All Hail the King of the North! And Chaos that Follows…

Complexity theory has never had much patience for five-year plans, and neither does British politics.

The King of the North arrived in Downing Street and, rather than leave it at the border, brought a court with him, creating “No 10 North” as the centre of his devolution-first government. Britain’s seventh PM has built his career on giving power away. Yet he has inherited a Health Bill, still making its way through Parliament, that does almost the opposite: abolishing NHS E and handing more power to the Secretary of State. A PM committed to devolution, leading a government pursuing centralisation. Even a soap writer might reject a plot twist that neat.

Complexity theory helps explain the contradiction.

The NHS keeps returning to its familiar hospital-centred model. Complexity calls this a strange attractor: a stable pattern reinforced by decades of funding, buildings and workforce. Neighbourhood health is an attempt to create a stronger alternative.

At the same time, every part of the system, hospital trusts, ICBs and mayors, is pursuing its own priorities. Complexity describes this as each actor climbing its own fitness landscape. What looks like progress from one perspective can easily look like failure from another.

The tension between a devolving Prime Minister and a centralising Health Bill is also likely to repeat itself throughout the system. Complexity calls this self-similarity: the same struggle over power will play out inside neighbourhood teams just as it does in Whitehall.

Then there is the timing. Mayors gained a legal duty for health improvement in April, while the Health Bill moves authority back to the centre. Rather than being a contradiction, this may reflect the system operating at the edge of chaos: the point where enough central direction and enough local freedom create the greatest capacity to adapt.

Finally, complexity reminds us that early decisions matter disproportionately. One adviser has already warned neighbourhood health could fail without a change of course. Whether that proves true or not, who sits around the table, who controls the budget and how responsibilities are shared at the start will shape the system for years.

If there is a lesson in all this for actually managing the shift well, it is probably these: 

• Expect several correct answers, not one. Because every part of the system is climbing its own fitness landscape, local variation that looks like confusion from Whitehall may just be different places finding their own genuinely good solution.
• Fix the pattern at every scale, not just at the top. Self-similarity means the row over power between No 10 and the Health Bill will replay inside every neighbourhood board, so a national fix that ignores the local version of the same argument will not hold.
• Calibrate the tension, rather than trying to abolish it. The edge of chaos sits between too much central control and too much local freedom, so the aim is the right mix of shared rules and local discretion, not a win for either side.
• Get the early design decisions right. Sensitive dependence on initial conditions means who sits on boards, and who holds the budget, will shape outcomes for years, so it is worth taking real time over those choices before scaling up.
• Set the outcome, then let the system self-organise around it. Neighbourhoods tend to find their own workable arrangements once the goal and boundaries are clear, and scripting the how too tightly from the centre, or from No 10 North, tends to crowd that out.

Whether the King of the North can govern through devolution while overseeing centralisation remains to be seen. Complexity suggests the answer is less likely to be either/or than both at once. Either way, it should make for an entertaining reign.