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Sustainability and systems change

Julian Corner, Lankelly Chase Foundation

24 November, 2016. CCSP Annual Conference

We stand at a point in our history when we are faced with problems of such complexity that

our only hope of finding a way forward is through deep patient collaboration. And yet it is

precisely at this moment that the demand for ‘silver bullets’ has become almost irresistible.

In the care sector, we’ve known for decades that we offer too many sticking plaster

solutions to some of our deepest problems. Too many crisis interventions when we should

be shifting money upstream into prevention. Now, as the money is draining out of the

system, the temptation to reach for quick fixes to deal with growing pressures will only

intensify, despite our best intentions and our collective wisdom.

So where can we look for role models to teach us the virtues of playing the long game?

The long game

Seven years since he first became World No.2 tennis player, Andy Murray recently became

World No.1.

A remarkable, towering achievement – but what brought it about? Is it simply that he is now

a more talented player than the rest? Is he just that bit more determined? Talent and

determination surely played a big part but there’s an awful lot more behind Andy Murray’s

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success than that. He has a team of coaches – the great Judy Murray, the unreadable Ivan

Lendl - medics, physiotherapists, sports psychologists, nutritionists, a tour manager,

publicists, technicians who look after clothing and racquets, a growing family providing

emotional and moral support.

Together, this forms a whole system that supports his physiology, his psychology, his game

plan and his technique. This is a system that has had to continually adapt, learn, evolve, as it

has worked out the margins of difference between Andy Murray World No.2 and Andy

Murray World No.1.

It is tempting when you see his extraordinary efforts on court to believe that Andy Murray,

the man, is World No.1. But this is the hero myth that endows him with almost super-

human qualities.

For anyone who has watched Murray’s slow painstaking rise to the top, that explanation

seems inadequate. Rather than asking ‘who is World No.1?’ we should rather by asking

‘what is World No.1?’. The answer to that question is Andy Murray the system. Andy Murray

the man plays a crucial part in this system, but he is not the system.

Occasionally we see a virtuoso player burn bright and fade almost as quickly. Sustainable

results are produced by sustainable systems.

Interventions vs systems

We all know this in our own lives. Sustainable weight loss comes from a balanced diet not a

crash diet. A rewarding life is sustained by a network of friends, family, colleagues and

community.

If I aimed to emulate Andy Murray’s achievement, you would think me pretty naïve if I tried

to get there by taking the same vitamin supplements, or if I turned up brandishing his tennis

racquet, or even if I splashed out on lessons with Judy.

It is obvious that it isn’t any one of these things that led to his success. While each is crucial,

it’s the interplay between them all that ultimately counts.

And yet, how often do we act as though a single intervention or project will create the

difference we want in someone’s life? We have commissioning systems, policy documents

and fundraising campaigns that hinge on the idea that one thing can make all of the

difference.

We call this confidence in the power of single interventions that can be replicated and

scaled ‘What Works’, an overly confident phrase if ever there was one. Commissioners and

funders now require organisations to provide evidence that their interventions literally

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produce social outcomes, as if creating social change was as simple as one brand of tennis

racquet striking a ball better than another.

What makes this faith in single interventions particularly baffling is what we know about the

complexity of the problems they are trying to solve.

Problems as systems

The problem that the Andy Murray system has been trying to solve is called Novak Djokovic.

Djokovic has seemed an almost insurmountable and impregnable barrier between Andy

Murray and greatness. And while Djokovic might look to us like another man hitting a tennis

ball, he is also a system made up of coaches, dieticians, psychologists, family members, and

so on. And this is a system that doesn’t stand still waiting to be beaten. It changes and

adapts over time, constantly improving, often reacting directly to the Andy Murray system.

These two systems over time have shaped each other.

The social problems that are our interventions are trying to defeat are also best understood

as systems. Inter-generational worklessness, the revolving door of homelessness and prison,

the cycles of violence and abuse within families, the dual diagnosis of drug misuse and

mental illness, entrenched poverty. These are all remarkably resilient systems made up of

many interdependent parts, that adapt and change all the time, that are self-perpetuating,

that resist our best efforts to make a difference.

Systems, adaptation, disruption

What Andy Murray understood was that to disrupt a system as intractable as Djokovic, he

needed a system even smarter, more able to learn, adapt and evolve. It takes a system to

defeat a system.

What Murray also knew was that his system needed to be sustainable. His path to world

no.1 was famously long, partly because the Djokovic system itself proved so resilient and

sustainable.

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My argument today is grounded in the idea that the social problems we face are so complex

they have become self-sustaining systems that adapt and evolve over time. And if we are

going to stand a chance of disrupting these systems, when so many attempts have failed

before, when our resources feel ever more dwarfed by the scale of the task, then our

systems need to adapt and evolve faster, and endure longer that the systems we seek to

defeat.

The most important lesson about sustainability and systems comes of course from the

environment. Ecology defines sustainability as “the property of biological systems to remain

diverse and productive indefinitely”. The reference to diversity here reminds us that

everything in nature, including our own bodies, depends for its survival on continual

renewal and evolution. In nature, things that stay the same die.

So, a system that is capable of sustainably producing positive social outcomes has to contain

ongoing disruption and change. Tiger Woods continually reinvented his swing during his

decade as the world’s no.1 golfer. People thought he was mad to do this, that he’d got the

best swing going and shouldn’t mend what wasn’t broken. But he knew that sustainability

requires continual risk taking.

Different thinking, different goal

And this is exactly the right time to be thinking differently about sustainability. Scotland, just

as England did 4 years ago, stands to lose considerable capacity from its care services. The

sustainability of those services, and therefore the results that they seem to produce, faces

enormous risk. The instinct will be to push for “more for less”, which as we all know is code

for stretching resources as thinly as they will bear. Commissioners and politicians

understandably will want to show that they are still covering all bases, keeping the show on

the road, despite the cuts.

However, while these are new pressures, they will only sharpen a problem we’ve already

got. And that problem is an unsustainable reliance on single services to solve complex social

ills. To be clear, the capacity of services is critical. Andy Murray cannot win matches without

his racquet, no matter how good his system is. We need excellent, well-resourced

interventions. But our urgent concern for the sustainability of services and interventions

should not distract us from the central insight that the social changes we seek emerge from

whole systems, not from individual services, projects, organisations or people.

Viewed through this lens, our collective goal shifts from ‘getting more for less’, to ‘creating

systems that can sustainably produce positive social outcomes in highly complex, changing

environments’.

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The systemic lag

Before I go on to explore what such a system might look like, I want briefly to look at the

current dominant model we use to produce social outcomes. This is a gross simplification,

but this is roughly what we think the system is doing:

A problem-defined group is objectively identified, we then apply a methodology to help us

prioritise within that group, in this case a risk assessment, and then we provide

interventions based on evidence of previous success, which we hope or even expect will

result in desired outcomes.

That is what we think or say the system is doing, roughly.

But we live in a world where our response to social problems lags behind the fast changing

reality of those problems. Our interventions are delivered by large institutions that find

change difficult. And what emerges from that lag looks a lot more like this:

Our response starts almost inevitably with the risk assessments and interventions we have

available, and indeed with the desired outcomes that we attach to those interventions. And

so the problem we seek to solve is shaped by the solutions that we offer, not the other way

round.

The way we define and view homelessness is shaped by the infrastructure of our hostels.

The way we define and view drug misuse and mental ill health is shaped by the diagnostic

techniques and treatments we have available. The way we define and view offenders is

shaped by our prison estate. In all cases, the fundamentals of these institutions were set

decades, even centuries ago.

The fall out of this is represented here by analysis undertaken by Dartington Social Research

Unit of young people in several local authorities across Scotland, England and Wales.

Problem-defined group

Risk assessment

Evidence-based

intervention Outcome

Problem-defined group

Risk assessment

Evidence-based

intervention Outcome

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The large circle is all the young people in the local authority. The medium-sized circle is all

the young people with multiple high end needs in that local authority. And the small circle is

all the young people in services apparently targeted at young people with multiple high end

needs. As you can see, the majority of young people with multiple high end needs are not in

these services, and the majority of young people in these services do not have multiple high

end needs.

What this suggests strongly is that the profile of young people in services is driven as much,

if not more, by the shape of the interventions than by the actual underlying needs of the

young population locally.

Systems and complexity

People are almost inevitably more complex than the services we commission to serve them.

This Venn diagram, produced for us by colleagues at Heriot Watt University, brings together

data in the same year from the homelessness, drug treatment and offender management

systems in England. (The Heriot Watt team are going to reproduce this exercise in Scotland

in the coming year.)

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As you can see, most people found in the homelessness system – about 2/3 – also show up

in the offender and drug treatment systems in the same year.

Same people, three labels, three systems, three methods of risk assessment, three sets of

interventions, three sets of desired outcomes.

The consequences of this are felt most acutely by those people at the centre of this Venn

diagram, those in all three systems. A mere 34 per cent said they could really count on their

support worker to listen to them. And a vanishingly small 14 per cent said they could really

count on the help of their support worker in a time of crisis.

What we see here are people who have been systematically pushed to the margins – and

often beyond the margins – of the very systems that were set up to support them.

This has me wondering why we humans find it so hard to contend with complexity. It seems

our instinct is to break it down into manageable chunks. It is how we are all taught to

problem solve at school. And it helps us deal with the anxiety of being overwhelmed. If I

can’t fathom the full complexity of someone’s situation, it helps if I think of him as a

homeless person. That way his problems are reduced, in my mind at least, to the shape and

scale of the solutions I have to offer.

I liken this to trying to deal with an unmanageable elephant by cutting it up into chunks.

What this doesn’t produce is lots of smaller more manageable elephants. You’re just left

with chunks of an elephant. The organic whole that is the elephant would be dead. But this

is how we try to cope with social problems. We attempt to break them down into their

constituent parts as if the connectivity didn’t matter.

This brings me back to the point that it takes a system to defeat a system.

So what might systems look like that could sustainably produce positive social outcomes in

highly complex, changing environments?

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Sustainable systems

I think one of the reasons many people can’t get on with the word ‘system’ is because it

immediately makes them think of this:

So when people say ‘we need to change the system’, there’s that heart sinking feeling that

we’ve got to talk about structures and processes, not about people.

What we rarely acknowledge is that the system this represents is a relatively recent

invention, based on new public management principles. It has arisen to deliver ideas like

scale, standardisation, measurement, evidence, performance and competition.

This is the tool kit we pick up every time we’ve got to solve the conundrum of diminishing

resource and rising demand. And now, at least south of the border, we are devising ever

more ingenious and complicated tools, such as payment by results and social finance, in

order to get the money to work even harder.

This tool kit has pros and cons. What it cannot do is magic money out of thin air. So when

faced with significant financial constraints, it stands continually on the brink of a death

spiral, in which it doubles down on controls such as procurement and inspection, drawing

more and more energy away from the frontline where the demand is rising.

But what if we drew a system something more like this:

Budgets

Risk

assessment and triaging

Inspection

Performance management

Procurement

Commissioning Service level agreements

Delivery chains

Eligibility thresholds

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As you can see, we’ve still got the other system in there, now as a sub-system, but what this

recognises is where a system’s capacity actually lies.

The most significant actors in this system are the community, or civil society; the people

themselves, or service users; and the frontline, the workers and volunteers. Collectively,

these parts of the system dwarf the rest. This is where the scale is.

As we saw in my diagram with the three circles, the majority of the young people with

multiple high end needs were not in services, they were outside the formal system

somewhere in civil society, presumably getting their support from people in entirely

unrecognised, unregulated ways. And many of those people at the centre of the Venn

diagram who said they couldn’t rely on support workers to listen to them or support them in

a crisis said they could rely on family and friends.

The community

An obvious starting point, looking at this representation of a system, is community

development. If most people are supported informally, then we’d better make sure we’ve

helped build resilient bonds and bridges within the community. At Lankelly Chase, we are

seeing organisations that have relied on service solutions for decades increasingly realising

they shouldn’t even think about service solutions until they’ve first built up a sustainable

bedrock in the community. And when their services do become necessary, they should work

with the grain of that community, not across it.

In Salford we’ve seen Unlimited Potential using positive deviance methods to reach

disengaged, unemployed fathers who go nowhere near a service, and indeed whom services

go nowhere near. We’ve seen St Mary’s Community Centre in Sheffield using appreciate

enquiry to reach highly isolated South Asian women who again are completely off the radar

of services. And we’ve seen Coventry Law Centre (with Grapevine) extend beyond their

The community

The

people themselves

Organisations

The frontline

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rights-based approach by engaging in asset-based community development to reach

families who don’t access legal advice.

For me, this is a very interesting evolution of the system. The fields of community

development and care services have taken increasingly divergent paths in recent decades. It

often feels like they are discrete solutions to discrete problems, and indeed they’re often

commissioned by entirely different parts of health and local authorities.

But many of the organisations we now support are showing that it is possible to develop

communities by including highly marginalised people from the very outset. In fact in Greater

Manchester, this focus on ‘what’s strong not what’s wrong’ in people is starting to feed into

the wider push for inclusive growth.

The people themselves

Which brings me to the people themselves - in quantitative terms, the second largest part of

our system, but in qualitative terms the most important by far. After all, the sustainable

change we are seeking is in the lives of these very people. I can’t think of anything less

sustainable than the way we view people as risks to be managed, and as needs to be met.

The problem is hopelessly framed in terms of unending scarcity.

Some of the most exciting practice I see relates to people from the very outset as (what you

might call) the ‘best versions of themselves’. They dispense as far as possible with the often

toxic processes of risk management. They relate to people as fully contributing, purposeful

human beings.

The Mayday Trust has ripped up its risk- and needs-based approaches, and now offers

people personal asset coaches. It seeks to bring out the talents, ambitions and problem

solving capacity of the people it serves, and to broker opportunities for them within their

wider community.

Camerados believes that you can find a homeless guy a flat, but if he sits there dying of

loneliness and boredom, then you’ve only shifted the problem. They bring socially excluded

people together to build friendship and purpose, finding out what they’re good at and

creating collective challenges, like setting up a café. Behind the labels they discovered

plumbers, business women, piano teachers, chefs. Talents in people that haven’t been

acknowledged or used for years.

And Love Barrow Families has brought co-production to the very heart of child protection,

helping families and social workers design a service together that inspires change in the

families and reignites the motivations and values of the workers.

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The frontline

And it’s the motivations of the frontline that form the third largest part of our system. When

faced with complex problems, every leadership manual in existence agrees that you need to

delegate problem solving as close to the problem as you can. Senior leaders cannot see the

fine grain of the situation, are blind to its context, will not spot its unique dynamics. Any

decision they take from a distance will fail, and will trigger perverse consequences.

We often relate to the frontline as a workforce that needs to be trained, managed and

monitored, as transferable units of delivery that can be TUPEd between organisations. We

tightly prescribe their roles for fear that they may become ‘unboundaried’, ‘go off piste’ and

‘collude’ with their clients.

But these are the people on whom we rely to do the moment-by-moment creative problem

solving that will allow our system to produce sustainable results.

I’ve met so many people who were ready to leave the caring professions because they had

been pulled too far from the values and motivations that brought them in.

Many organisations we work with have found it necessary to reframe the frontline, from the

treadmill of case work to the creativity of systems leadership. Because truly, this is the part

of the system that should be leading the rest.

At Cyrenians, they have been using Egan’s skilled helper model to refresh the role and

crucially the values of their frontline. This allows staff to coproduce their role with their

clients. As one person said to me there: “I don’t know what my role is until I meet the

person, then we work it out together”.

At the Holy Cross Centre in London, they have framed their organisation as a mutual

learning community, where their staff and their service users are expected to learn

continually from each other. The hierarchy of the helper and the helped is flattened, in the

expectation that each has as much to discover in the relationship.

And in Glasgow, the three homeless crisis providers have created the City Ambition

Network to tackle entrenched homelessness. At the heart of this network are key workers

who have formed a problem solving community of practice. If they need resources to be

shifted, they can call upon a group of operational managers. And if they come up against

obstacles that need policies and procedures to change, there is a steering group of CEOs and

senior managers who can effect system change.

As Lorraine McGrath from Simon Community Scotland said to me, the key worker group is

where all the magic happens. She likened it to the self-directed model of nursing in the

Netherlands called Buurtzorg. The change is driven from an empowered frontline, holding

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each other to account across organisational boundaries, with the management and

leadership following the direction they set.

The organisations

As all these examples demonstrate, these attempts to think and act systemically are in turn

shifting people’s understanding of what organisations are for. From commissioned

deliverers of services to enablers of a three way relationship between the community, the

people themselves and the frontline.

In some instances we are seeing organisations such as The Winch and Save the Children go

further and step back from a delivery role to work more strategically in localities, as

backbone organisations, supporting collaborative action across the whole system.

Collective impact and children’s zone models are starting to look more compelling as

organisations realise that their capacity to fulfil their mission through delivery alone is

becoming increasingly constrained.

Systems and change

As the difference between our first and second system illustrates, where you place the

system boundary, what you consider to be part of your system, reveals where you think the

change is going to come from, and hence what you think you should be trying to sustain.

A system led by procurement and contracting is limited to those parts that can be

controlled. It only wants the results that it can plan for and purchase.

A system led by the community, people and the frontline is open to results that can’t be

planned for or purchased. There is a recognition that no one, in fact, controls the system,

and that the controls we impose are only illusions of control.

In this system, the role of procurement and commissioning is to ensure that all the other

parts are able to contribute to their fullest potential. After all, a system can only ever be as

effective as its least powerful part.

This is why the decision by the Life Changes Trust to invest heavily in Who Cares? Scotland

seems such a canny system intervention to me, because it seeks to restore young people to

their rightful prominence within their system.

But as the City Ambition Network demonstrates, we need more than high performing parts

to create an effective system. The way they connect is equally critical. The different parts of

the City Ambition Network act as one system aiming for a collective goal.

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And when I say parts, I obviously mean people. In any system, it is how people, with all their

emotions, fragilities and quirks relate to each other that allows the system to function. And

this comes down to a set of behaviours.

System behaviours

In all the work that we are privileged to support, we see time and again that, regardless of

the issues being tackled, the people who are able to work effectively in complex systems

exhibit a common set of behaviours.

1. People see themselves as part of an interconnected whole

2. There is shared purpose and vision

3. Feedback and collective learning drive adaptation

4. Open, trusting relationships enable effective dialogue

5. All people are viewed as resourceful and bringing strengths

6. Power is shared and equality of voice actively promoted

7. Decision making is devolved

8. Accountability is mutual

9. Leadership is collaborative and promoted at every level

We hypothesise that it is the presence of these behaviours, more than any specific

methodology or style of intervention, that can create in systems the agility to stay one step

ahead of the problems they seek to address.

The community

The

people themselves Organisations

The frontline

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And we notice that the leaders we work with view their interventions, organisational

structures and processes, as well as their funding, all as vehicles for promoting these

behaviours. And this is because they equally describe the results we want as much as the

ways of achieving them. There is alignment between means and ends.

This list, or a variation of this list, would not look out of place in a Harvard Business Review

article on twenty first century leadership and management. And you would be stretched to

find a leader who didn’t at least say they were trying to promote most of these values

within their organisation.

So this being the case, the question arises of how these behaviours can be successfully

promoted between organisations, and between organisations and those they serve, and

between commissioners and organisations.

And here, I would suggest, is the rub. The ability of organisations to exhibit these behaviours

relies to a very large extent on whether they are mirrored in the wider system. A low trust,

command and control, highly transactional commissioning system cannot purchase deep

relational approaches. It doesn’t compute. There has to be alignment.

As such, these system behaviours can also be thought of as ‘governance principles’ for the

whole system. If we want to free people up from restrictive targets, then a system behaving

like this would be pretty self-regulating, with many more points of accountability at each

and every level, horizontally as well as vertically. And it would generate its own

sustainability because growing diversity in the system would surface new evidence, new

solutions and new resources.

Promoting these behaviours across systems will not be easy, and may even be painful, but it

isn’t necessarily the nirvana it may at first seem. The way that we steward the system,

through commissioning, procurement, inspection, and performance management, doesn’t

have to be a dead hand on these behaviours. We can reframe these mechanisms as

opportunities to promote healthy system behaviours. As we are starting to see with models

like Alliance Contracting, there is a growing recognition that how we contract radically

shapes what we contract.

Andy Murray would be the first to say that it takes more than heroics or hard work or a

better game plan to get sustainable results. It takes a system. And at the end of the day, an

effective system is just a bunch of people behaving in one way rather than another. And if

there was ever a moment for us to learn that lesson, then it is now.