Is top NHS leader Dr Amar Shah saying a shift towards ‘Systems Convening’ style leadership is ‘the biggest shift we need to see’?

During his recent keynote as part of QI Week, Dr Amar Shah seemed to me to be arguing very strongly for a shift towards a ‘Systems Convening’ type of leadership, and away from the kind of leadership currently rewarded in the NHS. (Amar is the first National Clinical Director for NHS Improvement at NHS England, leading the application of improvement across England’s health and care system.)

See what you think? Is this what he’s saying? (Full snippet, and link for the video, is further down).

Amar talks about how the heroic problem-solving leader, who rises up through the ranks in the NHS has “completely the wrong mindset for leading a continuous improvement organisation”.

Instead he calls for something that imho sounds much more similar to the cross-boundary convening work of Systems Conveners, seeing the wider landscape – and enabling new learning and solutions:

Here’s the full answer he gave:

“[Data is important in helping to make better decisions] It’s really useful to understand variation and to be able to make decisions based on a good understanding of variation, but I honestly think there’s probably an even more important aspect I think that’s holding back Quality Improvement’s, maturity and that is mindset.

I think the mindset of how we solve problems in NHS is the biggest thing we have to shift. Ultimately people will rise up through the ranks because they’re extraordinarily good problem-solvers and they are very used to sort of seeing a problem, finding a solution and implementing it. And actually that is completely the wrong mindset for leading a continuous improvement organisation.

You then need to see your role as problem-framing and creating the environment for others to solve problems. That’s the shift: unlearning that you are the source of the solution and learning that you are the ultimate architect of the environment, in which others can solve problems that for me that is the biggest shift we need to see.”

View the video here: https://youtu.be/SriEq0RQaRo?si=ghgvEBWqo_hjNVoa  (this answer is around 42:30).

It’s sad to see something that may be the “the biggest shift we need to see” struggling to find a foothold in today’s current NHS: Surrey’s impactful ‘Systems Conveners’ team (DoH was even taking an interest) was a casualty of the current round of large ICS staffing cuts.

Though obviously novel approaches, coming from a different mindset, will often struggle in today’s NHS.

In a perhaps similar vein to Systems Convening, I couldn’t help noticing recently that the calculated national saving if existing relational/strengths-based/’get it right first time’ style projects/services (aka Liberated Services, Human Learning Systems) were spread nationally would be £22bn (inflation adjusted).

This is the exact same as the UK’s entire budget ‘black hole’!

But such personalised, bespoke-by-default working remains too alien to the current system to really register with politicians and other leaders – and we carry on with pseudo-efficient systems that don’t distinguish between value demand and failure demand, wasting many billions as a result.