Beyond working with the grain
The previous post developed practical strategies for designers operating within programme management cultures: finding insertion points in existing governance rhythms, translating design insights into programme-legible forms, building alliances with operational staff. These strategies are honest about structural constraints, and they produce real if modest results. But they operate within a frame in which design enters an existing governance architecture and seeks to influence it from the margins - working with the grain, as the metaphor has it, but never reshaping the grain itself.
This series began by establishing the epistemological tension between design and programme management, and traced its institutional sources through audit culture, legibility requirements, and the accountability structures that determine what programmes can see. The first post noted that Le Grand's (1997) analysis of knights, knaves, and pawns exposes a deeper problem: the governance architectures that designers encounter in the public sector are not neutral administrative frameworks but expressions of specific assumptions about human motivation - assumptions that neither the pre-reform welfare state nor the NPM era ever grounded in evidence. Le Grand's (2003) prescription was not trust or control but "robust" institutional designs that would work regardless of whether individual actors were self-interested or altruistic. The question this post takes up is what happens when a government tries to redesign governance itself along these lines - and what role design plays in that redesigning.
The Swedish Trust Commission
In 2016, the Swedish Government established a Trust Commission (Tillitsdelegationen) as an explicit counter-movement to NPM's target-and-indicator regime. The Commission's diagnosis was precisely the one Shore and Wright (2024) document for the UK: years of increasing bureaucracy and micro-management had eroded professional autonomy to the point where frontline workers could not exercise the situated judgement that public service delivery requires. Bringselius (2017), who served as Head of Research for the Commission, conceptualised trust-based public management through three cornerstones - culture, organisation, and governance - operationalised through seven principles including delegation, user-focus, collaboration, and knowledge development.
Bringselius (2017) frames this through Freidson's (2001) three institutional logics - market, bureaucracy, and profession - arguing that NPM and what she terms New Weberian State trends had tilted the balance away from professional logic, and that trust-based governance is fundamentally a rebalancing. The practical definition she proposes is direct: trust-based governance aims to "reduce unnecessary control in publicly funded services and better utilise the competence and engagement of employees" (Bringselius, 2017). This is not a prescription for the absence of governance; it is a prescription for governance redesigned around professional autonomy within a framework of democratic accountability, with trust as the default orientation in hierarchical relationships rather than suspicion.
Häger Glenngård (2017), writing in the Swedish primary care context, explicitly maps Le Grand's (2009) trust-control axis onto the question the Commission was addressing. Le Grand distinguished four governance mechanisms - choice and competition, voice, trust, and command and control - and the question of which combination to deploy remained, in his framing, an institutional design problem. The Swedish Commission's answer was to shift the balance toward trust; Le Grand's deeper point was that any governance system that depends on a single motivational assumption - whether trust or control - is fragile. The question is whether tillitsbaserad styrning addresses that fragility or merely inverts it.
Design within the Commission
What makes the Swedish reform particularly relevant to this series is the role that design played within it. Johan Quist and Martin Fransson from CTF, the Service Research Centre at Karlstad University, and Katarina Wetter-Edman, a design researcher whose doctoral work connected service design to public sector innovation, all served as research directors within the Commission. Through Tillitsverkstan (the Trust Workshop), they ran experiments at government agencies - including Försäkringskassan, the Swedish Social Insurance Agency - using service design methods to capture citizen perspectives and test what trust-based governance looks like in practice. Design was positioned not as an aesthetic contribution to be accommodated within existing governance but as a governance methodology in its own right: a way of restructuring the relationship between public institutions and the people they serve that the indicator-compliance model had distorted.
The theoretical work emerging from this same research environment articulates why design practice specifically addresses low-trust governance, beyond the facilitation of workshops. Vink, Wetter-Edman and Aguirre (2017), writing from Experio Lab and Karlstad's CTF, developed the concept of aesthetic disruption - the process by which designerly practices surface and alter the mental models that drive system behaviour. Their argument, drawing on Meadows (2008) and Senge (1990), is that mental models are among the most powerful leverage points for systems change, but they are generally tacit, "existing below the level of awareness" (Senge, 1990), and defended by what Argyris (1985) calls "defensive routines" that protect them from scrutiny. Audit culture reinforces these defensive routines by substituting indicators for the situated encounters that might expose them; design reintroduces those encounters.
The mechanism is not facilitation, which could be done by anyone, but what Stephens and Boland (2014) call aesthetic knowledge: "what we know about a situation through our bodily senses". By engaging actors' senses through tangible and experiential interventions - prototypes, enactments, material provocations - design creates the conditions under which taken-for-granted assumptions become visible, contestable, and therefore changeable. Vink, Wetter-Edman and Aguirre identify four core components of this process: engagement of the senses (actors learn through embodied experience, not through indicators), experience of dissensus (confrontation with alternatives that do not fit existing frameworks), exposed assumptions (surfacing and testing the beliefs that drive system behaviour), and reflexive actors (creating space for actors to examine their own mental models).
From aesthetic disruption to institutional reflexivity
Vink's (2019) doctoral thesis extends this into institutional theory, identifying three processes through which design builds institutional reflexivity: revealing hidden institutions (making visible the norms, rules, and roles that actors have internalised as natural), noticing institutional conflict (surfacing the tensions between competing logics that indicators paper over), and appreciating institutional malleability (demonstrating that the structures people experience as fixed are social constructions that can be reshaped). The first two explain why design surfaces problems that indicator-compliance conceals; the third explains why it can rebuild trust - because trust requires the experience that institutions are responsive to the people they serve, and that experience is precisely what audit culture forecloses by replacing responsive judgement with standardised metrics.
The Aesthetics as a Design Problem post in this blog established Folkmann's framework for thinking about how aesthetic experience operates across sensual, conceptual, and contextual registers; the Aesthetic Disruption Meets Social Defences post took up Vink and Wetter-Edman's framework directly, asking what happens when the assumptions that aesthetic disruption proposes to surface are not merely cognitive habits but psychic defences - when the mental models exist precisely because they protect organisational members from the anxiety that the primary task evokes. That complication matters because the defensive routines that sustain low-trust governance are not simply bad habits waiting to be corrected; they serve a protective function, and design interventions that surface them without attending to what they defend can produce hostility and withdrawal rather than reflexivity. Subsequent work in the Systems Engagements series on affective architecture, neuroception, and containment extends this argument into the embodied and relational dimensions of how institutions are experienced by the people who work within them.
This is the inverse of the pattern Kimbell and Tonkinwise (2025) describe. Rather than stripping aesthetics from design to make it legible to management, the Swedish reform proposal used design's attention to experience as the mechanism through which trust could be materially reintroduced into governance structures.
The implementation difficulties
Whether the reform has succeeded is contested, and the difficulties illuminate the structural constraints this series has been analysing. Bringselius herself notes that formal control structures have proved difficult to change in practice. Askeland and Espedal (2020) observe that trust-based management was introduced as a public governance model in Denmark as early as 2005, and that the idea of "explicitly promoting the value of trust and materialising it in management and structures" has a longer Scandinavian lineage than the 2016 Commission might suggest - raising the question of whether tillitsbaserad styrning represents a genuinely new institutional architecture or a periodic resurfacing of the same aspiration.
Andréason and Winberg (2018), studying a home care unit in Luleå that had been implementing trust-based governance for two years, found that sediments of the old målstyrning (management-by-objectives) system persisted as organisational barriers; that high manager turnover prevented the stable relationships trust requires; and that some staff did not want the additional autonomy that delegation entailed. Their finding - that trust-based governance can decrease as well as increase motivation depending on whether relational preconditions are met - is precisely the kind of implementation friction that Le Grand's "robust" design criterion would predict: governance that depends on trust will struggle in conditions where trust has already been eroded by the system it seeks to replace.
These difficulties do not invalidate the Swedish experiment, but they reframe it. The legibility requirements this series has analysed - the standardised categories, the decomposition into workstreams, the audit mechanisms that assure control systems rather than first-order operations - are not arbitrary features of NPM that a trust commission can simply set aside. They are responses to genuine institutional pressures: political accountability, public spending scrutiny, the need to coordinate at scale. A governance reform that replaces indicator compliance with professional trust must still solve the coordination problem; it must still provide mechanisms through which political leaders can understand what public services are doing. The question is whether design can help build those mechanisms in forms that do not reproduce the legibility trap - governance structures that make professional judgement visible without reducing it to standardised metrics.
What the Swedish case means for this series
The Swedish experiment is not a solution to export. The institutional conditions that made Tillitsdelegationen possible - a strong tradition of professional autonomy in the Swedish civil service, a government willing to establish a formal commission with research directors, a design research infrastructure at Karlstad and Linköping connected to the reform process - do not obtain in most of the programme management cultures this series has been describing. The NHS programme manager reading this series will not be in a position to establish a trust commission.
But the Swedish case is an existence proof. It demonstrates that the frame within which design operates in programme management cultures - as an input to existing governance, working with the grain, translating insights into programme-legible forms - is not the only frame available. It is possible to position design as a governance methodology, as a means of restructuring the relationship between institutions and the people they serve, rather than as a downstream activity that accommodates whatever governance structure the programme has already established.
The implementation difficulties matter precisely because they illuminate the structural constraints this series has been analysing. The persistence of målstyrning sediments in Luleå is, in Scott's (1998) terms, the persistence of a legibility infrastructure that the organisation has learned to operate through. The challenge is not motivational but structural: the categories of legibility through which the organisation understands itself do not dissolve when a commission declares that trust should replace control. They dissolve, if they dissolve at all, through the kind of situated, experiential work that Vink and Wetter-Edman describe - the aesthetic disruption that makes taken-for-granted structures visible, contestable, and therefore changeable.
This returns the series to where it began: the epistemological tension between design and programme management is real, and it is structural. The working-with-the-grain strategies of the previous post are the appropriate response when design operates within existing governance architectures. The Swedish experiment suggests that there is also work to be done on the architectures themselves - and that design, understood not as a surface discipline but as a practice of institutional reflexivity, may have something specific to contribute to that work. Whether the contribution proves durable, or whether the legibility requirements that governance at scale demands will always reassert themselves, remains to be seen.
References
Andréason, C.S. and Winberg, T.E.C. (2018) Organisatoriska Hinder Och Motivation I Samband Med Införandet Av Tillitsbaserad Styrning. Luleå tekniska universitet.
Argyris, C. (1985) Strategy, Change and Defensive Routines. Boston: Pitman.
Askeland, H. and Espedal, G. (2020) Understanding Values Work: Institutional Perspectives in Organizations and Leadership. Springer.
Bringselius, L. (2017) Tillitsbaserad styrning och ledning: Ett ramverk. Tillitsdelegationen.
Freidson, E. (2001) Professionalism: The Third Logic. Cambridge: Polity Press.
Häger Glenngård, A. (2017) Dialog Och Prestationsmätning. Lund University.
Kimbell, L. and Tonkinwise, C. (2025) A Political Dialogue about Government Service Design Politics. In Penin, L., Prendiville, A. and Sangiorgi, D. (eds.) The Bloomsbury Handbook of Service Design. Bloomsbury Publishing.
Le Grand, J. (1997) Knights, knaves or pawns? Human behaviour and social policy. Journal of Social Policy, 26(2), 149-169.
Le Grand, J. (2003) Motivation, Agency, and Public Policy: Of Knights and Knaves, Pawns and Queens. Oxford University Press.
Le Grand, J. (2009) The Other Invisible Hand: Delivering Public Services through Choice and Competition. Princeton University Press.
Meadows, D.H. (2008) Thinking in Systems: A Primer. White River Junction: Chelsea Green Publishing.
Scott, J.C. (1998) Seeing Like a State: How Certain Schemes to Improve the Human Condition Have Failed. New Haven: Yale University Press.
Senge, P.M. (1990) The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Doubleday.
Shore, C. and Wright, S. (2024) Audit Culture: How Indicators and Rankings Are Reshaping the World. London: Pluto Books.
Stephens, J.P. and Boland, B.J. (2014) The aesthetic knowledge problem of problem-solving with design thinking. Journal of Management Inquiry, 24(3), 219-232.
Vink, J. (2019) In/visible: Conceptualizing Service Ecosystem Design. Karlstad University.
Vink, J., Wetter-Edman, K. and Aguirre, M. (2017) Designing for aesthetic disruption: Altering mental models in social systems through designerly practices. Proceedings of the 12th European Academy of Design Conference. Rome.