The place to be

by Mark Rogers

19 December 2017


Ahead of the HFMA’s integration summit in February, progressive public sector managers are urged to fully embrace the idea of place-based thinking as an essential step towards delivering services properly integrated around patients and service users.


There is much florid rhetoric out there about the need for a new approach to the leadership of public services. Appetite is growing for collaborative, emotionally intelligent, selfless, relationship-based leaders. These are seen as an antidote to the toxic legacy of ‘new public management’, in which heroics, competitiveness and institutional sovereignty were viewed as necessary evils by too many and, regrettably, desirable ends by a few.

If austerity – and the policies that have been introduced or developed alongside it – has anything to teach us, then it is that trying to make things better for other people on your own is, ultimately, self-defeating.

No one likes someone who thinks they know better than everyone else, when they don’t. To be honest, heroic leadership was always a daft notion. The idea that ‘doing to’ was anything other than offensively patronising and alarmingly disempowering should have been dumped a long time ago.

Viewing citizens as passive recipients of what their ‘betters’ prescribe them is just plain wrong. So, say hello to one of the causes of today’s political malaise: the public’s cynicism and, too often, alienation.

In recognition of this, what should modern, forward-looking, progressive leaders be getting to grips with then? Well, first of all, they need to embrace fully the idea of place and places. Citizens – the people we (are paid to) serve – live, work and play in a multiplicity of intersecting spatial dimensions, almost none of which conform to the institutional boundaries of the organisations that we work in.

We have to find ways to subvert organisational constraints to service people in the places they actually recognise and value. This has been recognised for some time. But the actual task of putting places before organisations has hardly begun – just look at the kerfuffle around the geographies of sustainability and transformation planning. Forty four STP areas that make little sense to the punter.

But establishing the primacy of place(s)-based thinking is only the first step. Leaders also need to get their heads around system thinking and how this can help to give people the integrated, effective, efficient and value-for-money experience they should expect from tax-funded services.

Systems thinking is not something that can be done ‘off the side of the desk’. A bit of applied study will be required here before we all start saying what clever system architects we are. And study it seriously we must or, as the saying goes: ‘do what you always did and you’ll get what you always got’. Banging your head against a brick wall was never a good idea – or career move.

And, in a classic three-legged stool move, there is a third consideration. The best leaders will take all of the above into account and then think really, really hard about how they reform themselves. Leading differently isn’t just for others – it’s for us too. We have to put ourselves through the mixer by asking if we are we fit for purpose

Do we seek to form strong relationships in order to get what we want – only more nicely or less obviously? Or are we truly seeking a new age of enlightenment in which we don’t just ask others to strip away their preconceptions and biases, but we ask the same of ourselves? And then get on and do it.

And this brings us back to the florid rhetoric. Are you a ‘do as I say’ or a ‘do as I and others do’ kind of person? The greatest characteristic of leadership is surely open-mindedness, accompanied by a willingness to change oneself in pursuit of the greater good.

Mark Rogers was previously chief executive of Birmingham City Council and was the system leader for the Birmingham and Solihull sustainability and transformation plan.

To find out more about the Integration Summit, please click here.