Six challenges to becoming an effective system leader

'We are in the century of the system!' declared Dr. Atul Gawande in his 2014 BBC Reith Lectures. And there is indeed much talk today of health and care systems, thinking systemically, complex adaptive systems, whole systems and so on. But what are the leadership implications of this way of working? What do people need to do well?

This is written from my perspective as a consultant working in Leadership and Organisational Development for over twenty years, with a particular focus on the health and university sectors over the last decade. I am currently providing Organisational Development support to one of the Clinical Senates, and had the recent privilege and pleasure of designing and facilitating a workshop on System Leadership for senior Clinical Senate Council members. This short piece builds on the learning shared and developed in this workshop, and sets out important challenges to be overcome in order to become an effective system leader.

Firstly, let me define my terms - I am using the phrase ‘system leader’ to refer to anyone who is involved in leading services, people, change, transformation, improvement, projects etc, which span boundaries. These could be organisational, professional, departmental, sector,and geographical boundaries, or indeed a mix of these. The key challenges I see facing system leaders are as follows:

1. Having the ability to step back
   It is important to be able to step back from solving the immediate problem, with which you are faced e.g. patient flow, to identify the links and connections to other parts of the system, to be able to see the wider picture. If you attempt to make changes in one part of the system, what impact and consequences will this have on other parts of the system?
    
2. Able to operate in a VUCA environment  
   Developing a level of comfort with an environment, sometimes described as VUCA – volatile, uncertain, complex and ambiguous. This is the nature of working in a system. It does not offer the greater clarity and certainty of only having to consider one’s own organisation in taking decisions. Given this novel environment, there is often the need to build an evidence base to persuade others, as a fundamental part of leading work effectively across a system.
    
3. Influence without line authority     
   When leading in a system, it is often not possible, nor desirable, to attempt to tell other people what to do. The sources of power which leaders may have relied on to get them to a position of authority in their own organisation are unlikely to work in these conditions. Instead, the abilities to be influential without having line authority, to build diverse teams, and to network effectively are vital.  
    
4. Collaborate and engage key stakeholders      
   A much greater emphasis on collaboration is required, with the attendant skills of being able to ‘let go’ and share power and control, handle conflict well, and build coalitions of different types of people. These include patients, service-users, carers and clinical leaders. Without their engagement, the ability to bring about change and improvement is severely constrained.  
    
5. Demonstrate greater openness   
   In general, there is a need for greater levels of openness, when leading a system – an openness in thinking (not being limited by past assumptions), an openness in attitude (being able to see the positive impact of a variety of perspectives), an openness in intention or values (to do what’s best for patients and the population), and an openness in learning (being able to unlearn unhelpful past behaviours, and learn new ones more suited to a systems perspective).  
    
6. Personal qualities and skills
   Last but not least, a particular set of personal qualities and skills is needed to lead a system, or within a system, effectively. These include patience (it often takes more time that you think it should to build support for change), persistence (the determination and flexibility required to succeed should not be underestimated), and resilience (setbacks along the way are inevitable). Networks can again be of great support on this journey. It is also important to be generous in any successes you have – these will inevitably be the result of the efforts of many other people, and this should be explicitly recognised. Finally, the ability to reflect on, learn from, and share experience with others, both successes and failures, is vital.

Do you recognise these challenges? Are there others you would add? Please let me know your thoughts.

Andrew is a Leadership & Organisational Development Consultant, www.twitter.com/ConstableAndrew