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This article explores the front‐line experience of a two‐tier shire county, Nottinghamshire, in using a whole‐systems working approach to the promotion of independence and well‐being for older people. Nottinghamshire has been one of the eight national pilot sites for LinkAge Plus. The experience of managing a whole‐systems approach in practice in implementing LinkAge Plus is explored. The importance of ensuring the systematic engagement of older people in the process is emphasised. The article describes six learning areas which helped the development of preventative and well‐being services in the context of whole‐system working and older people's engagement.

Whole system working is critical to improving health and social care services while using scarce resources more efficiently and this article aims to look at the urgent need to develop measures for it. It seeks to describe the development of a simple, practical, set of measures for benchmarking and analysing local use of key whole system resources as the basis for discussion and planning. Practical and usable tools are needed urgently as national measures are not available at present and key resource decisions need to be made now.

The paper looks at a simple framework for looking at integration in localities and some proposed measures as the basis for discussion. It describes the development and application of a simple, practical set of measures to use locally in the absence of a national set. It uses nationally available, comparable measures wherever possible to minimise work. It briefly describes how the comparative data enables localities to identify key differences in use of resources and outcomes and areas for improvement.

Taking a whole system, whole person approach and applying it across localities provides a useful framework to help local health and social care systems focus on improving patient outcomes while reducing unnecessary costs – particularly unnecessary use of high cost institutional care. The measures including the Audit Commission whole system measures identified key issues re different use of resources, costs and outcomes between localities. This article looks ahead to the implications of greater personalisation of services and the need to develop more effective information systems based on the individual patient which allow more rigorous measurement of service effectiveness including outcomes as well as activity.

In the absence of national measures of whole system integration, this paper describes how a simple, practical framework and measures were developed to analyse use of resources and identify key areas for improvement. It can be used by localities to provide a quick benchmark of use of resources and outcomes (especially whole system use of expensive institutional resources) to support value for money and service effectiveness work. It describes how it worked in practice and looks at how information systems could be further developed in line with personalisation to allow ongoing improvement based on individual outcomes, costs and service effectiveness.

This study describes the need to develop whole system measures to show the effectiveness of moves towards integration. In the absence of national measures, it describes the development of a simple set of local whole system outcome measures based on a framework based on recent work on whole system integration. The paper uses both health and social care evidence and summarises key elements that work. It shows how the measures have been applied in practice in localities as a first step in a local system improvement programme.

Abstract This article looks at the benefits of and obstacles to using a whole systems approach to plan and deliver personality disorder services. It does so using the example of the Leeds Managed Clinical Network, a community pilot service that employs whole system working to support people with personality disorder.

In working to develop multiagency adult protection policy and procedures in West Sussex, we were looking for ways to increase engagement and ownership across agencies, agree roles and responsibilities and consult in a collaborative way on the draft policy and procedures. A large‐scale event was organised with a ‘whole system approach’, as distinct from a traditional conference. Here we describe the origins, purpose, process and lessons from this approach.

This paper considers intermediate care as part of a whole‐systems approach to care. It argues that this perspective allows a wider appreciation of the potential benefits of intermediate care, and that this would also be a welcome feature in future research studies. The paper draws on an evaluation of intermediate care in Cornwall and outlines the central role of intermediate care co‐ordination in the whole system. The example of residential rehabilitation is then used to examine how an individual service relates to the system as a whole. Finally, factors that may also influence local systems such as partnership working and rurality are considered; these are seen as important considerations for any other authorities which might seek to replicate the Cornwall approach to intermediate care.

Top‐down or outside‐in change methodologies are increasingly seen to be ineffective. Systems thinking suggests that change in organizations is a much less straightforward and more subtle phenomenon than previous models allow. Since the late 1970s and as organic metaphors have become used more, the concept of organizational learning has emerged as central to the issue. However, an understanding of how this may take place is still undeveloped. Recently technologies for whole systems development have emerged based on Weisbord′s dictum that for change or learning to occur we need to “get everybody into improving the whole”. Whole systems development can offer a way to realizing the learning organization. Provides a case study of whole systems development in action within Walsall Metropolitan Borough Council in the UK. Begins with a brief account of the ideas on which whole systems development is based and concludes with a commentary on the case study.

Pressure for reform and change in the public services will continue irrespective of the political composition of governments. There are many interrelated pressures for change, some of the key ones being the need to contain public spending (to under 40 per cent GNP?) in the face of ever increasing global competition, changing demographic and employment patterns, increasing need and demand for services, and the need to find innovative solutions to obdurate problems of local levels ‐ health, housing, community safety, unemployment and so on. Above all, this will require greater productivity; changing skill boundaries, demarcations and mixes; far greater applications of technology and innovative community‐based multi‐agency working ‐ beyond rhetoric. Unfortunately, much current research, scholarship and commentary is “locked into” individual public sectors ‐ health, education, public administration and so on. This means that it is likely to be informed by existing frames of reference which already lie within these sectors. A wider flow of ideas, theory and critical analysis across private and all public sectors could lead to the development of new paradigms of insight, understanding and practice. This would prove a further impetus for a bottom‐up social movement with a communitarianist agenda. Unfortunately this is most unlikely to be promoted top‐ down because most politicians are also “locked into” the binary thinking of Fordist modernism.

This paper aims to use systems mapping as a tool to develop an organisation-wide approach to public mental health to inform strategic direction within a national public health agency.

Two workshops were facilitated with internal staff from a wide range of public health policy teams working in small groups to produce paper-based maps. These were collated and refined by the project team and digitised.

The approach engaged a range of teams in forming a shared understanding and producing a complex system map of the influences on population mental health and well-being, where current policy initiatives were addressing them and what the gaps and priorities were. Participants valued the approach which led to further study and organisational commitment to the whole system working as part of national public mental health strategy.

The approach was limited to internal stakeholders and wider engagement with other sectors and community members would help further the application of complex system approaches to public mental health.

It was a valuable process for developing a whole-organisation approach and stimulating thinking and practice in complex system approaches. The paper provides a practical example of how to apply systems mapping and its benefits for organising public mental health practice.

The modes of governance underpinning public sector services have been reshaped several times in the post‐war period, leaving a mixture of command and control, marketisation and partnership working. There is now a call for a new and ambitious phase that might be termed ‘whole systems working’, and the most ambitious focus for this phase is the Every Child Matters reforms being ushered in under the Children Act 2004. This article describes the whole‐systems nature of the changes and identifies a range of difficulties that need to be addressed.

A work system may be said to exhibit social sustainability if it utilizes its human, social, economic, and ecological resources with responsibility. This entails using these resources in a non-exploitive way, regenerating them, and paying due attention to the needs and ambitions of its stakeholders in the short- and long-term. For most presently existing organizations attaining and maintaining sustainability requires a midcourse correction, a transformation process. This chapter reviews the main concepts regarding sustainability and previous research of organizational development in this context. It presents a four-phase model for this transformation process and illustrates the model's application in four different contexts. The results are discussed and directions for further research are presented.