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Community Events 2020 – Edinburgh


Welcome to the page for the ‘Surviving the System’ Community Event 2020.

Dovecot Studios, Edinburgh| 13:00 – 16:00 | Monday 27th January 2020

‘Start where you are, use what you have, do what you can.’

Arthur Ashe


Our first Community event of 2020 was ‘Surviving the System’ in Edinburgh where more than 60 delegates came together to discuss our shared challenges across the wider system.

Our panel of contributors were

  • Anne-Marie Monaghan, User of Services
  • Angiolina Foster, CEO of NHS 24
  • Dee Fraser, Deputy Director of Coalition of Care and Support

We shared some Q&A before moving into conversations about some key challenges.  In our gallery below you can see the 4 scenarios we used to spark the discussion and opened up to the room for other ideas and a vote.  We were encouraged to receive 4 additional ideas from from the floor, 3 of which were voted through to take into group conversation (see gallery).

Our team from Kaleidoscope and Project Lift facilitated some rich discussions around these 3 challenges:

  • workforce recruitment and culture
  • enabling all to believe that ‘I’ not ‘they’ are the drivers for change
  • building an integrated relationship between Health and Social Care


We will be sharing an event pack of insights and outcomes over the coming weeks however in the meantime you can scroll down to see:

  • notes and themes from our panel and our group conversations
  • links to the resources shared in the run up to, during and after the event including the blog, webinar, Facebook streams and twitter activity (click on the icons below)
  • some insights into the Social Care and social services organisations
  • some pictures from the event


This is only one conversation in the wider work of the system and we aim to collectively enable more through our other events, supporting other groups and activities and working collaboratively where the energy and drive ask of it.

Angionlina Foster

  • Our system is a complex system made up of many different parts, its running hot yet there is an unspoken, insidious message that if only we could fined a 6th gear things would be better.
  • Busy is not the way to make a difference
  • We operate in a complex, adaptive system which throws up challenges that can draw you in
  • Be crystal clear about your own moral compass and your own values – and know where your lines are
  • Be different about your relationship with the content of your job to have meaningful impact – make your role your own
  • There is a direct correlation between these last two points and your own resilience

It was also Angiolina who offered us the Arthur Ashe quote as we finished up our event and reflected on the strong sense of everyone being ready to do something real.

Anne-Marie Monaghan

  • Insights from my lived experience as a service user
  • What happens in the gap between people who use the services and the system?
  • Its tricky to navigate the system, even experience from within the system
  • What troubles a trouble maker?
  • Where are the people you service in your strategy?
  • Challenge – what are the meaningful questions?
    • What is the purpose of your questions?
    • How are service users labelled?(physically and formally?)
    • How are we depersonalising people who come into our health and social care services?
    • Are you owning your decisions?
    • Are you brave enough to put your name to your decisions?
    • Are you enabling patients to focus on what is important to them?
    • Are you aware of the impact of the time it takes you to make decisions? (too fast or too slow?)
    • Are finance people making practice decisions?
    • Who gets to define risk?


Dee Fraser

  • System pressures adn leaderhsip practices from a care providers’ perspective
  • Leading across systems – there is no one place to stand and no one leaver to pull
  • We are working within an environment of Failure Demand and there are many unsolvable problems – wicked problems
  • Top Down leadership is still evident and occasionally helpful in a crisis but when we are looking at wicked problems, we really need to share power
  • Make sure the right person, not the right position, is making the decision
  • Many are working with high responsibility and low autonomy – this is very stressful
  • Collaboration and Collective leadership are key – we need to unlock the system
  • Alliancing is essentially collaborating in contract form
  • Transparency of costs, ‘best for person; decision making, shared risk taking – all important
  • We need a more systematic approach to solve intractable issue, sharing power, making explicit where possible and trying these out in our own organisations.

Key Themes from our conversations:

We can all learn from each other,

learning to understand each others’ situation, system, challenges and pressures.

This can lead to us now learning together, in conversation, to bring change.

Workforce Culture:

getting to know your team,

creating time and space to connect,

delegate to get the know the skills of your team,

role model and empower your team to ask questions

Senior levels don’t seem to value this but we can stand where we are and something in our bit of the system

Health and Social Care integrated relationships:

how do we listen and apply learning in our system,

who is the system?

we need less ‘they’ and more ‘we’.

it’s striking how much we don’t know of the system

services are set up with organisations in mind, not service users

Change owned by ‘I not ‘they’

we need to see it, to believe it for ourselves before others can believe it

it’s clear – see people, treat people as people, be brave

don’t just ‘hand off’ to the next step or team, ask what else can I do?