Part 2: Ten Key Features of the Whole Systems Approach

Strand 4: Evidence for a Whole Systems Approach to Obesity

Video

Learning Objectives

After watching this section, you should be able to:

• List the ten key features of a whole systems approach as described in the literature
• Explain why each feature is important for implementing and sustaining a whole systems approach
• Distinguish between the different types of capacity building and leadership required across a whole system

Key Points

• Feature 1 — Identifying system boundaries: whole systems approaches are typically described as ‘local’ because the boundaries of the system must first be defined; attempting to address the entire system without boundaries is impractical
• Feature 2 — Capacity building: this covers both knowledge and skills development (training, education, understanding) and the recruitment of people to lead and support the approach
• Feature 4 — Establishing relationships: understanding the requirements and constraints of different departments and organisations is essential for cross-sector working
• Feature 6 — Communication: the approach aims to optimise existing communication channels across the system rather than creating new ones
• Feature 8 — Distributed leadership: leadership must be developed throughout the system at all levels — not concentrated in one or two senior figures — to make the approach resilient and sustainable
• Feature 10 — Evaluation and monitoring: this is ongoing and continuous, not a one-off activity; evaluation feeds back into the system as it evolves

Further Reading

• Bagnall AM et al. (2019). Whole systems approaches to obesity and other complex public health challenges: a systematic review. BMC Public Health, 19, 8. — the source of the ten key features of WSA discussed in this video; 65 studies included, covering WSA to obesity and other complex public health challenges
• Whole systems approach to obesity: a guide to support local approaches (Public Health England, 2019) — the PHE/Leeds Beckett practical guide that operationalises many of these ten features into a structured six-phase process
• Health Matters: whole systems approach to obesity (GOV.UK) — a companion overview explaining the rationale and evidence behind the PHE approach, aimed at public health practitioners and local authority leaders
• A whole systems approach to obesity prevention: a rapid synthesis of evidence — the full IPH report for Northern Ireland; contextualises the ten features within the evidence base reviewed in this strand (Breslin et al., 2023)

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Knowledge Check

Complete the questions below before moving on.

Which of the following correctly describes one of the ten key features of a whole systems approach to obesity?

Replacing existing communication channels across the system with a new centralised platformPrioritising short-term outcomes and quick wins to demonstrate early impact to fundersFocusing exclusively on individual behaviour change through targeted public health campaignsDeveloping leadership throughout the system — including both formal and informal leadership — rather than relying on one or two people at the top

The correct answer is Developing leadership throughout the system. One of the ten key features is that leadership should be distributed across the whole system — not concentrated at the top. This means fostering both formal and informal leadership at multiple levels so that the system can continue to develop and change even as individuals move on or priorities shift.

• False — the approach aims to optimise and work within existing communication channels, not replace them with a new system.
• False — a whole systems approach acknowledges that meaningful change takes time; focusing on quick wins runs counter to its long-term, systemic orientation.
• False — individual behaviour change campaigns are precisely the type of siloed, event-based approach that whole systems approaches move away from.
• True

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