Integral Paradigm Shift in European Healthcare? (IEC 2016 conference preview)

By Zoe Nicholson and published at Integral European Conference blog

This article gives a taste of the workshop that the author will give at the Integral European Conference. Check here for other Integral European Conference previews from Enlivening Edge.

Teal Healthcare Delivery: bring your insights, skills and experience and help us solve some of our challenges

Zoe Nicholson is co-founder and Chief Executive of Brighton and Hove Integrated Care Service, a not for profit social enterprise delivering healthcare to 1 million people in the UK. Zoe will join us for the second Integral European Conference and share her experiences. Her invitation to you:

Come and co-create a space of collective intelligence,

sharing our story and seeking your help with the challenges we face in our journey to teal in a regulated healthcare environment. We invite you to be our advisers, supporters, challengers addressing real questions that we face today.

BICS (Brighton and Hove Integrated Care Service) operates in a highly regulated health sector, where extreme value is placed on delivering targets, resources are siloed, professional tribe is more important than the skills needed, where “what’s the matter” is valued more than “what matters to you”. Our journey to shift this paradigm started over 9 years ago, in the last 18 months we have embraced our evolution to teal. We hold questions about how best to interact with our external stakeholders, and how to mitigate the worst effects of the environment and still deliver with integrity and value to those we serve. We invite you to work with us on some of the real questions:

  • How can we increase shared learning?
  • How do we create a protective environment for experimentation in a highly regulated sector?
  • How do we maintain focus on what matters to us while still delivering what matters to the people we report to?
  • What approaches to quality improvement and quality assurance can we use that don’t take away from focusing on what matters?

Design principles of our workshop


01Story telling: Telling the story of our journey so far, our context and environment. Outlining our challenges and our questions.
Interactive and participative: In one large circle, with a check in and check out. We will use PeerSpirit Circle principles and maybe Case Clinic technique in smaller circles.

In small groups enabling intimate circle conversation on our questions, where we practice seeking to understand in order to form our insights and questions.

Team: Zoe will host with a small number of BICS people, who will be attending the conference.


Zoe Nicholson is co-founder and Chief Executive of Brighton and Hove Integrated Care Service, a not for profit social enterprise delivering healthcare to 1 million people in the UK. She founded BICS, 9 years ago after a career in the NHS. Her passion is finding purpose and meaning at work. Zoe is leading BICS on a journey towards becoming teal, and creating more possibilities for care in every moment.

  1. I love your questions Zoe. I find them very strategically important when wondering how to bring about a shift within a system that is sooo heavily crystalised and top down while at the same time socialised. My own approach has been to find areas where the system has no real answers and is stuck anyway. I try to offer something different which is not too different but different enough to enable a new experience for patients. It is after all the patients that healthcare professionals and the system as a whole serve. Unless people have a different and more enlivening experience, they remain too sceptical and cautious which includes patients, professionals and certainly those decision makers with access to funds. For example I started a pilot project within the NHS in a Memory Service without any need for extra funding. The project is called Brainfood which is not just about telling people what to eat but doing it with them, giving them a positive experience where they are being seen, heard and appreciated for whatever they contribute and however they show up. It has been very successful over the last 2 years with some patient’s cognitive decline even improving. Now they want to co-produce to share their experiences. At the moment I am looking for help with that. Another example that is making waves in Mental Health is the Open Dialogue projects in 5 UK Mental Health Trust. Dr.Russell Razzaque who is a force for change and the leader of OD in the UK also likes Laloux’s work and could explain how he managed to achieve this change. My understanding is that it may be more difficult to bring about a shift in other areas of healthcare as medical science is still very linear whereas psychology is open to a systemic approach. Even when medical professionals talk about holistic healthcare they only understand it from a limited reductionist and linear mindset. We dont yet have an approach or a medical science that includes and transcends our dominant medical scientific model. My sense is that it will only come when top meets bottom and bottom meets top and they really listen to each other even if they dont agree. Creating spaces for such deeper listening and spaces for safe experimentation (ie starting with nutrition and other lifestyle changes) seem to me a good beginning to usher in more change. Curious of what you think. Looking forward to join your workshop in May. Maybe we can organise more of them in the UK.

  2. Thank you for this. As a herbalist with a social enterprise I’ve been keeping appraised of the various health and social-care initiatives in Morayshire were I live. Their heart and vision is in the right-place, especially with the development of Self-Directed Support, but the process is frustratingly slow, especially for small service providers like myself. It seems you are also working on an alternate solution to the issue of widening the choices for individuals in the UK. Anna, I think you’re correct in regards to science and the health-care establishment…the social care setting seems more open-minded. On the “medical paradigms” side of things I shall be presenting my own work on the subject of “Integral Health and Healing” at the conference and am looking forward to some very interesting discussions.

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