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Max St John

The simple beyond the complex (More thoughts on the NHS)

I’m on an open journey to find out if I can support positive, purposeful change in the NHS

Sharing that intention has turned up lots of interesting people who share it – and each conversation is helping me refine my thinking or point me to other new people.

Every time things evolve, I’m trying to keep a note on here. My last conversation was with an executive coach who’s been working with the NHS for some time.

They gave me some valuable insight on the way the NHS supports its leaders, how well that is working (and/or it isn’t) and what those leaders might be needing.

I don’t feel like I can share all of that detail – although I believe in openness at all times, that has to be with respect for others. But, they did raise some critical issues that are worth exploring.

Their experience – and mine – is that everyone who they’ve met working in the NHS is values-driven, committed and working their backsides off to do the best that they can.

People go into the NHS because they want to use their skills, expertise and energy to care for other human beings. But in these large, complex and often stretched organisations, a lot of that precious energy is spent managing the system and keeping it off their backs.

Something about this system has them trapped. They keep trying to put their energy into the patient but they keep having it pulled away.

Even in my small organisation, something about this resonated like a gong in my head. Despite being a 14 people operation, I’ve put a lot of energy in the past year into managing the system, which I could have been spending on work with my clients and ‘the outside’. Of course, some of that is entirely necessary and helps others be their best (I like to think), but some of it is avoidable and unnecessary.

My latest connection introduced me to an idea that summarised part of this problem nicely: the simple beyond the complex.

We create, or find ourselves inside, these complex systems and structures, which end up taking over our thinking. Unable to consider all of the information in front of us, while holding all the potential decisions and understanding all of the likely outcomes, we can find ourselves overwhelmed and paralysed.

But – if at some point we can pop over the top of all of this – to look beyond it all and say: “I don’t know the answers but I’m sure we can work it out”, we can make everything much more simple. And start to draw in more information and diverse perspectives.

The trouble is that in many large organisations the systemic thinking is still: “I’m the leader, I should know what to do.” And I think this translates down and across, as much as it is a ‘leadership’ issue. The idea of saying: “I don’t know” is terrifying and leaves us trapped. Which can also leave us closed and alone.

So the opportunity is to help more people admit they can’t know all the answers and just deal with what’s in front of them. To put aside the fear of failure or not knowing. To accept that no one can know how things will pan out but we can act mindfully in the moment, and ask for help.

Then we can start freeing ourselves from the stickiness of the complex system and start focusing more of our energy on our purpose.

An opportunity not just for those people working in the NHS, but in other large systems, too.

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One Comment

  1. Telmo Carlos

    Great stuff Max. Keep going. This change is much needed.

    Posted 18th November 2014 at 9:08 pm | Permalink