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Continued improvement to the Workforce Race Equality Standard

The Workforce Race Equality Standard (WRES) was launched just under three years ago to help NHS organisations focus on fundamental improvements to the experiences and opportunities for black and minority ethnic (BME) staff.

It was launched to help increase organisational efficiency and productivity and, most importantly, to contribute towards improvement in the quality of care for all patients.

The WRES team in NHS England supported organisations in understanding the intensity of the challenge. We also developed a set of indicators designed to initiate continuous improvement in data relating to the treatment of, and opportunities for, BME staff within the NHS – holding up a mirror to organisations with regard to their own data and performance.

The 2017 WRES data report for NHS trusts, published last week, shows a welcomed degree of improvement in certain areas:

First, there continues to be a significant increase in the number of BME nurses and midwives entering senior grades. Almost 2,000 more BME nurses and midwives have been appointed in senior positions over the last three year period.

Secondly, the latest data highlight an increase of 18% in the number of very senior managers (VSM) from BME backgrounds – although the proportion of BME staff in Bands 8a – 9 and VSM is still lower than the overall BME workforce – 10.4% compared with16.4%.

Thirdly, there has been an overall decrease in the likelihood of BME staff entering formal disciplinary investigations – from 1.56 times more likely in 2016, to 1.38 times in 2017. Further work on this indicator is underway particularly with organisations and parts of the NHS that require the most support, with positive lessons learned being shared to reduce inequality.

There is also a significant increase in the number of NHS trusts that have BME members on their boards. There are now a total of 25 NHS trusts across England that have three or more BME board members – this is an increase of nine trusts since 2016.

There is still much work to do.

While, as highlighted above, some gaps in the workplace experience and opportunities between BME and white staff have decreased, they still nonetheless exist. Furthermore, white staff remain more likely to be appointed following shortlisting than their BME counterparts; the ethnicity gaps in the experience of bullying in the workplace remain, and both the London region and the ambulance sector remain outliers on this agenda.

Concerted work in all of these areas is underway. This work is based upon the shared characteristics of effective interventions on workforce race equality, which we presented in the 2016 WRES data report for NHS trusts. History tells us that work on race equality, and on equality in general, is often short-lived – when the budget runs out, or the champion burns out, there remains little knowledge of the good work carried out.

Sustainability is therefore the key here; not only will the practical support given to the system by the WRES team to date continue, it is also being augmented by interventions to help facilitate cultural and transformational change in this area. There is very often a misconception that it should be one or the other; however, we want to be at a place where organisations and people undertake work on this important agenda, not just because they have to, but because they want to.

Tackling workforce race inequality is not an optional extra. Investing in fairer treatment for staff has been shown to give excellent value for money by delivering better outcomes for patients, greater staff engagement and satisfaction, and the more productive use of resources.

Work to further emphasise these relationships continues to grow. However for now, in the ever evolving healthcare architecture, this year’s WRES data report is another reminder of what is possible when it comes to workforce race equality in the NHS.

Yvonne Coghill

Yvonne Coghill OBE, JP, MSc, DMS, RGN, RMN, HV, CPT, Dip Exec Coaching.

Yvonne commenced nurse training at Central Middlesex Hospital in 1977, qualified as a general nurse in 1980 and then went on to qualify in mental health nursing and health visiting. In 1986 she secured her first NHS management job and has since held a number of operational and strategic leadership posts.

In 2004, she had the unique opportunity to work at the Department of Health as Private Secretary to the Chief Executive of the NHS, Sir Nigel Crisp. In her three years at the Department, Yvonne held several strategic posts, including Programme Director for the Cleaner Hospitals Programme and External Relations Nursing Officer to the Chief Nursing Officer of England.

Yvonne is currently the Director – WRES Implementation in NHS England, and is a member of the equality and diversity council at the Institute for Healthcare Improvement (IHI) in the United States where she has helped develop their inclusion strategy, delivered workshops and was co-chair at their national forum in Orlando 2015. She has also been keynote speaker at the National Association of Health Service Executives (NAHSE) annual conference in New Orleans. She continues to work closely with world expert on health and race Professor D. Williams, of Harvard University School of Public Health.

Recently Yvonne has used her knowledge and experience of mental health to act as a commissioner on a report commissioned by the Royal college of Psychiatrists and chaired by Lord Crisp on ‘Adult mental health in patient services’ which fed into the NHS England task force review on mental health services in England.

In 2013 Yvonne was voted by colleagues in the NHS as one of the top 50 most inspirational women, one of the top 50 most inspirational nurse leaders and one of the top 50 BME pioneers, two years in a row. Yvonne was awarded an OBE for services to healthcare in 2010 and was appointed as Director for WRES Implementation in June 2015.

Dr Habib Naqvi

Dr Habib Naqvi has a background in equality and diversity policy, public health, and health psychology. Habib is the Policy Lead for the NHS Workforce Race Equality Standard, and is leading on the inclusion of the WRES within national policy levers.

Before joining NHS England in 2013, Habib worked on the development of national equality and diversity policy at the Department of Health, where he led on the development of the Equality Delivery System for the NHS, and took the lead for coordinating the health sector’s response to the Ministerial review of the Equality Duty.

Habib has experience in academia and research, including holding a strong portfolio of healthcare research.

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