The shape of our providers in care is wrong for this next digital world.

I wrote this four years ago in 2020. But in a recent private discussion around system mechanics with a very frustrated and angry friend following Frank Hester-gate. The discussion turned to the challenges of making positive change in institutions. The friend asked what they can read and I made some suggestions and also linked some old articles I wrote here based on talks and teaching I did back then.

This morning I read that writing preparing to cringe.

Instead what struck me is how much of the challenges I described as future states, now describe our current state. Unfortunately that is something I feel disinclined to celebrate.

The article focuses on organisations initially, but this and part 2 are actually seeking to consider how we organise more generally.

So I thought I'd share. I hope you find it interesting.

Let's get to the rub. I vehemently believe that if your organisation continues to be defined by your org chart, then you're dead in the water in ten years. Maybe five. This may not be patently true if you have a safety net, but I'd assert that you won't be doing that well, and will likely be subject to intervention, turnaround and control measures, particularly within the health and social care sector.

"What's wrong with an org chart?" you may ask... "Nobody actually looks at it".

Correct. But you don't need to look at it.

It's so ingrained in how most people work, that the parts of it that relate to you are hard-wired in your brain. Consider this - do you know who you work under, who they work under, and who works under you? Of course you do. Everyone does. There will be the odd nuance but most staff have a clear understanding of who controls them and who they get to control.

This is the essence of the issue, and the org chart is the flag that flies this methodology.

In practice it's the most simple and powerful symbol that decides who actually gets to decide what they can and can't do. In a sense it is the map of power, empowerment and disempowerment.

But that's just the start, because this map then translates into other forms of control mechanisms, such as policies, operating procedures, job descriptions, system rules, compliance reminders, and, more left-field, formed email circulation lists. We'll circulate back on emails in due course ⏱.

The org chart and the different manifestations are understandable, and will be entirely justifiable, because "it's the way we've always done it", and "it's worked fine so far".

That sentiment is predicated on us being in the same place that we were before. But are we?

Let's look at the writing on the wall:

• The continued rise of digital, now reaching a technological tipping point, has generated so much information in every part of our lives that we're overloaded.
• The very spread of these technologies has catalysed the speed of things that happen around us. Greater bodies of things can be instantly transmitted and repeated to more or less anywhere in the world.
• The turnover of these systems, and the frequency and constancy of change that is required of you is shortening. Think about how frequently you have adapted they way you communicate with your friends over 25 years.
• There is little sign of it decreasing. Whilst AI will come and replace some things, but very few predictions suggest that our work lives and careers will be slower and simpler. Quite the contrary.
• Our environments (and environment!), markets, politics, systems, structures and societies are becoming more unstable and unpredictable. Consequently your organisation and work life will be subject to this environment.

Often I hear that there has always been change and this is just another, but it's not, and don't take my word for it. If you consider the position of the EU, the Bank of England, the World Economic Forum, virtually every major consultancy, the Economist, the Harvard Business Review etc. then we are going into the second major industrial (digital) revolution. This is not change as usual, and the change is existential.

The human cost of these circumstances

In the many organisations I have spoken to and worked with I hear the same sentiments: that keeping up is getting difficult, that the stakes feel higher and that the costs are becoming greater, and that they're having to do more with less:

• On leaders - Overworked. Too many decisions. Plans coming undone. More questions than answers. Lacking the intel to make the right decisions. Uncertainty.
• On workforce - Increasing staff turnover. Disengaged and dissatisfied. Making demands.

In other words, the cost is real and it's personal. For leaders, for staff and for those who are affected by the organisation.

So what about the org chart Liam!?

Oh yes - org charts!

So whilst the ramifications of this major societal change aren't possible to know without a time machine, let's look at the present, and what we can know. Somehow you need to be able to respond, deliver and produce the goods more quickly. Therefore, the need, indeed, is a need for speed.

the need, indeed, is a need for speed.

But your org-charty organisation is not built for speed, it's built for precision, control and relative safety. Aaron Dignan's Brave New Work provides an inspiring and detailed case for what this means and how it manifests if you want a more detailed case.

Ask yourself this question - does the org-chart, policies etc. slow you down or allow you to go faster? The answer is pretty obvious, those agreed decision points and processes create many micro-bottlenecks that slow down the ability to do something new or different.

This will be culturally embedded, and whilst big strategic statements about being more agile, or digital, or innovative may be very nice, they'll be undermined and unrealised in real-time.

Having had these conversations many times with organisations, I know you may have questions about the alternatives and the simple principle of what happens if we take the safeguards and controls away.

We'll come to alternatives in the next article, but for now I'd invite you to humour me, and go with the following hypothesis:

The future of your organisation is digital. The future shape of your organisation needs to allow digital. The shape of digital is not compatible with the current shape of your organisation. A lot of things need to change.

The shape of digital 🤖

To put it in it's most simple form the shape of digital is transitioning from one of root and branch to one of more complex systems or the Rhizome. In a simpler world we created logical pathways of decision (or trees - which upside down = org chart) to try and achieve greater productivity with precision.

However this Rhizomatic structure, if put in a more digital term is that of the network, or arguably a series of communities. I'd highly recommend that you check out Manuel Lima's RSA short on the rise of the network effect. It's equally beautiful and informative.

If the shape of our external world is changing and the shape of the tools that we prioritise are changing, then history tells us that the only reasonable option we have is to reform, shift and realign our shape to be compatible. The true change in the first industrial revolution wasn't the combustion engine itself, but instead our human shift to align with, and capitalise upon, it. Those who resisted didn't fare well.

The true change in the first industrial revolution wasn't the combustion engine itself, but instead our human shift to align with, and capitalise upon, it.

Practically, if you're plan for being fit for a digital age by implementing and using some tools, training people to use them, getting a bit serious on storing and presenting data, and maybe popping the word culture or agile in a few times, then I'm sorry my friends, but you may be at risk of missing the real change that needs to happen.

I'm not saying the details aren't important, but like any new cultures (in a literal and figurative sense) digital in it's various forms needs the right kind of soil to grow in. That soil is the formation and shape of your organisation, and the many real-time micro rules that manifest as a result.

In the next article I'm going to try and move from the case for change (the why) towards the shape of that change itself (the what), but in closing I'd like to take a leaf out of the book of The Great British Bake Off, and offer you a preview of the next episode: the shape of the digital cake we're going to bake.

The much cited, and much adapted, manifesto of responsive.org defines five shifts in the shape of organisations seeking to be responsive in this new world of increased complexity and unpredictability we're entering, and represents the bedrock of what I try to bring about in the work I do with organisations:

More Predictable <-> Less Predictable [👉 direction of travel]

• Profit (or financial) <-> Purpose
• Hierarchies <-> Networks
• Controlling <-> Empowering
• Planning <-> Experimentation
• Privacy <-> Transparency

I'd go as far as saying that 90% of the work I do around digital transformation (if we're to use this crude term) is in helping care organisations to allow all, but particularly the last four, points to happen in real-time. By this I mean undoing the things that get in the way, slow them down, and stop them happening.

My friends, as we'll cover in the next article, those things all lead back to the org-chart, and how it manifests.

Quick 2024 footnote - how we organise is relevant to how we act, how we produce, how we create, and what we achieve.

The NHS is currently in a challenging state, and whilst we can look at the symptoms, how we organise nationally, institutionally, locally and within independent organisations individually and collectively is a critical question.

So often the conversation can feel like if we configure to X then Y will happen, but let me ask you: what difference does all this organising and reorganising make if the philosophical blueprint is still the same?

The org chart for the NHS is not clear, it's complex but it exists, and IMHO it's configured for a predictable world, and therefore ill equipped to deal with the challenges we face.

Unless we address this (as I'll cover in the next one) concepts of deck chairs and the Titanic come to mind.