The UK’s health and social care system is, appropriately, one of our most treasured national assets. However, the sheer size and complexity of the system, as well as the pressures it faces from an ageing population and finite resources, mean that making improvements to health and care can be a significant challenge. Successful transformation must take into account the needs of all patients, carers, healthcare professionals and other staff. It requires consistent consideration of every element of the system, the way each element interacts, and the implications of these interactions for the system as a whole – that is, it requires a ‘systems’ approach.

Clinical leaders are increasingly exploring and recognising successes by using a range of evidence based approaches to work on design and improvement, including systems techniques. This work is leading to improved pathways, processes and patient experience. However, such approaches are not yet consistently defined or applied throughout health and care design and improvement.

Engineering is a sector where systems thinking is routinely applied to understand, design, deliver, and sustain systems ranging from the development of worldwide telecommunications networks to the latest Boeing 787 Dreamliner. As a pioneer of minimally invasive surgery, I personally have always been an advocate of an interdisciplinary approach between engineering and healthcare sectors and this project has provided an excellent opportunity for mutual learning. It has led to the development of a rigorous yet workable framework for the application of systems thinking in the unique context of health and care.

I fully endorse the recommendation that healthcare leaders and transformation teams consider the questions and tools laid out here to support a more consistent application of a systems approach to health and care design and improvement. With this work we hope to deliver benefits for patients, carers, and staff, and showcase the value in cross-sectoral working.

Rt Hon Professor Lord Darzi of Denham OM PC KBE HonFREng FRS FMedSci

August 2017

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