System leadership: where can our leaders practise without breaking things?

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One of the great things about being a learning and development consultant at The King’s Fund is our unique role in supporting leaders from across the system. These leaders always come with a wide range of experience, many are incredible technical experts, many manage significant resources, and all play an essential role in the health and social care system. They are often greatly valued and respected within their own organisations and have a clear commitment to their own and others’ learning. But they are now facing a new challenge – the challenge of working beyond their current teams, directorates and organisations, of becoming a more effective system leader.

Here at the Fund we have regularly highlighted the importance of working across systems and of system leadership. The research base on system leadership is diverse by its nature, as systems span pretty much everything in modern life, but it has now been translated into many areas of leadership practice in health and care – so much so that it is highlighted not just by the academics but also by the government and our national public bodies. System leadership isn’t going away any time soon.

'"Great leadership" is no longer about being the cleverest person in the room, the one who can come up with the brilliant solution'

The NHS long-term plan sets out a clear expectation that leaders from different parts of the health and care system must work together in order to inspire the system-wide change. And there is now an acknowledgement that those in the next tier of leadership will need more than traditional leadership and management skills to succeed… that they need to do more than operate in the traditional hierarchies… that taking up the role of good corporate player, useful as it may be, may no longer be enough!

What is needed for this increasingly complex and interconnected world in which we now all live – a world where change is now constant and our working lives so unpredictable?

Many of our leaders are now being encouraged to accept that not everything can be predicted, directed or even understood, that the detail in their well-crafted plans may not get the expected outcomes, and that ‘great leadership’ is no longer about being the cleverest person in the room, the one who can come up with the brilliant solution.

A new vision is being suggested ‘if you want to progress further as a leader in this new world, then you will need to come with a new mindset and be up for utilising some new tools’.

This new mindset, put simply, has systemic thinking at its core. We now need our leaders, at all levels, to work with what emerges as well as what was planned, to sit with uncertainty and to embrace self-organising principles. We need them to seek out collaborative partnerships and conversations, to ask questions and be curious, and, importantly, to invite others to do the same. They need to embrace complexity, bring a fresh approach to old and familiar problems and be up for self-reflection and experimentation.

Our leaders are being asked to seek multiple perspectives on collective issues and to head towards difficulties (rather than run for the hills). They are being asked to connect with as many parts of the system as possible – proactively getting the right system players, communities, and users in the room. They are being asked to critically explore the roles that are taken up and think about their leadership in this context. They are being asked to support engagement, risk-taking, and innovation – to hold a space for people to share, learn and improve together – and to use their personal authority and influence to develop effective alliances.

'The NHS long-term plan sets out a clear expectation that leaders from different parts of the health and care system must work together in order to inspire the system-wide change'

Does operating in this new world sound a bit scary and unfamiliar – and how can people get the experience they need? There are some useful theorists out there to help us shape our thinking and actions. For example, ideas that can get us to think below the surface and identify group dynamics often help (Bion 1961). Recognition of complexity (Stacey 1996) and living systems (Rogers et al 1996) give the leaders a useful lens to view the world through, and ideas around dialogue (Bohn 1990; Isaacs 1999) and reflective practice (Schon 1983) add to a helpful mix.

When I presented some of these ideas to a group of emerging system leaders this month, one of them proclaimed excitedly ‘This is my first exposure to some of this, and I’m really sold! ... What you’re presenting offers some new ways of thinking! … But where the hell do you practise without breaking something?’.

The challenge for our smart adult learners is rarely about understanding the ideas and frameworks and more often about how to apply them in the real world. What is key here is that the development – and eventually the practice – of system leadership relies on one honing one’s skills with, and in relation to, others.

So that practice sometimes just needs to happen within the local system around the real work (hopefully with some care, compassion and recognition that mastering anything takes some time). That said, if you feel you could benefit from an intensive grounding experience that may allow you to fold some of the helpful theory into your direct practice then you could do this with the Building your authority programme.

Building your authority

This programme will equip you with the practical tools to build your personal resilience, understand your own leadership, and work effectively with colleagues, patients and communities to enable change.

Learn more

References

Bion WR (1961). Experiences in groups. London: Tavistock.

Bohm D (1990). On dialogue. London: Routledge. 

Isaacs W (1999). Dialogue and the art of thinking together: a pioneering approach to communicating in business and in life. New York: Crown Publishing Group.

Schon D (1983). The reflective practitioner: how professionals think in action. New York: Basic Books.

Stacey RD (1996). Complexity and creativity in organizations. San Francisco: Berrett-Koehler Publishers.

Wheatley M, Kellner-Rogers M, Lichtenstein B (1996). Leadership and the new science and a simpler way. San Francisco: Berrett-Koehler Publishers.

Comments

Simon Gilby

Position
Chief Executive,
Organisation
Covenrtry and Warwickshire Partnership NHS Trust
Comment date
12 December 2019

A great blog Mark thank you and, as ever, I applaud the role the King's Fund plays in helping to drive our thinking. I agree the NHS long-term plan 'sets out a clear expectation that leaders from different parts of the health and care system must work together to inspire the system-wide change'. I see this as a helpful reminder of what the best of NHS leaders have been trying to do since, well, as far back as I can remember. Don't we all have a duty of partnership?

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