered that certain people absorbed far more resources, visit their GP, or were admitted to hospital far more than others. These people often had a level of complexity to their situation that was not obviously identified when looking at their records. When we analysed a cohort of patients it was obvious to attribute age to the cause of increasing complexity. But looking at each person in detail we discovered the causes were various. And what was the highest cause of complexity? Loneliness.

It surprised everyone around us, that this was the result of the analysis. And how well had this health trust geared itself up to respond to this problem? Well, apart from having weekly public social gatherings, the problem was not on anyones radar as being important.

What we did
The continuation of this has been written up into a case study

Data sharing, often a major stumbling block to joined-up working in the public sector. How to use a systemic approach to thinking about the problem and delivering a different and far easier solution.

Lets start with a real case study and define the problem that this organisation had.

The Problem
I came across a new data sharing issue in a new Hub we were redesigning recently. In this situation local government Council staff were newly sitting next to and working with the Police. The question was:

How do we now share information between us?

This was a project started to develop the workflows, policies and practice in the Hub. The Police, and Council front line staff were in a multi-disciplinary change team, and the managers were connected to that team.

What the Police Did
If anyone works with the Police you will find that they have a quite different way of making decisions than any other type of organisation. In the situation with the Hub, they made a local decision to share data in the way that supervisors on the ground thought was reasonable. However, when they went and asked their Data Controller, and the Controller replied they could not share any of the data. As simple as that! The Police then spent the rest of the three months in this position - frustrated, but unable to proceed.

The Standard Solution
As is usual, the purpose has to be defined or understood. It will be defined by managers, and may be defined something like;

we need a set of rules on how to legally share data between us, that protects people and allows us to work together efficiently.

This is the usual approach in most organisations to solve a problem like this. They will ask a consultant with analytical knowledge to look at this as a project and study the data. They also need to be fully aware of the legislation, so they ask the Data Controller and get a copy of the Data Protection Act, and read it in detail.

This consultant then takes the data types from a data analyst, and attempts to categorise the data into the categories that make sense, and that show different levels of risk. They would look at the job roles of all the people involved and attempt to make a judgement as to the data they are required to view and why. And engage with the Data Controller and put all the collected findings on the table.

The outcome will be a report, that will be approved, and then circulated down through the hierarchy - as each manager makes sure that their particular concern or point is contained in the final report. In some cases this step in the process can take many months and the problem is seen as:

the needs of different stakeholders, which must be taken into account.

Staff groups are put on a schedule to listen to their managers tell them what the new rules are.

The Systemic Approach
Understand
Again, the first step that has to happen is that the problem has to be understood. This is done by going to where the work is. The change team listen to demands coming into the Hub, by actually listening to the conversations. They have to understand the whole problem and what matters to the person making the demand.

The purpose they define for the sharing of information remains undefined.

Redesign.
The next step, after listening to the demand, is to undertake the work - by just doing the work that matters to fix the problem - together with the person.

The Data
So what of the data sharing? Well, the example above is looked at by the team, and the key information that was needed to provide the knowledge required to solve the problem is written down.

The above process is repeated several times, until the team understand enough about the demands and the knowledge. They might do 20 or more demands.

Then the team sit together and analyse what knowledge is needed, and where it is usually held. Interestingly it is quite often held in peoples memories rather than simply in a computer.

The purpose they define for the sharing of information now emerges from the evidence.

The Outcome
This analysis is then used to define the agreement on the sharing of knowledge. If a manager does not like this, or wants to add other rules, then they have to work with the team to demonstrate that the evidence proves that this change should be made.

The word data is not included in any document or discussion. The purpose of this exercise is the sharing of knowledge

From a systems thinking perspective, what is important in this problem is not about data, but pertinent information regarding a council officer about to visit the property of someone. As soon as you make it data you have entered the world of concepts and ideas. Systems thinking has to be firmly rooted in the reality of what the the system is really about.

The solution was surprisingly easy, focus on the information - not the data. When there is a new demand, and the council officer wants to know about the what we know about the person making the demand, then they ask a police officer in-front of a computer if there are any issues I need to be aware of when I visit Mr. Smith.
The officer could respond with;

• no problem,
• maybe you should go with a colleague,
• the mother has  difficulties talking to a official,
• there may be someone staying there illegally,
• talk to Jason, he knows a bit about this family,
• a police officer will go with you as it might be tricky,
• dont go - lets have a conversation...

After the demands were understood, It took about two weeks to define, and make into a workshop for staff.


The Difference Between Systems Thinking and our Usual Approach?
Point 1 - there is are no stakeholder needs, as the person and the demand defines the need.
Point 2 - there is no inflexible set of rules that applies to certain categories of demands.
Point 3 - the managers do not initially define the outcome, the evidence does. Then the managers agree the analysis the team undertook.

What is needed is not the data, its the knowledge I need before the visit and during the process. This real need by-passes all data arguments, as the real basis of data sharing is the sharing of knowledge. The sharing of data can be a side issue to the main principle, that is often used when sharing is between people far away from each other and who are unable to collaborate. If you can collaborate with your colleague in the other service, then the sharing becomes one of knowledge - and a different and much easier problem to fix.

In addition, this approach supports the front line staff and is flexible to every situation. So no detailed procedures or rules are necessary - just the creation of a set of principles to work to in a framework that front-line staff can be coached to use.

This is an real example of using systems thinking to the problem of data sharing. The problem is redefined from data to knowledge - which is should have always been in the first place, if the legislation had been looked at from a systemic perspective then maybe the problem so many public sector organisations are having would be made alot easier.

The data protection act in the UK is actually written to help data sharing and to prevent private organisations from marketing our data. But we tend to see it only as the method of restricting communication. Certainly those who wrote it made a big error in the way that it puts across the central concept of what it is about. But, it really does focus on DATA, and in public sector operations we are far more interested in information.

Just when the news of the Scottish police centralisation of call handlng has shown that there are significant problems with this approach, Mike Penning, a home office minister has stated that the combining of three emergency services will bring significant benefits. This will bring in economies of scale with the sharing of back office services. Efficiency jsut drops out as the answer, doesn't it?

This is not the place to resort to egoistically stating one view over another. No, its time to realise that we, as a nation, relish in stating the obvious. At least, we all think we are stating the obvious, and each of us comes up with the solution that makes sense. Maybe its about time that we stood back a little, and recognise that we keep returning to this style of behaviour like flies around a light bulb.

Its obvious that covering a pan that is boiling over, to stop it from spilling its hot contents is a solution to a problem. But the better solution is to switch off the gas.

Transformation is about doing different things, not doing the same things differently. It is about looking at what we have been doing, and choosing to approach problems from different perspectives. I would suggest to Mike Penning that his good idea, based on common sense, just before he commits millions, to just do a few simple things:

1. Get someone to help you learn how the current system works. Understand its underlying assumptions. Discover the root cause of the issues.

2. Start with a better set of assumptions, and apply a different logic to the problem you have to solve.

3. Start to redesign the system, so that the problem's root causes are eliminated.

4. You end up with a system that works differently than before, will cost less, and performs better.

You need someone to show you how to do it, because it is very difficult to see the system we are in differently, without someone to help us.

Its actually not difficult, and will only take a few weeks to do 1 and 2, but it will save milllions.

Remember this from 2010? The principles were exactly the same...

“FiRecontrol was a project established under the previous Labour Government, and is now being scrapped because it does not work.

“This project has wasted millions of pounds of public money as well as thousands of firefighter hours in trying to bring it to completion.

This is a plea for trying something different, so my tax money will not be wasted again.

I just want to add this about Ian Duncan Smith and Universal Credits. Its the same principle as sharing control centres, related to a process:

"This is the man who is the chief architect of the Universal Credit, which was supposed to have been rolled out in October 2013, and in March 2016 has been rolled out to the grand total of 141,100 people - and by "people", I mean "single men without dependents", the only group whose claims are simple enough to be processed on the Universal Credit."
Stephen Bush, New Statesman

Good grief, look at this! facebook page about universal credit

Isn't it a fact that many people can talk at length about the reasons as to why we, as managers in organisations, are always striving to create a great organisation. We can list the top reasons as to why we need to change, and another list of what needs to change. How about a list showing the characteristics of successful leaders? Does anyone like to count the number of books on this subject?

Yet, when we actually look at what works, and what does not work, actually watch managers manage, what is the one thing that underpins what is REALLY stopping us. Is not the answer, that we all actually know deep down, is us - our own fear of the unknown - of stepping out of our zones of comfort? Its easy to say that we must become bold, etc. Its another to actually feel the wind of uncertainty grip our chests.

Which manager is prepared to take the risk of a new approach, when they are being measured on success, by a room full of grim faced, suited stalwarts. Isn't it easier to follow the tried and tested approaches, that were developed about 80 years ago?

Our real barriers are all in our heads.

Its not easy, but the first step is to recognise our limitations, and be prepared to challenge them. Then find an approach and the right people who share your vision. Then you have a chance to succeed...

So, the Scottish Police centralisation of calls is being put on hold. What is the problem? The problem is that we as decision-makers love to use the same clever principles to make decisions, that on reflection, seem to be plausible.

The problem is that the police service relies heavily on calls into the system. These calls arrive at all times of the day, with varied frequency over the day. At small sites the cost of managing these call handlers, arranging their shifts, and preparing for holidays and sickness is a challenge. So, the solution is to get them all from the smaller sites, put them in a big building, and connect them with technology, back to their original locations. Then, maybe we can recruit cheaper grade staff to answer the calls, based on best practice CRM systems. If we can call India when we talk to a bank, surely its a no-brainer?

It all makes sense to a decision-maker, who is being pushed to make savings, the like that have never been experienced by that leader in the lifetime of the service. The logic and the maths make perfect sense.

The reality is this. The demand that comes in is often complex and fails to follow a pre-determined pattern to resolve. That seemingly simple call about a Facebook spat can turn nasty if not dealt with according to the unique circumstances of what matters to that particular caller. The history of conflict within the facebook issue, shows that those invovled have been warring for some time.

Then, if we do pass on the call to a division, it gets categorised, prioritised, and then sits in a queue until someone in a locality picks it up and reads it. They read what was written by the call handler, not what was actually said, not understanding the intonation in the voice, not hearing the confused shy vulnerable message struggling to be heard over and above the categorisation they are being forced to be placed in.

The call-handler is trained to push away calls deemed not for the police. The unintended consequence is often an escalatin of the incident, until it becomes necessary to respond to with greater attention.

The locality the call eventually gets to, need to call the caller back, to obtain more information that was not detailed on the record. The phone number is tried several times, before contact is remade. The officer who can really help understand and help the caller, finally talks to the person with the problem, and then finally starts the value work of sorting out the problem. Hopefuly it is not too late by then, but it has caused a load of waste activity to ripple through the organisation.

One day someone will come up with the bright idea of in the first instance, getting the caller to talk directly to the person who can help them resolve the problem, and that same manager who set up the big building full of call handlers will find that the cost of doing this is considerably less than the old way. And, as a by product, the service is markedly improved.

It is what happens to all such contact centres if they are analysed in the right way, but it takes so many of us to make the expensive mistake before we learn that lesson. By that time, a new manager has taken the reigns, and they have a great idea to solve the cost of different localities taking their own calls... The wheel goes round again.

Take a systems thinking approach to this problem, and the right solution will be clear.

Scottish policing article from Ian Wiggett

So, you have decided to log demand into the police. Make sure you look at all the demands coming in, they come in on the phone, by email, and into the enquiry counters. And what about when officers are on the beat, and from the phone at enquiry counters, don't forget those...

Then a table is made up of demand. And if youre thinking a little further, you decide to focus using an outside-in perspective, to see what REAL demands are coming in. So split the demand into value and failure demands. Take a systems thinking view of demand.

The demand coming into the police are far more tricky to analyse than transactional based system. Why? well, because these demands are:

1. They are varied. Some demand is a simple questions, some are for requests for police service, and others are just plain calls for help. If you try and combine them together, on a spreadsheet, then you may be working with data that is just too summarised to make any real decisions on. A demand for a shotgun licence, to a call to attend a historic burglary, to a call for a domestic issue, to a call asking about help on a civil matter. Some of those demands will take a great deal of time to answer, and what matters to the caller and the subsequent response is vastly different.

2. In a simpler system, like a bank, a demand is a call for service, and the service delivery follows that demand. With the police a demand may be followed up by subsequent demands, that are of value. They represent communciation that is part of the flow of work. Maybe in these cases it is better to view these demands as in process demands.

If you treat the demands above as the same for computational and analysis purposes, you will aggregate apples and pairs as being the same fruit. And how useful will the information be? Maybe a better way is to look at the police system from an outside in perspective, and group demands into:

a. Transactional demands - that starts as a demand from the public, and the police provide a service or answer, and then it is complete. These transactional demands can then be further categorised.

b. Help me demands - where a member of the public needs help and support. These cases are sometimes complex, sometimes not directly do with the police, and their resolution may be long term.

c. Different types of demands follow different flows of work. If they do, then these demands are different and be wary of aggregating them into statistics.

So, whats the best thing to do with demands into the police? Be very wary of categorising them to any standard apart from that from the outside in perspective, and use what matters as a guide. Then you will create groups of demands that will truly be useful to operations to analyse how to deal with them.

Real Lean, when combined with systems thinking, gives a view of your organisation that is often difficult to view, in todays pressured and prioritised environment. Using it will help you to see why certain issues remain resistant to change, regardless of how many consultants, or how much money is thrown at it.

A link to Joan Donnelly article on Demand, from Policing Insight here

I was reading an article writen by John Bird, he of the Big Issue. In it he talked about the benefits system, the TV programme Benefits Street, and the ability to 'benefit' people. He has hit on a point that has been demonstrated in the last few years, by a few people.

In Stoke on Trent, they have experimented with trying a different way to deal with people who are struggling with something in their lives. This struggle is affecting them in ways like an inability to pay rent, running out of money, needing to get on the waiting list, etc.

What the team did was to take some people in need, and ask them what problems did they have that they needed help with? And whatever they said, the team would go about helping the person to fix that problem. It was that easy.

Chief executives from a range of public sector partners has agreed that the team has the ability to pull on any service they needed to to get the competence to fix the problem. In addition, the action they took and money they needed to put towards helping that person, was available to be spent.

The team took cases, and the first step was to understand the problems the person was facing, and the nature of their problems in the context of their lives. The next step was to then do only what is necessary to help the person resolve their problems.

What was found, was that the people they took, had a range of interdependent problems, that often took time to properly understand. Often, people were wary of this approach from an organsiation they did not trust.

Then, the team found that the problems that were presented with, were not usually solved by taking the standard approach that that service would normally take. For instance, if someone wanted to move, the first thing to do is to understand the reason for the move. It was discivered that most people who wanted to move, actually had problems that could be resolved, that meant that they then did not need to move.

The outcome is that the people with needs to be resolved, actually had their problems fixed, or had ways that they could continue to resolve the issues on their own. The majority of people that went through this system accepted the help, and the outcomes were positive in every situation.

It is difficult, in a short time to view actual financial benefits. However, the team calculated that for seven cases, the difference in the cost of the work done was £104,000 less in the new way. Even understanding that this figure is an estimate, the amount is staggering.

Another outcome, and one that is just as important, is the impact it had on the people. The intervention on each person was aimed at re-balancing them so that they could then continue to live their lives to develop into becoming independent of the welfare system.

The reason I wrote this example now is that John Birds article said that the benefits system should 'benefit' people. Benefit people in need, to help them to fix problems and improve their lives. The work that has been trialled, using a systems thinking approach, shows that this is not only possible, but that it actually reduces the cost to the whole system. The cost further reduces over time, as people are less dependent and more in control of their lives.