Your voice matters

October marks Black History Month and Speak Up Month. Here the National Guardian for the NHS looks at how they are closely aligned:

As a Jew I understand about discrimination whether subtle or overt.

There is a risk of indifference in national bodies to those of other faiths which could be seen as careless or thoughtless.

This year a national conference which spoke of inclusion was arranged on Kol Nidre and Yom Kippur, the holiest days of the Jewish year. This excluded a minority group and I spoke up about it. I am pleased to say that the organisation has taken positive steps when arranging future conferences.

As National Guardian for the NHS, I am privileged to be a member of the NHS Workforce Race Equality Standard (WRES) strategic advisory group. In the past three years I have listened hard to the experiences of NHS workers. I have heard about the corrosive effect of racial discrimination starting in early childhood, extending through early careers and into senior managerial and clinical roles.

This includes financial discrimination, promotion discrimination, disciplinary discrimination and discrimination in opportunity whether for training, secondments or simply encouragement.

All of these are speaking up matters.

Speaking up is a relational exercise and is only effective if listening up also happens. In trusts and foundation trusts, national bodies and independent sector organisations, Freedom to Speak Up Guardians are there for you.

There are over 1,000 guardians and champions in England. Guardians will thank you for coming forward, listen to you, preserve your confidentiality, support you and ensure that the matter is escalated. You will receive feedback on the outcome and the matter raised will be used for learning and improvement. In the past two years, over 19,000 cases were brought to guardians including bullying and harassment and patient safety matters from all types of roles and levels of seniority.

The Freedom to Speak Up Review identified that some workers may be less likely to speak up. This might include black and minority ethnic (BME) staff, but also locums, students and other groups. Guardians work proactively with WRES experts, diversity networks and others to tackle barriers to speaking up and identify hotspots of culture. The themes raised are presented to board so that senior leaders are actively engaged in the views of their workforce.

The best employers care deeply about their workers, fostering a supportive culture where speaking up is business as usual. I have heard of great examples where the needs of staff have been addressed:

  • offering night shifts during Ramadan
  • a pre-disciplinary checklist which has reduced the risk of BME staff being unfairly disciplined
  • measurable improvements in WRES indicators

I am not complacent and there is significant distance to go to embed the principles, values and behaviours of true inclusion so that everyone has a sense of belonging for current and future generations. Your voice matters.

Please join our Speak Up Month campaign by using the hashtag #speakuptome. Invite your Freedom to Speak Up Guardian to a team meeting or diversity network, speak up yourself and listen up when someone speaks up to you. Together we will work to make speaking up business as usual.

Dr Henrietta Hughes

Dr Henrietta Hughes was appointed in July 2016 as the National Guardian, a key recommendation from the Francis Report.

She provides leadership and support to Freedom to Speak Up Guardians across England in arm’s-length bodies, NHS and Independent sector organisations to ensure that speaking up becomes business as usual.

The National Guardian’s Office undertakes and publishes case reviews when it appears that speaking up has not been handled according to best practice, providing challenge and learning to the healthcare system as a whole.

Previously a Medical Director at NHS England, Dr Hughes continues her clinical role weekly as a GP in central London.

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