Systems Thinking and Organisational Change in the NHS

The phrase “systems thinking” has been increasingly evoked by politicians, policy makers and practitioners aiming to promote and implement new ways of delivering public services in England. This chapter purposes the narrow interpretation of systems thinking and explores how a management cybernetics approach can help in developing a cohesive response to the significant design challenges currently facing the National Health Service (NHS). It summarizes the key social and political drivers of change in the NHS, which will be broadly similar in other Western economies, and the response of the major political parties, particularly since the instruction of the Health and Social Care Act in England in 2010. The chapter looks at the way the emergence and self-organisation of the local health economy needed to provide integrated community health care but has been constrained and distorted by the dominant social and political discourses that have become established in the UK and elsewhere.