Following on from the excellent Qld Health System Performance and Review (SPR) Conference in August, we reflected on the Wigan (UK) case study described by Sir Chris Ham. By all accounts Wigan is an exemplar of how to work together at a local level, to transform health and wellness outcomes.
Can we learn from their experience? Yes. Will we learn the most important lessons? Probably not.
Too often, we learn lessons about outcomes, outputs. In Wigan, we observe the new ways in which their communication mechanisms operate, how key stakeholders behave, how resources are shared and how (for Wigan) these changes have led to transformed health and wellness outcomes despite an environment of reducing budgets.
This is of great interest, so we naturally want to see whether and how these new mechanisms could work for us. We tend to jump to solution, by trying to emulate the new Wigan. This is a mistake.
Every complex problem relates to a unique complex system that cannot be reduced to its parts. Wigan is successful as a unique blend of interactive factors, parts and dynamics. No one part or mechanism in the new Wigan is right or wrong, or better or worse even for Wigan. They only work as a system, and we cannot translate the Wigan system into our environment as a whole because we are not Wigan.
Instead we need to dig deeper, into how Wigan learned and hence changed. In its own unique health environment, how did Wigan’s leaders start their journey? How did collective, shared leadership develop and become effective? How did they decide what to do next, at each stage? How did they (and do they) work together to decide how to adapt the system they are all part of?
From Wigan, we can and should learn about collective learning. So that we, in our own unique health system environment, can learn our way forward together.
In doing so, we should acknowledge that different people, cultures and environments learn differently. While we should watch and learn from others, we need to be careful. We need to remember that our own ‘system’ is unique.
Even under pressure, real transformation of health outcomes is possible. Wigan proves that. Will we learn the right lessons from Wigan? Probably not.
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