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24 July 2015
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“We are in one of those great historical periods that occur every 200-300 years when people do not understand the world any more and the past is not sufficient to explain the future.” Peter Drucker

Many moons ago, life consisted of long periods of stability interrupted by occasional turbulence which we all moaned about. Many people, perhaps all of us some of the time, long for those days to return. Some are still waiting, only to face perpetual disappointment. The wise (perhaps) accept the state of ‘persistent white water’ and we all need to contemplate the acronym VUCA whilst praying for Churchill’s words to come true: “out of intense complexities intense simplicities emerge!” With military origins, VUCA describes the modern world as Volatile, Uncertain, Complex and Ambiguous. Recognise any of those? Most need little explanation but if this is the world we inhabit but we hanker for something else, it might be wise to ponder a while and connect a nonetheless abstract grouping to our world.

Volatile implies that both the magnitude and pace of change can be fast. That is a big enough challenge in health but it is compounded by a seemingly huge intolerance of those unable to keep up with the pace – often by those who have had longer to ponder. It would seem wise to give significant thought about how to make change happen as well as telling people constantly what needs to change – after all the NHS has invested heavily over the years in improvement science in all four corners of the UK. I am a novice in change management but I do know that it takes more than playing the over-bearing hierarchy game with sanctions galore, or as Dwight D. Eisenhower put it: “You do not lead by hitting people over the head - that's assault, not leadership.”

Uncertain refers to the increasing difficulty of predicting the future, a far cry from the US humourist Kin Hubbard’s whimsical definition of forecasting: “To observe that which has passed and guess it will happen again. Woody Allen got closer with: If you want to make God laugh, tell him your future plans.” This rather makes a mockery of the ubiquitous five year plan and the over-reliance on the action plan but where is the balance? In the target era, has natural selection favoured those whose preference is that well-defined plan followed through with precision when we are asking for, nay demanding, something altogether more fleet of foot? It is a feature of our success as a species that we draw on our past experiences to guide us in the future; modern uncertainty calls for great thought before we rely too much on experience which is quite scary!

Complex is obvious and also implies that simplistic, single solutions are highly unlikely to work and yet we are fed a daily diet of chewed-over shortcomings, overlain with the piety of hindsight often followed with something along the lines of why don’t you just .... . Those critically wielding the retrospectoscope should heed more the words of Judge George Bramwell in 1869 in Hart v The Lancashire and Yorkshire Railway Company:  “I have often had occasion to tell juries, to hold that, because the world gets wiser as it gets older, therefore it was foolish before.”

Ambiguous is the lack of clarity regarding what events mean and what effect they may have - this is particularly challenging. Successful leaders cope with ambiguity but need to be aware that their teams will vary in their ability to do the same; indeed part of the leader’s role is to offer clarity in an unclear environment. Hauntingly, Kail opines that ambiguity can lead to “the inability to accurately conceptualize threats and opportunities before they become lethal.” He adds: “A symptom of organizational ambiguity is the frustration that results when compartmentalized accomplishments fail to add up to a comprehensive or enduring success.” Is this the scenario where well-meaning, committed staff are very busy failing?

The successful will see VUCA as positive and a manifestation of rapid change rather than a tough temporary chore to be endured as we metamorphose towards utopian stability. But are we doing enough to prepare our leaders and the larger workforce to tackle this chaotic world or, to misquote Eric Hoffer, are we preparing people to cope with a world which no longer exists? We are fast moving from the world many of us grew up in where leadership development was non-existent to one where it is more of a right, more expected. A recent anodyne report on NHS leadership in England was accidentally (!) buried in a load of other huge announcements but it recommended sending lots of people on a course and giving them a certificate?

Before leadership development develops its own dependency culture we need to take stock of contemporary literature which supports much of the current (horizontal) approach but highlights the need for another dimension of ‘vertical’ leadership. Fundamental to that is self-directed learning, not spoon-feeding. In defining the levels of vertical leadership it also lays to rest the notion that we just need to skip a generation or two and find the answer in a twelve year old who can write ‘apps’.

We do not need dinosaurs but we do need the wisdom and experience of those who have come to leadership through the school of experience, who have made mistakes and survived, who know when to challenge and when to support, who are wise, kind, courageous and robust; in short those who have a mind of their own, their own moral compass but who still retain their humility and openness to challenge and being wrong. The focus needs to address collective, not just individual leadership and above all, to successfully navigate VUCA we need to be creative in our methods.

“While we're talking, envious time is fleeing: seize the day, put no trust in the future”. Horace Odes Book 1

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7 years 5 months ago


As someone who has been familiar with the VUCA literature for a while, I must say this probably the best and most appropriately nuanced elucidation of it appled to context, I have read to date. It should be a 'read and reflect on' essential for FMLM memebers and the larger medical leadership community. Well said Peter!


7 years 6 months ago


Well said Peter.I couldnt agree more .You have nailed the issues down .

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