Part 6: Phase Four
Strand 2: Conceptualising a Whole Systems Approach
Video
Learning Objectives
After watching this section, you should be able to:
- Describe the purpose of Phase Four and its role in developing a whole systems action plan
- Explain the iceberg model and its four levels of system action
- Explain why acting only at the event level is insufficient for lasting change
Key Points
- Phase Four involves stakeholders proposing actions to change the system, forming the basis of the whole systems action plan
- The iceberg model describes four levels: Events (what we see), Structures (rules, policies, infrastructure), Goals (what parts of the system are trying to achieve), and Beliefs (values, attitudes, mental models)
- Events are visible above the waterline; structures, goals, and beliefs lie beneath and drive the events we observe
- Actions targeting only events — such as high obesity rates — do not address the underlying causes and so cannot prevent the same problems from recurring
- Evaluating actions against all four levels of the iceberg helps ensure the approach creates genuine, lasting system change
Further Reading
- Whole systems approach to obesity: a guide to support local approaches (Public Health England / Leeds Beckett, 2019) — the PHE guide covering Phase Four, which focuses on implementation: taking aligned actions across the system and building momentum for change
- Human Learning Systems — practical guidance on how organisations can move from planning to adaptive action in complex systems; relevant to the leadership and coordination challenges of Phase Four implementation
Knowledge Check
Complete the questions below before moving on.
In the “iceberg” model described in Phase Four, which level represents the most visible part of the system?
The correct answer is Events (e.g. high obesity rates, high consumption of high-fat food). The video uses an iceberg metaphor to describe system levels. Events — such as high rates of obesity or low numbers of children walking to school — are the things we see happening around us and sit above the waterline. Beneath them lie the structures, goals, and beliefs that drive those visible outcomes. Actions that only target the event level do not prevent the same problems from recurring.
- False — structures sit beneath the visible surface of the iceberg and are less immediately apparent.
- False — beliefs are the deepest layer, underpinning everything else in the system.
- False — goals are a deeper layer of the iceberg that shape what structures produce.
- True