Seeing the whole picture
People facing multiple and complex issues rarely have to deal with one service, but find themselves interacting with multiple parts of the system including homelessness services, drug and alcohol treatment, healthcare and criminal justice.
Often, trying to fix or invent one individual service is not enough. While you mend one part of the system another breaks, or there are damaging unintended consequences caused by change in one area.
Systems mapping can help local areas to better understand how people facing multiple and complex needs consistently fail to get the help they need and crucially where there is most potential to help them.
It turns the lens away from individuals or services to the wider context in which they live or operate. Systems can include people, organisations, institutions, commissioners, policies and even wider societal values.
The Revolving Doors Agency approach
Our process was developed through our experience of changing services and systems and underpinned by key academic theory on systems thinking and action research, in particular Danny Burns.
Burns emphasises a highly collaborative approach which seeks fundamentally to engage those experiencing the system – people with experience of the complex nature of the problem. This echoes participatory research approaches, in which those often considered ‘powerless’ influence the direction of research.
Our approach also borrows from appreciative enquiry which explores the strengths and positives which already exist. Every system has hidden and underutilised strengths which can help drive transformative change.
1. Burns et al, 2012
2. Ludema and Fry, 2008
Our approach involves
- Valuing collaboration in which participants learn their way to a solution
- Engaging numerous stakeholders with different perspectives
- Large scale action learning events
- Understanding of the power dynamics between participants
- Involvement of those with direct experience of the issues
- Making most of existing strengths in an area and build on what was working well
We have recently conducted system mapping in both Hertfordshire and in Sutton
This involved a series of stages including securing strategic commitment, scoping the different sectors, identifying stakeholders, coming together at a learning event and establishing enquiry groups on key emerging themes.
In both areas, the system mapping led to changes.
The process was supported by Sarah Pickup, Deputy Chief Executive at Hertfordshire County Council. In shaping the strategic direction from the beginning, involving multiple stakeholders and allocating essential resources, this senior involvement helped ensure the longevity of the process.
Hertfordshire County Council have subsequently commissioned a new multiple needs service that aims to work with people who experience multiple problems.
We met early on with the Director of Public Health, Dr Nicola Lang, who championed this work locally, as well as commissioners and strategic leads from the Metropolitan Police, Housing, Mental Health & Community Services, and Drug and Alcohol partnership.
We were already aware of exciting work underway in the borough, in particular the development of the Central Sutton mental health partnership through the Our Place! Community Budget programme.
In Sutton, Dr Nicola Lang and team took forward many of the recommendations, as well as pioneering new approaches to ensure former prisoners are registered with a GP on release.