Design Thinking and Creating Hope in Complex Systems

Rendered image of the Fans for Life 2 – Love What We Do Together Design Sprint at the NWG Innovation Festival 2026

Like me, you’ve probably sat through too many "transformation" away-days, listened to an inspiring keynote and bought into the bold new vision statement, only to return to the status quo and a refreshed sense of hopelessness in a matter of weeks.  

I was recently part of Northumbrian Water Group's 10th Innovation Festival, working in a design sprint to co-create strategy with customers. Partway through and in the midst of a heatwave, exhausted and energised in equal measure, I caught myself falling into the old habit of wondering whether any of this would actually make a difference. This time though I felt a different kind of hope.

Reflecting on this hopeful feeling after the event, I was reminded of a recent Harvard Business Review piece about hope by Meister, Dael and Bach, and an associated Linkedin discussion led by Helen Bevan.  The article makes the deceptively simple argument. Hope is neither hope optimism nor wishful thinking. It's a goal-oriented motivational force that only works when it connects what people are doing today to a future they can genuinely believe is achievable. 

Your organisation is probably not short on vision but vision without the right type of hope is not enough

It’s not a lack of vision that leads to hopelessness. Leaders fail because their vision does not calibrate the size of the aspiration and the credibility underpinning it.  High aspiration with no credible, evidenced route to achieving it leads to inflated hope that rapidly deflates, leaving staff eye-rolling with cynicism. On the other hand, credibility without aspiration results in empty hope, often manifested as a managed decline disguised as resilience. One leader I work with, a medical director, put it bluntly: "I'm not sure how much longer I can keep pointing to the Trust’s vision statement and then ask people to just cope." Her senior staff don't need another rousing vision. They need to believe that today's effort actually reduces tomorrow's crisis.

Between these two failure modes sit two more productive states. Stabilising hope is the slow-burner that pairs realism with incremental progress. Mobilising hope matches a genuinely compelling vision with a grounded, visible and consistent pathway to achieving it.  How can  stabilising and mobilising hope be harnessed in complex and dynamic systems like the NHS?

Design thinking and creating hope

I discovered design thinking a few years ago, learnt as much as I could about it and went onto facilitate a couple of events. Often misunderstood and dismissed as a a workshop filled with sticky notes, whiteboards, flip charts and, yes, fun, design thinking may be fine for an innovation festival but not serious enough for an organisation running on empty. That reputation is worth correcting, because design thinking is one of the most reliable ways to rapidly build the credibility and aspiration to stabilise and mobilise with hope.

Vision built on evidenced understanding is inherently more credible than one built on aspiration alone

Lived reality is the start point

Design thinking begins with empathy and the genuinely understanding the compounding problem cycles people are living and working with. Instead of a version of the problem sketched out in a strategy deck, participants describe their realities and those realities are heard, not assumed.

Prototyping reduces risk

Hope collapses when people can't see how their effort connects to an outcome. Small pilots and rapid prototypes make that connection visible and testable before anyone commits a full budget or their reputation to it.

Enthusiasm is matched with evidence 

Boards need numbers. A design-thinking process generates real data from real cohorts and that’s the currency that turns a hopeful pitch into an approvable business case.

Iteration makes failure productive 

In periods of ongoing disruption, stabilising hope beats grand transformation rhetoric. You're not promising the mountain gets climbed in one leap. You're showing that the next foothold is real.

Everyone is included 

Design thinking is inherently collaborative.For the people in your organisation who want to make a difference but don't know where to start, the structured design-thinking approach is the credible pathway. It replaces "I'd love to do that" with an actual, achievable first move.

fixing the wrong problem destroys hope

Most large organisations already have a tool that looks, on the surface, a lot like design thinking. The Rapid Process Improvement Workshop (RPIW) is a Lean methodology, often three to five intense days, aimed at fixing a known issue. It's tempting to assume design thinking duplicates this but that would be a mistake, and understanding hope explains why.

An RPIW starts from the assumption that the problem is already understood and the process is mappable. The team walks the value stream, identifies waste and variation,and runs improvement cycles against metrics that are usually already agreed. It's superb for known, repeatable workflows that need to run better.

Efficiently mapping and optimising the wrong thing produces inflated hope, because it isn't solving the real problem

But your hardest problems, the ones driving retention crises, quiet disengagement and burnout, are different. There's no existing value stream for why good people leave. Run an RPIW on a problem like that and you misunderstanding what's actually going on for the people involved. When people notice the "fix" never touched what actually mattered, the damage compounds and the process for finding future solutions becomes suspect.

Design thinking's empathy and reframing stages embrace complexity and ambiguity whilst seeking to deeply understand the problems. Solutions only begin once there's real consensus about what needs fixing.

The practical upshot

None of this works if it's badged as innovation theatre. Aspiration without grounding breeds cynicism faster than no vision at all. At NWG's Innovation Festival, I noticed that despite the organisation having hard data suggesting which problems to focus on, we didn’t start here. The sprint began by listening and capturing the customers' stories. Together, this provided a credible, evidenced route from where we are now to where we collectively want to be, driven with the people who live with the problems. When we pitched our solutions to a panel of executives at the end of the sprint, I felt something rare: genuine, grounded hope.

Hope isn't the vision poster on the wall. It's not a soft skill, a fun workshop or a rallying call to action. It's the pilot that was built with and for people that works, after being tested incrementally, reported honestly and built on again.

If you are interested in running a design thinking event, particularly focusing on senior health workforce retention in your organisation, drop me an email victoria@hamiltonhill.co.uk or message me on Linkedin.

Reflecting on: Meister, A., Dael, N. & Bach, D. (2026). "For Hope to Inspire, It Has to Be Grounded in Organizational Reality." Harvard Business Review.

Thanks to Northumbrian Water Group's customer service team, Explain and Wordnerds for facilitating the design sprint and enabling us to do our best thinking in the heatwave.