The one sentence summary

It is often possible to solve problems before they happen.


  • We all have a tendency to work around problems by being resourceful and improvising. We are so used to dealing with emergencies that we don’t stop to think about how we could prevent them in the first place.
  • We have the capacity to solve some of our thorniest issues if we start to think about the system rather than the symptoms – if we start to think upstream. First, there are three barriers to overcome:
  1. Problem blindness: “I don’t see the problem,” or it just seems inevitable.
  2. Lack of ownership: “That’s not my problem to solve.”
  3. Tunneling: “I can’t deal with that right now.” When people are juggling a lot of problems, they adopt tunnel vision. Short-term, reactive thinking prevents long-term planning.
  • Anyone leading upstream change needs to address 7 questions:
  1. How to unite the right people? Surround the problem. Use data for immediate learning, not just for inspection.
  2. How to change the system? Fight for systems change. Fight the water (fish can’t see water), and don’t enable a system that is known to be flawed.
  3. Where to find a point of leverage? Get closer to the problem and don’t assume that prevention must save money.
  4. How to get early warning of the problem? Deploy sensors and look for predictors, whilst ignoring false positives.
  5. How to know you’re succeeding? Pre-game your measures and use paired measures – work out how people will game the system, and pair quantitative measures with qualitative ones so that they cannot hit the target but miss the pint. Ignore ghost victories that create the illusion of progress when unrelated to the action taken. If a rising tide lifts all boats, the ‘victory’ would have happened anyway.
  6. How to avoid doing any harm? Look beyond the immediate and close any feedback loops. Do not fail to test and avoid overconfidence.
  7. Who will pay for what doesn’t happen? Align incentives and stitch together pockets of value, avoiding the wrong pocket problem, in which no single budget will cover the initiative, so no one contributes.
  • In summary, upstream leaders need to detect problems early, target leverage points in complex systems, find reliable ways to measure success, pioneer new ways of working together, and embed their success into systems to give them permanence.


  • Most of us would agree that an ounce of prevention is better than a pound of cure, but our actions don’t match those words. We celebrate response, recovery and rescue. What we need is a quieter breed of hero, one actively fighting for the world in which rescues are no longer required.
  • Three themes to implement all of this:
  1. Be impatient for action but patient for outcomes.
  2. Macro starts with micro.
  3. Favour scoreboards over pills. How can we make progress this week? is better than repeatedly handing out hopeful remedies.
  • There is also inattentional blindness: where our careful attention to one task leads us to miss important information that’s unrelated to that task.
  • Moving to open plan in offices reduces face-to-face interactions by 70%.


  • Not much. This is well-structured and summarised so that you can take action straightaway.