Thinking in systems, a natural fit for SLTs 

Annabelle Burns, Head of Integration at Homerton Hospital, shares her journey from working in paediatric speech and language therapy to applying systems thinking in leadership. Reflecting on her passion for reducing health inequalities and her work bridging acute and community services, Annabelle explores how Systems Thinking is transforming healthcare delivery.

Seeing complexity in everyday practice  

As SLTs, we are often very aware of the inter-connectedness and complexity of everyday life. We know that communication does not occur in a vacuum but is impacted by physiology, psychology, environment, circumstance and many more interacting factors.  

I have always loved the varied nature of our profession, especially the skills and tools we utilise to make a real difference with our patients. From neurobiology to sociolinguistics, group facilitation to behaviour coaching, amateur dramatics to Lego-building and play. The experience of developing my clinical skills within this eclectic, multi-disciplinary, creative profession was enriching and stimulating.  

A new perspective in leadership 

When I became Head of Integration for my organisation and began to engage in leadership and development activities at more strategic and organisational levels, I fully expected to continue to draw on a wide range of knowledge and practice from across disciplines.  

However, I was soon disappointed to find, particularly in the NHS, management training is often reduced to a small range of project management tools and personality matrices.  

That is why I was so excited to discover the theories and practice of Systems Thinking, and why I am keen to share this discovery with others in the profession. 

What is Systems Thinking? 

Systems Thinking is both an art and a science. It offers us a way of conceptualising and articulating complex situations, as well as incorporating a number of tools and methodologies that can be used in different ways.

Systems Thinking is not new. In fact, it could be argued that ancient philosophies from across the world have been thinking in these kind of holistic ways for millennia. Exploring any observation of biology or an eco-system demonstrates how instinctive it is to think systemically.

However, to apply Systems Thinking principles to the workplace or social contexts, it is helpful to learn some of the core theories and methodologies, such as:

• system dynamics
• the viable system model  
• critical system heuristics. 

These theories offer ways of modelling complexity that capture the dynamic and inter-connected nature of organisations and behaviours.

How has Systems Thinking helped my practice? 

Using these tools has helped me to better understand how, factors within my workplace are impacting one another and how to influence the complex environments where I am seeking to make a change. 

Some Systems Thinking methodologies include an analysis of factors such as power, marginalisation, boundaries and perspective. They have enabled me to approach mapping and articulating complex situations with a more critical lens.  

Recently I applied my developing knowledge of Systems Thinking to a hospital-focussed pilot project aiming to address the financial and social needs of patients in the hospital.

Systems Thinking tools helped me to map the complex interacting factors that connect poverty and health, to pinpoint how these needs are identified and best addressed in healthcare settings across the patient pathway.

This approach offers ways to reflect on the purpose of the system, as well as the ways in which my own perceptions and leadership style are impacting my assessment of the situation and how it could be improved.  

A growing and transformative field  

Systems Thinking is a dynamic field and it continues to develop in its theoretical basis and application. If you have not previously explored Systems Thinking, I would encourage you to do so. As an SLT, I am sure you will discover that thinking in systems is already intuitive to your practice.  

I am currently undertaking a Level 7 Apprenticeship to become a Systems Thinking Practitioner alongside an MSc in Systems Thinking and Leadership. Understanding and applying the theories and methods from this eclectic and inter-disciplinary field of learning has been transformational. It has changed my personal understanding of the world and workplace, as well as my own approach to managing change and leading others.  

Exploring the tools and theories that underpin this way of thinking will provide you with a structure and a language that can affirm and develop your clinical work, leadership and management and the ways in which you can make positive change.