Getting to equity

In October we celebrate Black history: from the nurses and midwives who came over from the Caribbean to establish a post-war NHS; to the scientists, mathematicians, writers, and leaders whose action and ideas helped shape the modern world.

Nurses and midwives form the largest collective professional group within the NHS, and one in every five are from ethnic minority backgrounds, rising to much higher levels (up to 40%) in some regions and parts of the country, such as London.

Improving equity of opportunity for nurses, midwives and care staff of all ethnicities is a top priority for our Chief Nursing Officer (CNO) for England, Ruth May. In 2020, the CNO established an action plan which made clear her ambition and goals for development, opportunity and leadership for ethnic minority nurses and midwives.

The plan spans a range of actions and initiatives with a common goal to ensure all nurses and midwives are valued and respected, and have equality of opportunity, irrespective of their ethnicity.

This work has led to some key achievements across health and wellbeing, leadership and development, supporting staff from ethnic minorities and encouraging our colleagues to speak up and feel supported to do so.

So far, we have:

  • Run dedicated webinars focused on support for our ethnic minority nursing and midwifery workforce through the pandemic, and mental health and wellbeing during COVID-19 and beyond. Over 1,300 staff have now joined and participated in these.
  • Set up a Freedom To Speak Up (FTSU) pilot study (run by the People Directorate) examining how we can better support sites to improve representation, build confidence in ethnic minority staff and strengthen FTSU recruitment processes to be more inclusive.
  • Set up the Ethnic Minority Executive Directors of Nursing and Midwifery Group, Ethnic Minority Strategic Advisory Group and the Ethnic Minority Men’s Group to provide advice to the Chief Nursing Officer and Chief Midwifery Officer and improve representation in decision-making.
  • Established a CNO Ethnic Minority Advisory Collaborative (EMAC) to further strengthen the voice of ethnic minority senior leaders across England. The EMAC acts as a collective advisory body and amplified voice in relation to team CNO’s key priorities, providing strategic and senior operational advice on nursing and midwifery, as they impact on the workforce, patients, service users and communities, with a specific focus on issues relating to race and ethnicity.
  • Through our international recruitment programme we have improved the pastoral support and care for overseas – trained nurses. The small grants programme, in partnership with the Florence Nightingale Foundation, supports the projects of a number of international nursing associations to provide culturally sensitive pastoral care including mentoring, building digital platforms to improve reach and workshops for career development. A co-consulting course is also offered as part of the leadership development for the emerging association leaders.
  • Enabled an enhanced voice, representation and support for ethnic minority colleagues who have been disproportionately impacted by COVID-19, by appointing a National Ethnic Minority Nurse Advisor, Jennifer Caguioa, to work across all ethnic minority groups (with an initial focus on the Filipino community in the first wave of the pandemic). As part of her work on the international recruitment programme, Jennifer now supports a network of 18 international nursing associations from different nationalities, which provides colleagues with a collective voice to raise their concerns.
  • Committed to developing opportunities to develop nursing leaders – by providing a leadership programme in partnership with the Florence Nightingale Foundation which has seen 60% of participants get promoted.

As we strive to do more to remove the barriers that prevent the talent of ethnic minority nurses and midwives being recognised and rewarded, we were delighted to launch the Getting to Equity Sponsorship Programme in September this year.

The Getting to Equity Sponsorship Programme provides an evidence-based framework that enables executive leaders to promote the careers of aspiring ethnic minority nurse leaders and midwives. It connects and builds on existing talent of nurses or midwives from an ethnic minority background working at Band 8C or above, to grow into senior or executive NHS leadership positions.

The programme draws on tools and techniques that are used in some of the most successful organisations in the world – it aims to bring out into the open the power of connectivity for those who are most likely to be disconnected from senior and influential roles, because of under representation at those levels.

Throughout the 6-month programme, sponsors and participants undertake a development programme comprising seven modules, all the while receiving coaching and participating in group coaching sessions to support their development.

This course provides an opportunity to connect to the power of sponsorship and position talent where it is recognised, rewarded and brings maximum return for organisations, our communities and the patients we serve.

70 sponsors and participants have already embarked on the programme, as part of the first cohort. I look forward to seeing their progress and welcoming another 70 colleagues to the programme as we roll out to our second cohort in January 2022.

I would also encourage all aspiring ethnic minority nurse leaders and midwives to consider this programme as part of their personal and professional development.

If you’d like to find out more, please email:

Hilary Garratt

Hilary Garratt CBE, BSc, MSc, RGN, SCPHN (RHV), PGCE is the Deputy Chief Nursing Officer NHS England and NHS Improvement.

Hilary leads the implementation of a range of national programmes that focus on safeguarding vulnerable people and programmes that support the professional development and leadership of the nursing profession.

Hilary is a registered Nurse and Health Visitor, with 36 years’ experience of working in clinical, public health and Executive leadership roles in the NHS. Hilary has held a number of Executive Director posts across both commissioning and provider organisations in addition to holding and Deputy Chief Executive post for both. Hilary has been working at National Director level for the last 7 years.

In addition to her professional life, Hilary enjoys volunteering at the front line and also for the third sector. From 2013 – 2017 Hilary worked for BBC Children in Need as a committee member that undertook grant making for the North of England. Hilary also engages in hands on volunteering, working with the homeless and other vulnerable groups in her home city.

Hilary received a CBE in the 2017 New Years Honours for services to Nursing and her national work to safeguard some of the most vulnerable people in society. In 2018 Hilary was nominated as one of the country’s 400 Women of Achievement and Inspiration.

Follow Hilary on Twitter: @HilaryGarratt.