Many moons ago, I was fortunate enough to observe a multi-disciplinary team (MDT) in Dudley. The team, which today would be called an ‘Integrated Neighbourhood Team’, included multiple specialist nurses, a voluntary sector link worker, a GP, a social worker, and other professionals.

They were discussing different cases. Each was complex in its own way: physical health problems blended and blurred with social and psychological needs; cases worsening, cases improving; treatment plans followed, others unravelling.

It was fascinating. Different professionals seeing different ways into the same case. Each adding their perspective; these fragments combining into a richer view. And, talking to the lead GP afterwards, the MDT members were learning from each other: their perspectives expanding over time.

I now see that this is what the best analytical teams also do.

They blend perspectives like a clinical MDT. A systems-dynamics modeller sees differently to a data scientist, who doesn’t see the same world the social researcher does, who adds a slightly different perspective to that of the strategist, who shares some of the economist’s assumptions, who in turn combines well with the impact evaluator.

Undoubtedly, a mono-disciplinary perspective is sometimes needed. No-one wants my view on database architecture, for example. But for the kind of thorny, entangled problems faced by health and care services, no single discipline has ‘the answer’.

A confession…

The night before I joined the Strategy Unit (nearly 11 years ago), I was on Wikipedia, trying to find out what this thing called the ‘NHS’ was, and how – in practice – it worked. I wasn’t totally wet behind the ears. But the more I thought about it, the less I was sure of knowing. Not a good start.

Day 1 began with a jangle of nerves. But I relaxed within about half an hour: the first few colleagues I met seemed to know everything about the NHS. And they didn’t seem to care about my ignorance. If anything, they were more interested in what I knew that they didn’t. The pattern repeated. And it got richer and richer as conversations got more technical. The question that attracted my new colleagues seemed to be: ‘how do we combine our skills to do the best work and have the greatest impact?’ The same question being addressed by clinical MDTs.

The GP’s point about time has also proved true. She talked about learning from colleagues: gaining a richer perspective by working through many cases over many months.

Where the MDT sees patients, the Strategy Unit sees programmes. What I learnt in Dudley has stayed with me. We were there as evaluators, so we saw and addressed measurement problems that we have pulled through into our work as the Intelligence Centre for Neighbourhood Health.

Our work on neighbourhoods has drawn concepts and results from our New Hospital Programme, translating modelling work - via our data science team - into tools and products for spotting ‘left shift’ opportunities. These will be iterated and improved for our work to improve analytical capabilities of strategic commissioners; they will also supply refined measures for our evaluation work; and these results will refine our policy work. (And so on).

Complex problems need nuanced perspectives. Every technical perspective has blind spots; combining them carefully reduces the chance of overlooking something vital.

And each new problem requires a new blend of perspectives. For example, last year 30 of our staff have contributed to our work in the New Hospital Programme; the alternative would be recruiting 10 full-time staff. Our approach increases the diversity of backgrounds, skills and expertise.

What does this mean for practice?

For analysts, it means humility. To know that your skills – however great – cannot wrestle complex problems into submission. But some purchase can be gained by combining your skills with others. But which ones? And how? This requires the meta-skills of curiosity, humility and listening.

For teams, it means providing a supportive home for technical experts. They need opportunities to constantly sharpen their skills – primarily through exposure to new ways of seeing and addressing problems. This means having multiple projects and programmes requiring an ‘MDT approach’. To some extent, this means reaching a decent scale: lone experts can get blunt and bored.

And for the NHS, it means recognising that the logic of the MDT applies in other technical areas. Complex, critical programmes cannot be served by single disciplines. Specialism is needed; but the real power of specialism is found in combination. And combination does not happen accidentally or overnight.

So how can the NHS create the best possible environment for this kind of combinatorial quality to flourish?

The answer is in the question. Bringing analytical MDTs to life is about creating the right environment, not determining the outcome. Teams like the Strategy Unit cannot be blueprinted into being. We have grown organically: recruiting and expanding in response to demand. Our business model – recovering 100% of our costs through commissioned work – has helped this.

Fundamentally, the task is to assemble talented staff (maybe even extending to those who need Wikipedia), giving them a supportive operating environment and training them on complex problems.

That was what I saw years ago in Dudley; and that’s what I see at the Unit today.