Transforming Public Health Provision with Systems Thinking

Nirosha Dissanayake, a qualified medical doctor turned public health specialist at Kent County Council, embarked on a transformative journey through The JGA Group’s Level 7 Systems Thinking Practitioner Apprenticeship.

Her experience shows the transformative impact of this course. Through the apprenticeship, she has significantly contributed to public health by designing innovative interventions and inspiring others to embrace collaborative, systems-based solutions. Her story stands as a powerful example of how systems thinking can be applied to improve health outcomes and drive positive change within complex systems.

Moving to the UK from Sri Lanka and changing careers from being a practising GP to working in public health posed numerous challenges for Nirosha. Along with adapting to a new country and culture, a new job and having a busy family life, she also took on Systems Thinking Level 7 Apprenticeship. Despite these challenges, Nirosha’s coach, Bee Dalrymple, describes her as someone who “embraced every learning opportunity, remaining committed to her personal and professional development.” She balanced a demanding job, family responsibilities and the rigorous apprenticeship with exceptional time management and dedication.

The public health challenge in Kent

Kent is the largest county in England, serving a population of 1.8 million people. The scale of homelessness in the region is significant, with an average of 125 adults sleeping rough each day. Annually, around 3,500 adults experience homelessness, and approximately 50% of these individuals face additional support needs, such as substance misuse, mental health issues, physical health concerns, or a history of involvement with the criminal justice system. Notably, 80% of the homeless population has substance misuse needs, highlighting the complexity and magnitude of the problem. Traditional housing solutions alone are insufficient to meet the needs of this vulnerable population so to effectively address these challenges, a holistic approach is essential.

Nirosha Dissanayake

Innovation and problem-solving through Systems Thinking

Through the Systems Thinking Apprenticeship, Nirosha’s work at Kent County Council has been transformative, particularly in applying systems dynamic modelling. One of her major contributions involved predicting future bed needs for the local authority detoxification services. She enabled more effective resource allocation by analysing large data sets using systems thinking tools. Her modelling directly informed the council’s commissioning decisions, ensuring sufficient future resources to meet demand. Additionally, Nirosha presented her findings at the Southeast England Public Health Conference, sharing insights with over 500 public health professionals, further establishing her as a thought leader.

Jess Mookherjee, Assistant Director of Public Health at Kent County Council, shared how Nirosha’s presentation was received. “She had to present her work twice due to the overwhelming interest,” Jess noted, highlighting Nirosha’s role as an ambassador for Systems Thinking in public health.

“She has pioneered the application of complex systems thinking to her role as a public health specialist with great success and this has generated a lot of interest amongst the medical and public health professionals”.

In another key project, Nirosha applied her systems thinking knowledge to tackle complex issues in public health, particularly in supporting homeless adults with substance misuse and mental health challenges. This approach led to four initiatives:

  1. Co-locating wrap-around support workers to provide holistic care
  2. Establishing recovery housing support to meet the housing needs of those in recovery
  3. Developing training models aimed at housing managers to support adults with complex needs
  4. Developing Real-time Drug and Alcohol-Related Death Surveillance System

Her Skills Coach, Bee Dalrymple, commented on the approach. “She mapped the system by analysing the interconnectedness of stakeholders and their roles in supporting vulnerable populations. This innovative approach exceeded expectations and created sustainable, impactful solutions such as boosting homeless adult referrals to substance misuse services and improving support systems to ensure ethical, community-centred solutions.”

A powerful example

Nirosha’s leadership and innovative approaches learnt through JGA’s Systems Thinking apprenticeship have transformed how her team tackles public health challenges, inspiring her colleagues to adopt more comprehensive and interconnected strategies. Currently, she has just secured a critical grant for her department off the back of systems thinking methodologies.

Nirosha is also co-authoring a research paper advocating for the inclusion of systems thinking in public health training for future consultants. Her work has sparked broader discussions about integrating systems thinking into public health policies, positioning her as a leader in driving effective interventions.

Her story stands as a powerful example of how systems thinking can be applied to improve health outcomes and drive positive change within complex systems.