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Our work to connect and build trust with black, Asian and minority ethnic (BAME) staff working across our NHS has never been more urgent.
The disproportionate impact of COVID-19 on BAME people and the Black Lives Matter movement propelled longstanding and wide-ranging inequalities into the media spotlight, and to the forefront of our conversations.
The conversations we had with BAME staff provided a stark but essential line of sight into the need for urgent action around staff protection and safety.
We heard from staff network members who had engaged directly with those whose voices are not always heard – the lowest paid agency workers, porters, cleaners and security staff, including those whose first language is not English – with some of the themes including concern for their safety, not being sure how or whether to speak up, and in some cases this was compounded by loss or difficulties at home.
Combined with what the emerging evidence on COVID-19 was telling us, even before PHE published their review, these conversations convinced us that many more were essential. That’s why in April NHS England and NHS Improvement asked the leaders of local organisations to risk-assess their staff who were at potentially greater risk of serious illness from COVID-19, and to agree and make appropriate arrangements to protect their health, safety and welfare.
Accompanying guidance from NHS Employers strongly encouraged them to pair the risk assessment process with a compassionate and confidential conversation between line managers and their staff – not just to ensure the formal process captured all the relevant information, but also to promote open and ongoing dialogue, which we know is the basis of understanding, and feeling understood.
As a result, more than a million conversations and engagement, have taken place in just a few shorts weeks across trusts and GP services, with more than nine out of ten staff who are known to be at risk taking up an assessment, with that figure rising to over 95% of staff from BAME backgrounds. Thousands more still have taken place in community dental, pharmacy and ophthalmic settings.
Importantly, this means that many more staff are now better protected from and informed about the risks posed by Covid-19 – whether that’s working in different areas or adjustments to their current role – helping us to meet one of the key pillars of our recently-published We are the NHS: People Plan for 2020/21 – action for us all, to look after our people, now and into the future.
But we also hope that these conversations – and the actions that are informed by them – continue, and play a role in one of the other pillars, which is to ensure that all of our staff feel a sense of belonging in the NHS: that they are seen, valued as individuals, treated fairly and equally, and supported when they need support.
If this happens it will continue to strengthen confidence, trust and morale amongst our current staff, and help us to attract an ever-broader range of talent to the NHS and therefore grow our workforce – another core ambition – with the benefits being seen beyond the pandemic.
There is more to do of course. A small minority of people are yet to have the risk assessment, and while in many cases this will be due to staff turnover, leave, illness or other understandable factors, local employers need to understand any other reasons for this and find ways to close the small remaining gap completely.
At the same time we can continue to share good practice, including the support that line managers get, in order to have those conversations sensitively and effectively, and the important role that staff networks and Freedom to Speak Up Guardians can play in giving staff confidence in the process.
The health service’s focus right now is of course preparing for winter and a potential second wave of Covid, at the same time as making sure as many people as possible who need non-urgent tests and treatment are able to get it in a safe way. But if anything this makes it even more important not to take our foot off the gas on ensuring that every member of staff is as safe as possible, and feels as safe as possible, in their work – because it is they who will make these things possible. Our call earlier this week on frontline staff to take up their flu vaccinations is a vital part of this – as Chief Nursing Officer Ruth May said, the NHS needs as many of its staff as possible to be fighting fit over the coming months, for their own sake, but for our patients too.
Encouraging further progress in this area also sits alongside other work going on to tackle health inequalities, including the appointment of a named inequalities champion in every NHS organisation from this month, ensuring all trusts have a thriving BAME network, a five-year plan to ensure organisations reflect the communities they serve and greater involvement and engagement with BAME communities, as colleagues across the NHS continue to work hard to bring back services and prepare for the months ahead.
Leadership and ownership remain central to all of this. What we have experienced this year has shown us that we need leaders at all levels to actively, genuinely and authentically own, sponsor and champion the need to ensure that health and wellbeing – including psychological and physical safety – is front and centre of our offer as a modern employer.
I see this acknowledgement and this ambition in the conversations I have with leaders on a daily basis, giving me confidence that together, we can do even better for all our staff – and therefore, most importantly, for our patients too.