Single, heroic leaders will be unable to address such problems as they will not individually have sufficient resources or command the necessary authority.
Miller, 2020
Leadership of systems
Background
Systems thinking is based on the principle that complex problems are not due to one constituent element, but rather the dynamic interaction of all the elements. Such insights will be familiar to all who work in health and social care due to the numerous influence that contribute to the wellbeing and safety of individuals and families. Policy makers have increasingly recognised that this is also true on a population level when they are trying to address wicked issues, for example in addressing long-standing inequalities or improving inter-agency processes such as helping people to be discharged safely from hospital. This is why all parts of the UK are seeking to adopt a more integrated approach to local oversight and planning of services.
Defining systems leadership
Systems leadership is a form of leadership which acknowledges that many issues of mutual concern in public services cannot be solved by any one person or institution, and require leaders to collaborate across organisational boundaries.
Systems leadership is often contrasted with the more traditional notion of ‘heroic’ leadership; a model in which a single individual is perceived as driving an organisation to success. A systems leader, conversely, is focused on how they can work with others to bring about change, at times giving away power, or encouraging others to take on a leadership role. As Miller (2020) argues in a briefing on systems leadership:
Solving complex problems
Systems leadership is often seen as a response to the problems posed by ‘wicked’ issues; problems which are multi-causal; difficult to define; socially complex and that require a whole-system, multi-agency response. Systems leadership – involving collaboration across organisations and enlisting the creativity of people from all levels within organisations and from those who use services – is often recognised as the best way to address such seemingly intractable issues. In the space of social care, such problems might include:
- How do we keep adults safe across a complex health and care system?
- How do we encourage a whole community to become more self-reliant and draw on less formal care?
- How do we integrate health and social care systems around the needs of a family?
Core features of systems leadership
Focus on collaboration
Systems leaders seek to collaborate with people at all levels within their organisations, with people in other organisations, and with communities to make change happen.
Co-production and citizen engagement
The most effective forms of systems leadership are those which involve co-production with communities and citizen involvement. Good systems leaders recognise the deep reservoirs of ideas and talent which reside in communities, and seek to co-produce solutions with communities.
Properly embraced, the insight, experience and expertise of citizens can make services better tailored, more sustainable, and ensure that service changes command legitimacy. Services should engage with, involve, and empower patients, carers and the public.
National Voices, 2016
Sharing and sacrificing power
Writers on systems leadership tend to emphasise the importance of leaders being humble and where necessary ceding power. Achieving shared goals may not always be in the sole interest of individual organisations. It may require leaders to share resources, use personal influence and improve performance for others – not just those within their own organisations.
As several interviewees put it in one form or another, “you can achieve almost anything so long as you don’t want to take the credit for it”. You have to “give away ownership”.
Timmins, 2015
Core skills, capabilities and behaviours of systems leadership
A number of papers and writers on systems leadership discuss the typical behaviours, skills or capabilities that systems leaders require. These tend to include:
- identifying and scaling innovation (e.g. from pilots)
- having a strong focus on outcomes and population health
- building strong relationships with other leaders, and often working with them informally to develop joint priorities and plans
- establishing governance structures which drive faster change, often going where the commitment and energy is strongest
- setting the overall outcomes and expectations on behaviours, but handing day-to-day decision-making to others
- supporting the development of multidisciplinary teams
- designing and facilitating whole-systems events and workshops to build consensus and deliver change
- understanding and leading cultural change
- building system-wide learning and evaluation frameworks
- fostering a learning culture across the whole system
- being comfortable with diversity and uncertainty
- having a facilitative rather than directive style of influence
- embracing values of positive difference and equality
- accountability to local people and communities.