The NHS Six Thinking Hats 

 April 4, 2022

By  Dave Litten

The NHS Six Thinking Hats

What is it?

To make improvements to services, you will have to change the way things are done. This means thinking up, considering, and testing new ideas. Six Thinking Hats® will help you evaluate a potential change from a number of perspectives, offering a more balanced view.

Nhs Six Thinking Hats

This way, you and your team can move the best, most viable ideas forward.

NHS Six Thinking Hats® is a simple yet powerful tool created by Edward De Bono based on a principle of parallel thinking: everyone thinking in the same direction, from the same perspective, at the same time.

The Nhs Six Thinking Hats Nhs Six Thinking Hats

So much time and energy is wasted when people can’t agree on the way forward.
Usually, this is because they are coming from different perspectives ie one person is thinking of all the positives of a new idea or development whereas someone else is thinking about all the negatives.

De Bono suggests that it is far more effective if everyone has the same perspective (ie wears the same hat) at the same time.

When to use it

The Nhs Six Thinking Hats Nhs Six Thinking Hats

Six Thinking Hats® is particularly useful during or after the ‘harvesting’ of ideas as it can help to extend your understanding of an idea, thereby helping to determine whether it should be taken forward. You can also use it in any context requiring a well-rounded view that comes from applying a variety of perspectives.

How to use it

De Bono’s six hats represent artificial distinctions in common patterns of thought, helping you and others involved in the process to adopt different ways of thinking (taking your normal hat off and wearing another).

Six Thinking Hats® has been specifically designed so that everyone thinks in parallel using only one hat at a time. The process works best with a time limit (4–5 minutes maximum) for each hat. This encourages the group to ‘try on other hats’ and specifically helps people who may have very entrenched views to consider the idea from different

The Nhs Six Thinking Hats Nhs Six Thinking Hats

Ask leading questions to activate different hats:

  • What data do we have or need? ( white )
  • What could go wrong? What are the possible negatives? (black)
  • List all the benefits (yellow)
  • Is there a different way of looking at this? How could the idea be further developed? (green)
  • What do you feel about this? What is your gut feeling? (red)
  • Could you summarise the findings so far? What needs to happen next? (blue)
  • The hats have natural pairings: yellow is positive while black is negative; red is emotion-driven while white is data-driven. In general, if you use one hat, you should also use its partner for balance.
The Nhs Six Thinking Hats Nhs Six Thinking Hats

To use the Six Thinking Hats®, someone in the group ‘puts on’ the blue hat as the leader of the session. The leader explains the overall plan for flow to the group and then takes responsibility for managing the time, keeping the group focused as well as actively contributing to the thinking associated with just one hat at a time.

A useful sequence of hats for the initial harvesting of ideas could be: green, yellow, black, white, leading to a final
red hat assessment (getting people’s gut feeling) of whether the idea should go forward with the blue hat focusing on managing the process and the big picture – so what are we going to do?

Six Thinking Hats Tips

Nhs Six Thinking Hats

Some groups can be put off by the concept of the hats, but you can still get them to use parallel thinking by just asking them to consider all the positives, negatives, data needs, etc. Remember you do not have to use the hat metaphor if you think it may get in the way.

Don’t be afraid to re-visit certain hats if you feel further exploration is necessary.

Discourage people from characterizing themselves as being a particular hat. While people will have natural preferences, you should encourage them to practice different modes of thinking.

The six hats can be used in different orders and combinations depending on the individual situation. The key point is that everyone ‘wears the same hat’, thinks in the same direction, at the same time.

The technique can also be used by individuals to help generate ideas or make decisions.

Can’t remember the hats?

The Nhs Six Thinking Hats Nhs Six Thinking Hats

Six Hat Example

If you are considering introducing a one-stop clinic for multiple diagnostic tests, you could use the hats in discussion as follows:

The Nhs Six Thinking Hats Nhs Six Thinking Hats

What next?

Having reviewed all the ideas using the Six Thinking Hats® tool, you will have narrowed ideas down to the best few. You can then move on to:

  • run several small scale tests to see how the ideas actually work in practice (PDSA)
  • share the findings. Consider using stakeholder analysis and communications matrix
  • if you are stuck for new ideas try that’s impossible!


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