Diversity in the NHS is everyone’s business

The Equality and Diversity Council at NHS England works to ensure everyone’s contribution to our health service is fairly recognised. In the second of two blogs, the Chair of the BMA Representative Body reports on the Council’s work and outlines what steps we can all take to ensure fair treatment for NHS patients and staff:

I left the January Equality and Diversity Council meeting feeling uplifted and encouraged.

All of us who champion equality and diversity in the NHS face huge challenges but I feel confident that there is a common drive to tackle the issues and a strategic focus behind it.

One of the main reasons for such a positive mood in the room was hearing Barts Health’s inspiring story.

Banji Adewumi , Associate Director of Inclusion, and Michael Pantlin, Executive Director of People, highlighted how the trust is working to increase numbers of BME staff at senior levels.

It wasn’t inspiring because it was an overwhelming success story. It isn’t – yet. It was inspiring because Banji and Michael were so open and honest about the challenges they faced: having recently moved from an ‘inadequate’ to ‘requires improvement’ CQC rating, WRES data showing BME staff are underrepresented in senior levels, and high levels of bullying.

They have introduced a really practical transformational programme, based around career development workshops. And it is beginning to yield tangible results: overall 20% of participants successfully achieved higher bands.

For me, the Barts Health example is a great illustration of three interrelated themes that were also explored during the EDC meeting.

Firstly, what gets measured gets done. Changing organisational culture and attitudes on diversity is hugely complex. However, holding a mirror up to trusts’ diversity – or lack of – is an extremely powerful lever.

Between 2016-17 at Barts there have been increases in BME representation, at most grades, including senior levels. The BMA hopes that WRES will include more detailed information on BME doctors in future.

The themes from WRES and the challenges it throws up resonate with us at the BMA. For example, in medical training. The BMA has recently highlighted how nationally BME doctors on average get lower scores in assessments compared with their white counterparts, are less likely to be recruited into the medical specialty of their choice and are overrepresented in fitness to practise complaints. Yvonne Coghill, WRES director, recently spoke to the GMC group leading work on differential attainment, which the BMA is part of.

The BMA is also shaping key reforms to regulatory guidance which will ensure that disabled doctors are better supported at work. Similarly, on gender, the requirement for all NHS trusts to publish their gender pay gap data should encourage many to address the issues behind the gap, including women’s representation at senior levels.

Secondly, it hardly needs saying but greater diversity amongst NHS staff really does create healthier, higher-performing organisations. Significantly, Barts Health has moved from inadequate (2015) to requires improvement (2017). I was struck by the results of Jeremy Dawson’s new report, which the WRES team shared, showing how well-supported BME staff relates to positive patient outcomes.

Banji spoke about levels of bullying at Barts Health. In 2017, the BMA launched a bullying and harassment project, following a resolution passed by members at our annual conference. The aims are to raise awareness and help promote culture change, to better support doctors who are affected, and to encourage better resolution of problems in the workplace.  

The final message I took from Banji and Barts Health is that for a healthcare organisation to truly embrace diversity, the whole organisation, and especially the leadership need to actively engage. At Barts Health, senior leaders participated in the career development workshops to share their experiences and have continued to champion the programme.

My own trust recently held a WRES Conference in Lincolnshire along with the two other Lincolnshire health communities, with excellent presentations from Yvonne Coghill and Marie Gabriel, which also showcased the successes that BME Fora have had in each of the settings. We can do more, but it is a good start in highlighting the importance of diversity across the organisations.

As I started by saying, these are major challenges that require our collective, concerted efforts. As we celebrate 70 years of the NHS, it is important to remember that this could not have been achieved without its wonderful diverse workforce.

Anthea Mowat

Dr Anthea Mowat is Chair of the BMA Representative Body, one of three elected Chief Officers, and is the lead for Equality and Inclusion, as well as for Education, Training and Workforce.

She is an associate specialist in anaesthesia and chronic pain management at Pilgrim Hospital, Boston, which is part of United Lincolnshire Hospitals Trust (ULHT).
Born in Newcastle, she completed her medical training in Aberdeen, and her anaesthetic training in Aberdeen and Inverness.

Anthea has been Involved in SAS Grade representation locally since 1993 and nationally since 2002.
She was Chair of the Trust Local Negotiating Committee 2007-2014 and Trust SAS Clinical Tutor since 2009, looking after 190 SAS staff.

She is a member of the AAGBI SAS committee and was honoured to be awarded AAGBI Pask Certificate in 2009, and BMA Association Medal in 2010.
Anthea lectures nationally on appraisal, on job planning and on SAS issues.