Guest blog by Will Cleary-Gray, Chris Edwards, Andrew Gates, Joe Horobin, Sheena McDonnell, Sally Pearse, Car Ross, Rupert Suckling
Our Public Value Proposition
“We will tackle the fact that too many of our children are locked out of a successful future and are dying too soon, and we will do this because we want our children to have a good start in life, so they live healthier and happier lives.”
It’s hard to disagree with. It has a galvanising clarion call. And it’s deliberately blunt.
Which is why we liked it.
Doing something about it though – that’s the tricky bit. It is, quite simply, a cracking WICKED problem.
The problem we’re trying to fix – and the reason why it’s so important
“The first 5 years of a child’s life determine their next 50.”
This was the opening line as eight of us stood in front of the assembled masses on our last morning in New York City. It remains our opening line wherever we go, whoever we present our work to, whoever we meet. And it will continue to be so as we move forward.
It’s a powerful articulation of our focus.
Because, the fact is that in South Yorkshire, too many of our children are locked out of a successful future and are dying too soon. And things are getting worse not better.
And that’s not something that we cannot tolerate morally, economically or societally.
That’s why the Mayor brought us together. 8 individuals from across South Yorkshire, from different disciplines, different perspectives, different experience. Some of us having worked together before, many of us new to each other.
Bound together through an agreed team constitution, catalyzed by a pace and discipline (and homework deadlines) and inspired by learning and insight from the Bloomberg Harvard team, we started our work.
Early Difficulties and a Fair Amount of Wondering What on Earth We’d Gotten Ourselves Into
So we started the work in earnest.
And that’s where it got difficult.
The Bloomberg Harvard teams’ obsession with forcing us to explore the problem, with defining it, with testing it with others, with telling us that we had solutions masquerading as problems, with pressure to keep asking why why why.
It’s exhausting.
Especially when SURELY WE SHOULD BE THINKING ABOUT SOME SOLUTIONS NOW.
And then to make matters worse once we’d got a good problem defined things got worse as we moved to really unpacking the problem (the fishbone!).
Seeing the problem you’re trying to fix – and all the causes of that problem laid bare like this led to some fairly frank statements at our regular team check-in and updates with the Bloomberg Harvard team…..
Team of 8: “Daunting”. “Overwhelming”. “Where do we start.” “Why are we doing this?” “I’m not even sure why I’ve been asked to be part of this”. “We can’t tackle some of these problems”.
Bloomberg Harvard team: “Trust the Process”. “Trust the Process.” “Trust the Process.” “Trust the Process.”
And so we did.
We did the homework. We met twice a week. We worked into the evening. At the weekend. We found time in busy diaries during the week to build the work we were doing into our day job. We’ve talked to hundreds of people. We’ve shamelessly weaved the work into other meetings, forums and conversations.
We have, I think it’s fair to say, attacked the problem.
And despite the complexity of the problem, despite the demands of the day job. Despite glacial macro-progress we’re galvanised almost daily by recognising (and capturing the small wins), in accepting every insight, every step forward or step back as something we can learn from, the belief that we’ve each and every day built the authorising environment, that we’ve nudged something closer to having a bigger change space, that we’ve catalysed ‘teaming’, that we’ve created a space where we can access senior decision-makers, where we have license to have a go and try some things.
Progress we’re making
We now have a clear political (and wider mandate) to take forward four key workstreams in places across South Yorkshire:
- Deepening our data analysis. Helping us understand the problem at a more granular level and where support is most needed (at the level of the individual).
- Exploring the diverse / fragmented / complex services in a place. Using that as a base for helping professionals and users access or navigate the offer available.
- Exploring ways of building ‘trusted relationships’ locally. Acknowledging that trust in the system for many of those we want to help is too low – and that a focus on this could really help deliver change
- Safe Spaces to Sleep. Commitment to build out a programme that ensures our 0-5’s have a safe space to sleep as a foundational base for being able to thrive.
So what did we learn?
There were some meta learnings:
- We won’t fix this overnight.
- There’s no silver bullet.
- We might never fix the whole problem.
And some insights that surprised us:
- Resources might not be the problem. Our system spends £3.8bn on health and social care. Perhaps, just perhaps we could invest some of that differently – or make sure those that need the support exists are accessing them.
And some insights that help us shift into getting some things done:
- We have hundreds of organisations and thousands of people working across the region. We have an army available to us.
- We’ve got pockets of brilliance – that we might be able to scale.
- We have the right strategies in place – and a pretty strong authorising environment.
- Some of the things we can do are definitely do-able (better data) and we have some ready made projects that we can bolt on some pilots.
And what have we learned from the programme and learnings for the future?
It’s almost impossible to distil a set of key learnings from the PDIA process. Each and every bit of the PDIA approach has value in and of itself – but when taken together and driven as a programme of activities and behaviours it has the potential for transformational change.
But – in true Bloomberg Harvard style, we’re not allowed to prevaricate or avoid answering the question because it’s difficult. So, here are our top 3:
- Trust the process. And if that means you have to break everything down before you start putting it all back together again then so be it. Or spend time coming up with a team constitution when you really just want to be cracking on with coming up solutions. Or test your fishbone again. And again. And then do another one. Just trust the process.
- The power of small wins. Without this module and the focus of the programme in capturing them I think we’d have been sunk. Many of us work on things that have no beginning, middle or end. So capturing successes, however small, or big is transformative – and not just for the team but for building your authorizing and acceptance environment.
- Building your authorizing and acceptance environment. There’s no rocket science to the concept that you need to get tacit and implicit approval and support for things you’re trying to do. But without it you are nowhere. And thinking about this, having the tools and processes to work it through is, and will continue to be invaluable.
And for the team of 8 specifically – our role is already morphing – and will continue to do so. We have the potential to be agents of change, stitching together bits of the system that don’t necessarily always connect, to design new ways of working with the more formal governance structures that exist, to act with a license to push and prod.
And each and everyone of us will (and indeed are) taking the tools we’ve learned and are seeking to apply them on other parts of our day job. Building on an unhealthy obsession with ‘doing a fishbone’, to properly defining problems, to thinking about the change space you have to operate in, to finding some ‘entry points’ and just getting started. Even if that first step is having a conversation….
One Final Reflection
The process has been an unbelievable experience and an absolute privilege to be part of.
We have, from day one been supported by brilliant colleagues from cities across the world and by an outstanding cadre of academic and practitioner support that has been inspiring; all of us grappling with seemingly intractable, complex problems in multi-agency and multi-stakeholder environments. All of us doing it in a spirit of collaboration, with honesty and trust baked in.
And – it’s been a huge amount of fun…..
This is part of a blog series written by city leaders who participated in the Bloomberg Harvard City Leadership Initiative cross-boundary collaboration track during 2023.