‘Employers can’t assume that being culturally inclusive means they’re doing okay’
It takes more than embracing diversity to improve career opportunities for BME staff
It takes more than embracing diversity to improve career opportunities for BME staff
Sheffield Health and Social Care NHS Foundation Trust is an organisation that prides itself on embracing diversity – so much so that it would be easy to assume that everything in the garden is rosy.
But when mangers delved into data about how black and minority ethic (BME) staff at the trust fare on key issues such as career progression it proved eye-opening.
‘To be honest, once you start looking, it’s shocking,’ admits the trust’s head of equality and inclusion, Liz Johnson. ‘You realise you’re not that good after all – and that’s very challenging.’
Before the Workforce Race Equality Standard (WRES) was introduced by NHS England in 2015, the trust had already begun benchmarking its equalities statistics on ethnicity, as well as developing a strategy to promote a diverse and culturally competent organisation.
All NHS providers in England are required to implement and report data from WRES, which allows them to measure how they are addressing race equality issues in a range of staffing areas. Organisations are expected to show progress against a number of indicators of workforce equality, including a specific indicator relating to BME board members.
‘We’re trying to take things forward in a very challenging environment’
Liz Johnson, head of equality and inclusion, Sheffield Health and Social Care NHS Foundation Trust
‘When the WRES started, we were able to identify very quickly where our deficits lay. It’s been really helpful in looking at the detail,’ says Ms Johnson, a former nurse who joined the trust in 2004 as a general manager.
WRES: the key indicators
Since April 2015 all NHS organisations in England have been required to use the Workforce Race Equality Standard (WRES) to demonstrate how they are addressing race equality issues.
The second WRES report, published in April 2017, shows a trend of continuing improvements in some areas, but there is still much work to do, says NHS England.
WRES determines progress against key indicators, including:
- The percentage of BME staff in each band and also on the board, compared with in the overall workforce
- The relative likelihood of BME staff being appointed from shortlists for all posts
- How many BME staff have faced disciplinary procedures, compared with white colleagues
- The relative likelihood of accessing non-mandatory training
- The percentage of those experiencing bullying, harassment or abuse in the previous 12 months, whether from patients, the public or other staff
- The percentage of those who believe their organisation provides equal opportunities for career progression and promotion
- BME staff members’ personal experience of discrimination by a manager or colleague in the previous 12 months
‘We can’t just sit back and assume that just because we’re an organisation people like working for, and we’re culturally inclusive, it automatically means we’re doing okay.’
Signing up to targets
Among the issues identified was a disproportionate number of BME staff on lower bands, with far fewer at bands 6 and above. With bank staff included in the figures, 13% of 2,850 staff members are BME.
In 2015, the trust found that at band 5 at least 16% of staff were BME. This figure was 6% for bands 6 and 7, falling to 3% for the highest bands.
‘For me, the board signing up to some targets was key,’ says Ms Johnson. The trust now aims to reach 9% BME staff at bands 6 and above by 2021. Current figures are 7-8% for bands 6 and 7, and 4.5% for higher bands.
But the gains have been made against a background of big organisational changes and reductions in staff numbers, so may need to be reviewed in line with current figures, says Ms Johnson.
Among the significant factors in the changes so far is a comprehensive mentoring programme. With money from an Innov8 diversity scheme run by Yorkshire and the Humber Leadership Academy, the trust set up a project to pair board members with BME staff, who in turn mentor someone in the band below them. ‘We felt it would produce results for our organisation, supporting leadership development,’ says Ms Johnson.
Feedback from the project has helped to drive further initiatives, including development workshops for those who want to progress, getting more staff involved in the trust’s BME staff network and improving an annual ‘working together’ conference.
‘We’ve developed what we’ve done in a fluid rather than rigid way, evaluating what people want,’ says Ms Johnson. ‘For example, after our first conference, staff said they would like to see more middle managers attending, so we targeted them and more came along the next year.’
The trust’s programme was recognised last year with an award from the Healthcare People Management Association (HPMA) for ‘the most effective use of diversity to strengthen governance, recruitment or promotion’.
‘We were proud to receive it,’ says Ms Johnson. ‘A lot of people have become involved in what we’re doing, including many nurses, and that’s what makes the difference.’
BME staff network: ‘more than a talking shop’
For Angela Herft, the chance to attend a conference on BME issues in the NHS in 2015 proved to be inspirational. ‘I felt I wanted to make a difference,’ says Ms Herft, who qualified as a mental health nurse in 2004 after being seconded to do her training through the widening access programme.
She joined Sheffield Health and Social Care NHS Foundation Trust's BME staff network group and was elected its chair in January. ‘I’ve found it so supportive,’ she says. ‘It’s not a place where people come to moan – it’s solution-focused. Being voted in as the chair is amazing and a wonderful experience.’
The network meets quarterly, with anyone who identifies as not being white British eligible to join. ‘I like to motivate people, and this has given me the position to be able to do that,’ says Ms Herft, who is currently on secondment as a placement quality facilitator, supporting nursing students.
‘I know a lot of my colleagues feel hesitant. I can encourage them to think about what they can do to improve themselves and be able to progress.
‘Sometimes people think the network is just a talking shop, but it’s absolutely not. We’re forward thinking in what we’re doing.’
Career progression and recruitment are discussed regularly at meetings, with members studying the latest data. Among their agreed proposals is that a BME staff member should sit on recruitment panels for posts at band 7 and above.
‘By helping you address your own psychological barriers, the programme energises you to step forward’’
Since becoming active in the network Ms Herft has applied successfully to take part in the NHS Leadership Academy’s Stepping Up programme, designed to help black, Asian and minority ethnic healthcare staff in bands 5-7 to develop their leadership skills.
‘You can get quite despondent, so you stop applying for jobs,’ she says. ‘But by helping you address your own psychological barriers the programme energises you to step forward. It’s been very powerful for me.’
She is also about to be mentored by one of the trust’s board members. ‘I’m looking forward to it,’ says Ms Herft, who has worked for the organisation for more than 30 years. ‘I think it’s all about confidence building and believing in yourself, but also believing in the organisation. Things are getting better. There has been disparity, but I’ve seen that change a lot.’
She hopes to see a point when networks for BME staff are no longer needed. She says: ‘That will be a barometer of change.’
A rarity in the boardroom
But while there is much to celebrate there is still a long way to go, says Ms Johnson. ‘We’re trying to take things forward in a very challenging environment,’ she says. ‘So if people are off sick, you have vacancies, or there are clinical priorities, you can’t free your staff up to take part in things like the conference.
‘And there are groups in the organisation who aren’t as engaged, particularly those working in services that are more dispersed. Part of our strategy now is to really get down to the grassroots.’
Former mental health nurse Clive Clark joined the trust as a manager in 2000 and was promoted to his current post of deputy chief executive three years later. ‘I don’t think of myself as a role model,’ says Mr Clark, who is from an African-Caribbean background. ‘But I’m very proud of the senior black people we have in our organisation and feel I’m contributing in some small way.’
He is all too aware that BME staff are a rarity at the board table. According to a WRES data analysis report for 2017, NHS trust board members are 88% white and 7% BME (with 5% ‘unknown’), which does not reflect an overall workforce that is almost 18% BME.
‘Most trusts north of Birmingham find their clinical or operational leadership doesn’t represent the communities they serve,’ says Mr Clark. ‘Outside of consultants, there are few people of colour.’
‘Most trusts north of Birmingham find their clinical or operational leadership doesn’t represent the communities they serve’
Clive Clark, deputy chief executive at Sheffield Health and Social Care NHS Foundation Trust
His ambition is to increase the numbers at all levels. In April this year Laura Serrant, who is one of only six black professors of nursing in the UK, joined the trust as a non-executive director.
‘A potential workforce that we’re not tapping into’
‘The skills and talent are out there,’ says Mr Clark. ‘If you ask senior managers what is their biggest challenge, it’s around staffing.
‘We need to start looking at it as a resource issue. There’s a potential workforce that we’re not tapping into. We could talk up the NHS a lot more than we’re doing. We need to make people aware of the opportunities and make them think “I could do that”.’
But he has also witnessed incidents where BME staff have been overlooked at interviews. ‘I’ve sat on too many panels where the black person has been the best candidate and I’ve had to argue for them to get the job,’ he says.
‘My challenge is also to people of colour, to say get yourself qualified, gain the experience and take on board that it will be hard work. I don’t want to be the only black person sitting in a room of 20 leaders. It can be hard and lonely – but I’m hoping it’s changing.’
Staying ahead of the curve
While WRES provides a useful overview, Southern Health NHS Foundation Trust believes it’s always been slightly ahead of the curve.
A year before WRES came in, the Hampshire trust introduced its own equality standard, which was designed in-house.
‘While people understand that equality, diversity and inclusion are really important, the question that’s always asked is what do we need to do to implement it and bring about positive change,’ says the trust’s head of well-being, engagement and inclusion, Ricky Somal.
‘Those on the front line take ownership’
Clinical divisions complete the trust’s standard over three years, receiving bronze, silver or gold awards. To achieve a gold, divisions must take part in a programme of ‘diversity moments’.
These are ten action learning sets, presented monthly by the trust’s diversity champions and designed to stimulate conversations on issues such as how unconscious bias might influence staff recruitment or the treatment of patients.
‘Through delivering this training locally, it empowers those at the front line of our services to take ownership of the agenda,’ says Mr Somal.
The trust’s learning disability services achieved a gold award this year. ‘I’m proud to be part of a team that has achieved this,’ says community learning disability nurse Hazel Chimombe, who joined the trust shortly after qualifying in 2015.
‘As I come from a BME background this is very important to me.’ She is soon to become one of the trust’s 300 or so diversity champions and is applying for a leadership programme run by the Florence Nightingale Foundation.
Underpinning the trust’s standard is a diversity scorecard, published annually, that measures all the protected characteristics – including race, age, disability, sexual orientation and religious beliefs – across the trust’s 5,800 or so staff.
Currently this shows that 14% of staff are from a BME background. Now almost 100% of staff report their race – up by nearly 8% from 2014.
‘Get your data right first of all. It gives you a better understanding of what’s happening’
Ricky Somal, head of well-being, engagement and inclusion at Southern Health NHS Foundation Trust
‘My advice is get your data right first of all,’ says Mr Somal. ‘It gives you a better understanding of what’s happening. Equality monitoring has been a fantastic improvement for us. Four years ago people were asking, “Why do I need to tell you my sexual orientation or religion – it’s none of your business”.’
But by sharing information about why the data is collected, the trust helps staff understand its impact on equal opportunities, he believes.
‘Our score is one of the highest’
The most recent figures show a 12% decrease in the numbers of BME staff experiencing bullying, harassment or abuse from patients or the public in the previous 12 months – down from 38%. There is a 4% drop in those experiencing similar behaviours from colleagues – now 17%, and 6% lower than the average similar trust.
Meanwhile the results of last year’s NHS staff survey show an engagement score of 3.96 for the trust's BME staff. This measurement of key findings, including whether staff recommend their trust as a place to work or receive treatment, feel motivated and feel able to contribute to improvements, has a national average of 3.78.
‘I think our score is one of the highest in the country,’ says Mr Somal. ‘Now I want to analyse the key elements of that improvement so we don’t take our eye off the ball.’
No quick fix
Among the areas that remain challenging is the disproportionate number of BME staff who face disciplinary procedures, compared with their white colleagues. Although numbers have fallen from the previous 12 months they are still not good enough, says Mr Somal.
‘It’s unacceptable and we’re addressing it,’ he says. ‘We need to eliminate any elements of unlawful discrimination, unconscious bias or differential treatment.’
BME staff are also under-represented at band 7 and above. ‘Career progression is our biggest challenge. We need to promote leadership opportunities more,’ says Mr Somal. ‘There’s no quick fix for this. But the pleasing thing for me is that overall we’re on the right track.’
Lynne Pearce is a freelance health journalist