Systems leadership: how chief executives manage tension between organisation and system pressures.

AIM: System leadership is the requirement for a leader of a single organisation to operate on behalf of a wider system, rather than their individual organisation. The current policy landscape does not incentivise system leadership, as many national structures emphasise a focus on individual organisations. This study aims to understand how chief executives in the National Health Service (NHS) in England implement system leadership in practice when faced with decisions that benefit the system to the detriment of their own trust. METHODOLOGY: Semistructured interviews were conducted with ten chief executives from various NHS trust types to understand their perceptions and decision-making process in practice. Semantic thematic analysis was used to draw out themes in relation to how chief executives approach decisions which weigh up the system and organisation. RESULTS: Interviewees expressed advantages (such as support in managing demand) and disadvantages (such as increased bureaucracy) of system leadership and practical considerations in operationalisation (such as the importance of interpersonal relationships). Interviewees endorsed system leadership in principle, but did not feel that current organisational incentives support the implementation of system leadership in practice. However, this was not seen as a major challenge or impediment to effective leadership. CONCLUSION: As a specific policy area, a direct focus on systems leadership is not necessarily helpful. Chief executives should be supported to make decisions in a complex environment, without a specific focus on healthcare systems as a unit of operation.

The narrow gap between norms and cooperative behaviour in a reindeer herding community.

Cooperation evolves on social networks and is shaped, in part, by norms: beliefs and expectations about the behaviour of others or of oneself. Networks of cooperative social partners and associated norms are vital for pastoralists, such as Saami reindeer herders in northern Norway. However, little is known quantitatively about how norms structure pastoralists' social networks or shape cooperation. Saami herders reported their social networks and participated in field experiments, allowing us to gauge the overlap between reported and emergent cooperation. We show that individuals' perceptions of reciprocal cooperation within their social networks exceeded actual reciprocity, although both occurred frequently and were concentrated within herding groups. Herders with more extensive cooperation networks received more rewards in an economic game. Although herders overestimated reciprocal helping, cooperation in this community was still extensive, suggesting that perceived norms potentially allow network structures promoting cooperation to emerge and be maintained.

Kinship underlies costly cooperation in Mosuo villages.

The relative importance of social evolution theories such as kin selection, direct reciprocity and need-based transfers in explaining real-world cooperation is the source of much debate. Previous field studies of cooperation in human communities have revealed variability in the extent to which each of these theories explains human sociality in different contexts. We conducted multivariate social network analyses predicting costly cooperation-labouring on another household's farm-in 128 082 dyads of Mosuo farming households in southwest China. Through information-theoretic model selection, we tested the roles played by genealogical relatedness, affinal relationships (including reproductive partners), reciprocity, relative need, wealth, household size, spatial proximity and gift-giving in an economic game. The best-fitting model included all factors, along with interactions between relatedness and (i) reciprocity, (ii) need, (iii) the presence of own children in another household and (iv) proximity. Our results show how a real-world form of cooperation was driven by kinship. Households tended to help kin in need (but not needy non-kin) and travel further to help spatially distant relatives. Households were more likely to establish reciprocal relationships with distant relatives and non-kin but closer kin cooperated regardless of reciprocity. These patterns of kin-driven cooperation show the importance of inclusive fitness in understanding human social behaviour.