Why Systems Thinking Is Fast Becoming the NHS’s Missing Lens

As pressures on the NHS intensify, from workforce shortages and rising demand to fragmented pathways and limited resources, approaches that help make sense of complexity are becoming increasingly important.  

This theme was central to NEC Digital Studio’s recent webinar, “Why Systems Thinking Is Vital to the NHS,” chaired by Tom White, Head of Research and Service Design, and featuring experts from NHS England and Loughborough University. Across the conversation, the panel explored what systems thinking really entails, why it matters, and how it can shape more coherent and resilient change across the health and care system. 

What followed was a practical, honest and people centred conversation about how organisations can make progress in complex environments.
 

A System Under Strain: Why Healthcare Is So Hard to Fix 

The panel began by reflecting on why improving health and care services often feels so challenging. According to Tero Väänänen, Head of Design at NHS England, one of the biggest issues is fragmentation across the system. He explained that “healthcare is deeply fragmented. No single part of the NHS owns the end-to-end service.” 

He described how patients rarely move through care in straight lines. Instead, they navigate repeating cycles of prevention, treatment and ongoing management, often interacting with multiple organisations. Many of these journeys extend beyond the NHS into local authorities, community services or even the Department for Work and Pensions. 

Another barrier is language. Different professional groups rely on different frameworks, methods and terminology, and Tero observed that “we often do not talk the same architecture or design language across the system, so even when we aim for the same outcome, we are not always talking about the same thing.” This misalignment can slow decision making and lead teams to misunderstand the problem they are trying to solve. 

These realities make change difficult. But they also underline why systems thinking is such a valuable mindset for anyone working in NHS transformation.
 

What Systems Thinking Really Offers the NHS 

Professor Thomas Jun of Loughborough University encouraged attendees to view systems thinking as a practical way of understanding how people, processes and technologies interact. He drew a distinction between systematic and systemic thinking. As he put it, “systematic is structured, systemic is relational. Systems thinking is about that holistic, relational perspective.” 

For Thomas, systems thinking is both a mindset and a method. Practitioners need to be comfortable exploring and revisiting boundaries, mapping relationships, understanding how behaviours emerge from interactions and listening to multiple viewpoints. He stressed that boundaries in complex systems are rarely fixed, which means teams must remain open to new information as they learn more about the environment they are working in. 

This understanding set the tone for the rest of the session, which explored the practical value of systems thinking across the NHS.
 

Why Systems Thinking Matters for the NHS 

Dr Val Mitchell, Senior Lecturer in Experience Design at Loughborough University, highlighted that one of the most important benefits of systems thinking is that it brings people together around a shared understanding of how a service works. She explained that “one of the most valuable things systems thinking brings to healthcare is shared understanding,” particularly when it comes to language, priorities and the impact of change. 

Val noted that this shared understanding helps teams identify the areas where change is most achievable. These “bright spots,” as she described them, create opportunities for progress without trying to change the entire system at once. 

Tom White reflected on the value of visual tools in building this shared view. As he observed, “everyone understands their own slice of the system, but maps give us a common language.” 

Together, these reflections reinforced the idea that systems thinking is a practical way to improve clarity and collaboration in a complex environment.
 

Applying Systems Thinking in Practice 

The discussion moved on to how organisations can apply systems thinking day to day. Tero emphasised the importance of starting with users, whether they are patients, clinicians, reception staff or operational teams. Understanding their needs, their frustrations and the context in which they work provides essential insight into how the wider system operates. 

He explained that “visualising complexity is one of the most powerful ways to build common understanding.” Tools such as system maps and service blueprints make interactions visible and help teams identify where change is possible. He stressed that these artefacts are not end products, but working tools that should be shared early and used to facilitate open dialogue. 

Codesign plays a central role in this process. Tero noted that designing with people rather than for them helps ensure that solutions are grounded in real experience and informed by lived expertise. 

Val added that successful transformation requires an understanding of the system as it truly works, including workarounds, legacy systems and the pressures frontline teams face. She cautioned that “if we try to implement change into a misunderstood system, it will almost inevitably fail,” and highlighted that constraints should be seen as creative prompts rather than barriers.
 

Moving Beyond Solutions: Stewardship and Unintended Consequences 

Thomas offered an important reminder that complex systems do not respond well to single, definitive ‘fixes’. He argued that teams should think in terms of stewardship, where multiple interventions evolve over time. He described how tools such as AcciMap can reveal contributing factors at organisational and operational levels, helping teams design changes that address root causes rather than symptoms. 

Tero built on this by highlighting the risk of unintended consequences. He explained that “unintended consequences happen when we ‘fix’ one part of the system without seeing its impact elsewhere,” and warned that “when one part of the system delivers its part without understanding what happens next, we risk simply shifting the burden elsewhere.” As the NHS continues to focus on productivity, outcome improvement and cross organisational collaboration, this kind of joined up thinking will become increasingly important.
 

A New Lens for NHS Transformation 

The panel agreed that systems thinking gives NHS teams a more realistic and human-centred way to understand the services they design and deliver. It encourages curiosity, supports collaboration and helps teams prioritise effectively in environments where resources are tight and needs are varied. Additionally, systems thinking provides an approach which goes beyond linear journeys and organisational boundaries.  

For NEC Digital Studio and partners across the NHS, systems thinking provides a shared language and a practical framework for designing improvements that reflect real life rather than idealised models. It supports better conversations, better decisions and ultimately better outcomes for the people and communities the NHS serves. 

If you would like to explore these themes in more depth, you can watch the full recording of our Why Systems Thinking Is Vital to the NHS webinar.

To discuss how NEC Digital Studio can support your organisation with systems thinking, service design or transformation projects, please get in touch with our team. We would be happy to help.