In our latest analysis for the Midlands Decision Support Network (MDSN), we explore the long standing problem of access to GP practice consultations we consider the implications, and explore potential solutions.

The Strategy Unit is collaborating with the Health Foundation to help address key health and social care issues by combining our expertise in data analysis.

All light brings shade. My list of ‘changes that have been all upside and no downside’ is short and debatable. It extends to anaesthetic dentistry, clean air, and clean water.

Maybe there are more.

But rather than trying to add to this list, what I'd like to do is to employ the founding insight: to look for the downsides that come with any innovation, however positive seeming. Plenty of people want others to see the light; I want them to recognise the shade.

I’ll do that here using the example of data to inform decision making.

I’m argumentative. Not in the interpersonal sense – at least I hope not – but in the sense of having an eyebrow that cannot stay put while listening to people’s claims and propositions. It inches its way up my forehead, ruining my poker face and revealing my misgivings.

I’m not sure there’s a superlative strong enough to describe ‘The Matter With Things’ by Iain McGilchrist. The most immediately breath-taking thing about this book is its scale. The hardback version is as big as it is beautiful. It comes as two volumes and weighs in at 1,579 pages – 182 of which are bibliography.  

I’m a fan of Shane Parrish and his organisation Farnam Street (strapline: ‘Helping you master the best of what other people have already figured out’). I’ve gained a lot from their books on mental models and have enjoyed many episodes of their podcast.

But the most valuable thing I’ve picked up from Shane’s work is a question.

Two starting points:  

Imagine this: 

You are reading a big policy announcement, a business case for something strategically important, or maybe even a bid for significant levels of resourcing.  

The content, narrative and framing of it is pretty much what you’ve come to expect. So far, so humdrum.  

You finish the main body of the document, and are about to put it down, when the following catches your eye: 

Learning is one of the joys of teaching. And I’ve learnt a lot while helping people develop their decision making skills.

Some of these lessons have been encouraging. Inspiring even. It has then been a privilege to share them through the Decision Support Network’s education and training programme.  

But some of the things I’ve learnt belong on the negative side of the ledger. I’ve heard about constraints on decision making that are serious enough to require broader, more systemic change.

Some forms of leaders’ power are obvious. Leaders hire and they fire. They grant resources and they withhold them. They require some things and they prohibit others. These are the ‘hard’ powers that most of us think about when asking how leaders get things done.