Systems thinking in partnership working for wellbeing and health practice in an English city: absent competence or constrained capability?

I know it is a long name for a blog title – but that is the working title of my research project.  I thought I would share here the first iteration of the Introduction and Background for the project – in the hope that any reader can offer comments or new perspectives.  It’s all been done to strict word limit guidance – there was so much more I could have included…

So here it is: Continue reading

Ideas for my research project

(T847, Block One, Activity 1)

The quest for this activity is to identify particular ideas, concepts, theories, arguments, propositions, techniques, tools, case studies – in fact any material – that I have found particularly interesting in my studies to date.  An odd question because if I did not find all of it interesting I would not have got here.  Nonetheless, what is particularly engaging my interest right now?

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Governance for health in the 21st century

The World Health Organisation (WHO) European Office commissioned a study into ‘Governance for health in the 21st century’.  The primary purpose of the study is to inform the WHO European Region’s new policy Health 2020.  It was carried out by Ilona Kickbusch who I heard speak about the early stages of the study at the WHO European Healthy City Network annual meeting (Liege, June 2011).  The final version of the study formed part of the papers at the sixty-first session of the Regional Committee for Europe and is available here.

There are a couple of reasons why this paper interests me.  Continue reading

Outcomes

Way, way back I wrote a post on Systems perspective on health and wellbeing where I touched on the problems associated with performance frameworks derived from the concept of ‘outcomes’.  Although the post was ages ago, it’s still something that is current in my mind – not least because my friend who I mentioned in that post is currently writing a paper about this very issue.  I read through an early draft and am looking forward to his next version.

My exploration into projects, which started with this post, has just brought me into touch with some interesting material – you know, when someone else explains really well what you have been thinking but have been unable to articulate. Continue reading

A need for social learning?

The UK government outlined their ambitions relating to the domain of wellbeing and health, in a range of publications including:

At the time of writing the related Health and Social Care Bill 2010-2011 is currently before parliament.

Stakeholders in the city where I work have responded to these changes as an opportunity for a step-change in the way in which we organise ourselves to work together to improve wellbeing and health and reduce inequalities in health. Senior leaders of the main statutory partner organisations have agreed to what is locally referred to as “a whole system approach” to the implementation of these changes. Continue reading

Natural resource management, health and wellbeing: drawing parallels

Woodhill (2002) describes the development of natural resource management over time as:

– a technocentric era – where it was seen as a “technical problem requiring technical solutions” (page 69) and primarily the responsibility of government

– a localist era – focussed on community participation and local level change.

However, his work challenges this localist perspective and says it needs to be complemented by “broader scale institutional change” (page 70).  He says that NRM is entering an institutional era.

He advocates that a paradigm of social learning is central  to “overcoming such institutional constraints and engaging with the deeper causes of the ecological unsustainability of modern society” (page 70).

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My experience of appreciating the NHS and public health reforms

(Activity 3.12)

As Blackmore (2010, 20) explains in an editor’s note, Vickers did not represent his idea of an appreciative system in a diagram or model.  However, Checkland and Caser did produce a model based on their understandings of Vickers work in 1986.  This is reproduced in Blackmore (2010) on page 21.

I struggled with this diagram at first – mainly because of its title “Diagram of Vickers’ appreciative systems model”.  After posting about this to the course forum, I was helped by one of the tutors (Jitse) who said that it may be better to think of the diagram as a “conceptual representation of the process of appreciation”.  I found this much more helpful as a trigger to understanding my own experience.  I am still not sure about the diagram itself but I can now use it as a springboard for reflecting on a recent experience  of appreciation.

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A Systems perspective on health and wellbeing

The other evening, I went out with a colleague and friend of mine – T. Well I say colleague, we used to work for the same organisation – now we work for different organisations but within the same partnership arena.  When we worked together, we routinely had a friday night drink during which we discussed society, organisations, management and so on – at the time he had just finished a social policy PhD and I was embarking on my MBA.

It’s been a while since we have seen each other outside formal meetings.  In our conversation the other evening, we started talking about complexity.  T has an emerging interest in the complexity of individual’s lives and the tension created when organisation’s have to be accountable for the ‘outcomes’ they achieve through their interventions.  Entire voluntary sector funding regimes are founded on organisations making claims for the outcomes they can create.

Contemporary public health research has an underpinning systems perspective.  The most reproduced model is that by Dahlgren and Whitehead which shows a series of influences on the health and wellbeing of an individual.  In Newcastle upon Tyne, I have been involved in work to raise awareness of this ‘holistic perspective’, most notably with our Mythbuster brochure.

What my discussion with T made me realise, is that to date, I have not seen health theory expressed using the language of Systems (the academic/intellectual discipline).  So here is my first iteration…

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