Diversity and complexity – moving the change conversation to the edge

Posted by: NHS Horizons - Posted on:

Originally published by Horizons – 7th March 2018

Whatever your experience of leading or implementing change and improvement in health and care, most people would be keen to apply diversity to their practice and to work in a way that aligns with their values and principles. This year, the School for Change Agents has used a range of concepts to support change agents and these all have a strong alignment to diversity and inclusion.

The modules have focused on:

  • “Change starts with me” – exploring how diversity always starts with being authentic and building a heightened sense of self awareness and self-consciousness. 
  • Being resilient and dealing with resistance to chance – including how to see diversity through a variety of lenses and to understand dissent and disruption.
  • From me to we: organising and mobilising – and looking at how diversity is about connecting with others and engaging people in change strategies and collective action.
  • The change agent of the future – learning how to build future leaders who are diversity competent.

Paul Deemer (Head of Diversity and Inclusion at NHS Employers) and Jagtar Singh (Chair of Coventry and Warwickshire Trust) led the conversation about diversity for this EdgeTalk

Participants were asked to share their interpretation of  diversity, the value it holds to supporting change and the strategies and tactics they have used to support their organisations to adapt and survive in an increasingly complex environment.  

We started the session by watching  George The Poet – Search Party, and this sparked an in-depth and honest discussion about what it means to be authentic, human, and to tell our diversity stories.  This followed by a detailed discussion on what is diversity, and the challenges this agenda brings for change leaders. 

Most change agents who have undertaken Modules 1-3 of the School for Change Agents would be familiar with the importance of cognitive diversity and its value in terms of generating innovative ideas, and improvement practices. 

This is not the same as different thinking styles and the Six Thinking Hats principles developed by Edward de Bono. He argues about the positive benefits to considering a problem from an emotional, intuitive, creative or risk management viewpoint. The benefits of using Six Thinking Hats are well rehearse however how does this apply to diversity and the way we understand change in organisations, and the strategies and processes we use to encourage positive disruption, visible and invisible diversity, and positive action.  It is very easy to fall into group-think even though we know it stifles innovation, limits the possibility for adopting change ideas and spreading new approaches to widespread transformation.

Diversity is firmly on the agenda of change and innovation in the NHS. If homogeneity worked in the past, it is no longer a viable solution. Surviving this level of turbulence demands a diversity advantage position – being proactive about developing diversity strategies across all areas of our work.  As our presenters pointed out, the solution to the problem of complexity is not homogeneity—it is heterogeneity.  

Efforts are being made to encourage inclusive leadership in the NHS and the recent Developing People -Improving Care report points to the need to address the power differential and to open a conversation about the lack of BME leaders in senior positions across organisations and the wider system. The Commission for Leadership and Inclusion mandate also aims to quicken the pace of change towards greater levels of equality, diversity and inclusion at all levels.

Diversity and complexity – we need both

Diversity and complexity can be mutually complimentary and at yet at polar opposites. Some people in the EdgeTalk session felt that diversity makes ‘common sense’ while others shared how difficult it is to speak to power, to challenge colleagues on inappropriate behaviours, or to move outside a ‘grade’ focused culture in the NHS.

Diversity can also become unnecessarily complex when we invite people from different backgrounds and experiences to engage in change conversations and nothing changes.  Have you engaged in change conversations and invested in gathering different and sometimes conflicting perspectives, yet on reflection thought how this led to nothing changing in practice? Diversity sometime requires us to ‘rock the boat’ as well as exercise strong staying in power to make a difference.  It can be further complicated when we add unnecessary layers on to what is already a complex system and hide behind the illusion of shared or distributed power. Challenging existing power imbalances across the horizontal and vertical divide requires confident articulation of diversity leadership.

The diversity temperature in organisations can be a litmus test to determine if the culture of the organisation is ready for change. Is there an entrepreneurial spirit and a creative culture for problem-solving, and learning from mistakes and failures? Do change leaders feel they are given sufficient space to grow their talents and interest, beyond their job descriptions or grades? Are leaders willing to share their failures, mistakes, unconscious biases and work preferences, as a way to support a more open culture? 

Diversity should be complex because this is not about reluctance – being told what to think and do. We need to support those who would resist or react against change to explore these concepts for themselves. On the other hand, the familiar argument that diversity will lead to more costly complexity undermines the search for innovation, and change agency.


To guard against this danger, we need to provide a safe space for the cross-pollination of ideas and appreciate the positive benefits diversity can bring to organisational development and service improvements as well as the efficiency savings that result.

  • Do people from diverse backgrounds feel safe to speak up, to challenge the status quo?
  • As a change agent leader, how do you respond when someone disagrees with your change idea?
  • Do they feel safe and even encouraged to express their authenticity, vulnerability and bias?
  • Here are some practical tips to support change agents who wish to develop their diversity leadership skills:
  • When making a decision try to suspend judgement.
  • Use collaborative problem solving approaches.
  • Don’t be afraid to pressure-test ideas.
  • Exceptional leaders work to become more aware of their unconscious biases – find ways to uncover and then share yours.
  • Keep an open mind. Welcome differences. Don’t force sameness.
  • Be humble – share your failures as well as your successes.
  • Lead by example – give people the freedom to explore their change ideas and be open to doing things differently.
  • Think about your personal, positional and organisational power – be prepared to let go, share and be challenged.


With grateful thanks to the contributors:

  • Janet Wildman – Associate, NHS Horizons
  • Paul Deemer – Head of Diversity and Inclusion, NHS Employers
  • Jagtar Singh – Chair of Coventry and Warwickshire Trust

Diversity can also become unnecessarily complex when we invite people from different backgrounds and experiences to engage in change conversations and nothing changes.