Tony 2

I'm finding this platform very useful to explore just how systems thinking is understood in the NHS. I'm not suggesting that this discussion is not very helpful, because it is. However, from a systemic point of view there are a couple of points that might be worth considering. a) FMEA is systematic rather than systemic. b) Standardisation only optimises outcomes if each case is identical. The outcomes of my cooking, for example, are reliably delicious, but what I cook depends on what vegetables I'm working with. I don't boil lettuce or put tomato slices in the toaster.

Yes I do find this useful, mostly because it supports my perspective, I suppose. At the heart of my motivation is frustration that the NHS keeps talking about systems thinking without, apparently, having spent much time exploring the discipline. When looking at what passes for a system model in the NHS, I've found that they almost invariably miss out on two to the fundamental elements of soft systems: i) the feedback loop, without which there is no learning, and ii) a proper system description - a purposive system is not a thing but an evolving social construction that is best described as "a system to.........". Mark has identified the lack of feedback as one of his crucial concerns. Disengagement appears to be another, but if people felt they were participating in the evolution of "a system to" do whatever is under consideration, they might feel more positive about it. The third relevant aspect of my perspective concerns the multiplicity of reporting templates. As far as I can see, most of them relate in some way to systems thinking, so if during induction people were made aware of how systems thinking outside the NHS works, they would have an understanding of the basic model from which these NHS templates are derived. This would both enable them to critique those templates - for example the omission of feedback loops - and also provide understanding of the common underlying structure, which, if you'll excuse the jargon, is the essential principle of gestalt education. If anyone's interested I'll offer the PSL hub some examples of all this. Thanks, Mark.

Hi, as a patient and a systemist I welcome what you say here, but the reason I came to this hub was in the hope I'd find evidence that the blueprint assertion that "ICB leaders and staff need to be adept at system thinking" would be backed up by systems thinking resources. Could someone tell me if there is a clear consensus in your profession of what systems thinking is all about, and, if so, where can I find it?