The wicked problems

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I joined hundreds of NHS colleagues at the NHS Confederation annual conference in Liverpool last week.

I spoke with a lot of delegates over the 3 days and the vast majority were very much aware of our work here at the Academy –  both on and offline. I’ve been to many of these conferences over the years, but never has there been such a sense of change as there is now – of those changes that have happened and those that are yet to come. With that, I also saw a real openness and a refreshing acknowledgement that changes don’t just happen – they take time and a sustained effort.

As well as the exhibition, there were presentations and panel discussions, where key themes emerged around the increasing need for transformational change and how it will be achieved. I was a panel member on day 2 in the session ‘Great Leaders, difficult decisions’ (5 – ‘Leadership Panel Session’ on the video below) which is now available to watch. I would be interested to hear what you think.

The clear openness that emerged at the conference is, I believe, vital in tackling some of the issues raised. There are two issues in particular I want to mention.

Firstly, diversity – particularly at senior level.

This isn’t a new issue, and while there are some positive approaches out there, we really must continue to address the gap between communities and their representation in our organisations. It’s not a numbers game (although they matter) it’s about having the necessary breadth and depth of perspectives to innovate and take forward new approaches. There are some useful guides available on the website around this which I’d recommend having a look at.

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Secondly, I noticed some differing views about the future.

While most were excited and up for the task, there were some who had that sense of caution and scepticism which is natural and understandable after a period of change. Though slightly polarised, I feel this balance makes for a healthy mix and think we are in a good place with both the energy and realism to work together to tackle the challenges ahead.

In the panel discussion I took part in, I spoke about ‘wicked problems’ – a term I first came across from Professor Keith Grint. These issues are defined by their complexity, changing nature, multi-dimensional issues and moral dilemmas. They are not resolved in just a few months; they require a sustained intervention and effort.

Many of these problems are complex, long term and are hard to measure in terms of success. They often don’t have concrete financial data or information and involve many organisations and teams. For example:

  • Gaining better integration around vulnerable people
  • Getting more support in the community for people with long term conditions
  • Delivering a sustainable model of urgent care

If we analyse these types of issues, we see no immediate fixes and that they are different to those sort of “tame issues” we have seen in the past. It’s clear that  people in the system need to work together, with concentrated effort over  a sustained period, like never before.

So, is it reasonable for us to expect our leaders to be automatically equipped to tackle this different approach to wicked issues?

In many cases I think it’s unfair and like in most walks of life we need to give people the skills, experiences, knowledge and behaviours to take on these challenges. The Academy was designed to support leaders at every level in order to improve patient outcomes and people’s experience of the NHS. We are not the only answer, but we are certainly part of it.

I’m really pleased that we have received hundreds of applications in just a number of weeks for our new suite of programmes. I want to take this opportunity to ask you to explore these further and if you haven’t done so already, register your interest.

As always, I welcome feedback on these observations and what else you think we could be doing here at the NHS Leadership Academy.  

4 thoughts on “The wicked problems

  1. Interesting ideas, Jan and thanks for the blog.
    Thinking about diversity, I’d go further and say that biological diversity is not in itself sufficient: More female, ethnically heterogenous, disabled and gay senior leaders might still result in organisations that are externally colourful yet at the internal thought level, rather grey, dull and stilted in terms of uniformity of world-view. The challenge for interview panels is learning how to spot the highly capable candidate who has a completely different view of the world, the nature of the issues faced by the organisation and the ways to address these. Our evidence about the nature of innovation is that truly revolutionary approaches do not instantly inspire admiration but paradoxically, tend to seem a bit odd, quirky and ‘wrong’.
    As well as a set of skills for dealing with wicked problems, I’d add the importance of developing the virtue of temperance: My experience is that we have a tendency to rush the process of arriving at a shared vision and there seems to be a pervasive assumption that the leader needs to ‘act’ and ‘produce a robust plan’ whereas wicked problems require time for questions, argument, reflection and the successive illumination of a shared way forward.
    I do also increasingly wonder if the notion of ‘leadership’ is becoming dated.
    The history of management development in the 20th century saw ‘administration’ supplanted by management which then itself was superseded by ‘leadership’. None of these are concrete objects of course, but metaphors we use to illustrate a set of values, attitudes and behaviours. Leadership is perhaps too redolent of the imagery of ‘chief’ , ‘person out in front’, ‘boss’?
    I’d argue that our knowledge worker age just doesn’t require or particularly want that particular dynamic and persisting with ‘leadership’ risks the lost opportunity cost of full engagement with every single person who works within and with an organisation.
    I think I would pitch for the development of ‘enterprise’ attitudes and skills within a healthcare organisation culture that re-connects with the fundamental human basis of governance i.e. trust and relationships rather than mechanical mountains of rules, regulations and reporting structures.
    Thanks for starting an interesting debate, Jan and I look forward to reading and reflecting on other comments.

  2. The term “Wicked Problem” was definitely NOT coined by Keith Grint, but by Horst Rittel in the 1960’s, who wrote about it in his landmark article “Dilemmas in a General Theory of Planning” in 1974. I hope that you will let Professor Grint know that you have mistakenly credited him – otherwise he might be blamed for it.

    For a background, see “Wicked Problems – Social Messes: Decision support Modelling with Morphological Analysis”. Springer, 2011.

    You can see a description at Springer here:

    http://www.springer.com/business+%26+management/technology+management/book/978-3-642-19652-2

    Regards,

    Tom Ritchey
    SweMorph

  3. It’s very exciting to see leadership organizations accepting, and even embracing, the real nature of the problems humans are increasingly facing on the planet!

    One small correction: the term ‘wicked problems’ was first mentioned in print by C. West Churchman (http://en.wikipedia.org/wiki/Wicked_problem) and was developed by Horst Rittel and Melvin Webber in this monumental paper: http://www.uctc.net/mwebber/Rittel+Webber+Dilemmas+General_Theory_of_Planning.pdf, which is still very much worth reading.

  4. Thank you for the insightful comments. Keith Grint did not coin the term, however it was down to him that I first came across ‘wicked problems’. Apologies – I’ll make the changes now to avoid further confusion! Thanks again.