In this new blog, ICS Associate Karen McNeill reflects on a challenge many of us recognise: lots of engagement, consultation and good insight – but too little change on the ground. Drawing on community engagement work we’re undertaking in Lochaber, she explores what happens when learning is treated as something we do together, in real time, rather than something written up after the fact.  The work in Lochaber forms part of a wider shift towards a more connected way of learning and improving across health and social care in Highland through an improvement system that is driven by learning. At its heart is a simple idea: listening to communities, acting on what we hear, and learning as we go.  This blog is for anyone interested in how communities, practitioners and leaders can work differently to make change stick.

 

Are you fed up feeding into consultations and redesign programmes only for nothing to happen?

If you work in or around public services, this will feel familiar.  You attend the workshops, you contribute to consultations, you share insight from practice and lived experience.  A few months later, a report appears, clear recommendations, a refreshed programme, a renewed sense of intent and yet, very little changes.  This frustration is widely shared, across health, social care and community services, we have become highly skilled at consultation and redesign. We are far less consistent at turning that insight into action, learning and sustained improvement.

The challenge is not a lack of insight, the system already knows a great deal about what is not working.  People using services tell us, staff tell us, communities tell us and data and inquiries reinforce it.

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In Scotland especially, we are not short of thoughtful analysis or progressive policy intent. The issue is not understanding the problem. The issue is what happens next.  Too often, systems default to caution, decisions are delayed in pursuit of certainty, more evaluation is commissioned, more assurance is sought, more governance layers are added and certainty feels responsible.

In complex systems, it is largely unattainable and often unrealistic.  Change does not come from waiting until we are sure, it comes from acting, learning from what happens, and adapting accordingly.  Decisions are not endpoints, they are starting points for learning.  We struggle with iteration, and the consequences are real.

 

Many of our public systems were designed for a different era, they are now operating in the context of changing lives, stretched workforces, rapid technological change and widening inequality.

Yet we often behave as if the answer is a single redesign or structural change.  It rarely is.

 

What is needed instead is learning as an active, ongoing practice, embedded in how systems operate day to day, not learning as reporting, not dashboards for reassurance, but learning that repeatedly asks:

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• What is actually happening?

• For whom?

• In what context?

• With what effect?

• What does this tell us?

• What should we try next?

 

Data plays an important role, but data alone is not learning. Learning comes from collective sense-making, dialogue and the ability to act on what is being seen.  Moving beyond recommendations that sit with “someone else”.  A familiar pattern in system change is the production of recommendations that rely on others to act.  Reviews highlight issues linked to housing, employment, income, trauma, community safety or access to support. These are often entirely valid.  But when responsibility is diffused, accountability becomes foggy and progress stalls.

For example, meaningful and effective alcohol and drug support cannot exist without safe and secure housing. Naming that truth matters. But writing it into a report does not, by itself, change housing outcomes.

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What helps instead is clarity:

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• Who has the ability to act?

• Where are the barriers?

• Which changes can be made locally, now?

• What needs escalation, and through which routes?

 

This shifts the focus from abstract recommendations to shared responsibility and practical pathways for action.  This is ultimately about power and decision-making.  Most people working in public services are deeply committed. The limiting factor is rarely motivation, it is how power and authority are structured.  For systems to adapt, decision-making needs to sit at the right level. Those closest to people’s lives must have the authority to change what they can. Senior leaders must focus on removing barriers, aligning resources and enabling learning across the system.

This is what I describe as working at different altitudes of decision-making. Public facing support teams should not be expected to work around broken national rules and national leaders should not be determining the detail of local practice.  Right decisions, right level, right information.  Everyone has a role in change

System change is not the responsibility of one group alone. It does not sit only with senior leaders, middle managers or public facing support staff, everyone has agency, everyone has a role.

The task is to use the agency you have, act where you can, and ensure learning travels upward when change is blocked. When learning flows, systems improve.

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Scotland’s challenge is implementation, not intent.  Scotland has strong policy frameworks and a clear commitment to prevention, participation and place. Community Wealth Building is one example among many.  The challenge is not the absence of good policy. It is implementing policy in ways that reflect its original intent, rather than admiring it from a distance.

That requires systems that learn in real time, adapt as conditions change, and support people to act rather than wait.

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A different way forward

In Control Scotland and I work with the reality of complex systems. That means focusing on learning, iteration and action rather than perfect plans. It means making barriers visible, responsibilities clear and improvement continuous.  If we want things to change, we need to stop doing work that looks good but achieves little.

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Instead, we need to build systems that:

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• learn as they go

• make decisions closer to lived experience

• support adaptation rather than compliance

• treat change as normal, expected and supported

 

People are ready for this shift, many have been for some time.  We do not need more consultation to tell us what is wrong, we need systems that are brave enough to act, humble enough to learn, and mature enough to change.