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Increasingly attention is focusing on the inadequacies of attempting to understand and address many contemporary healthcare problems from a reductionist biomedical paradigm.1–3 Complex adaptive systems theory redirects attention towards understanding the patterns of non-linear behaviour that emerge from contextually embedded and highly interactive agents. This picture (view from Canal Street during ManchesterPride parade 2004) shows that a broadened perspective and patterns of order can emerge from a more careful examination of the relationships between components (each window’s reflection) and the dynamic interplay of embedded contexts.