Time for action: Midlands workforce, race, equality and inclusion strategy

About Midlands workforce, race, equality and inclusion strategy

The goal of health and social care services are to run the best health and wellbeing service possible, but this can only happen with a healthy workforce.

Information and the lived experience of staff shows us how discrimination can make staff unhealthy and how race discrimination affects people’s health the most. The disproportionate level of discrimination among Black, Asian and ethnic minority staff is evident in our NHS staff survey and WRES data.

The People Plan written in summer 2020, says the problem of race discrimination needs to be tackled urgently. Senior leaders and staff in the Midlands region have worked together to write the Midland Race Equality Plan. The plan explains how racism can be tackled in health and social care across the region.

The NHS was first set up to create a healthcare service that is supposed to be accessible and inclusive to everyone. However, many people who are disadvantaged in society do not have good access to healthcare and still have poor health outcomes. This also rings true for our staff who continue to experience discrimination within the NHS.

This plan will only succeed if everyone takes responsibility for their actions and how they behave.

How will this plan work?

Three principles guide this plan:

  • Educate – “We can all learn more about racial discrimination”
  • Challenge – “We need to work together to challenge racism”
  • Support – “We need to support each other to take action”

This plan does not just support staff from an ethnic diverse background. By making the Midland region fairer it will support other protected groups in the Equality Act 2010 which includes people of different ages, disabled people, people who are changing their gender, pregnant women and mothers, people who believe in a religion or have no religion, people attracted to the same sex or the opposite sex.

Find out more

Download the Time for action: Midlands workforce, race, equality and inclusion strategy.

Watch a recording of the Time for action: Midlands workforce, race, equality and inclusion launch strategy.

Read the Time for action: Midlands workforce, race, equality and inclusion strategy below:

Leadership

What is leadership?

Leadership and management are two different things. You can have good managers that do not inspire people or know how to provide good leadership. You can have leaders who inspire people but do not have ‘manager’ in their job title.

Our plan includes the things are necessary for managers to become leaders. We know that this plan will only succeed with the right leaders.

Leaders will:

  • Know how to tackle racism
  • Understand the lived experiences of staff
  • Get the right support
  • Stop discrimination even if it is difficult to do so
  • Have the right skills and training to be a good leader
  • Show that they care
  • Take steps to make things better or explain why things have not changed
  • Be happy for their leadership skills to be measured

Taking action

The People Plan and the People Promise says we should look after each other and make the health and social care service a place where everyone feels included and is happy at work.

The health and social care service need to act urgently to end discrimination for everyone. This means that racism needs to be tackled so that staff can access good support and work opportunities to run better patient care.

In the Midlands, our work with senior leaders and staff tells us that racism is the main problem that stops the NHS from being an organisation that is for everyone, both workers and patients.

This view is supported by research, data from the workforce race equality standard (WRES) and staff feedback. So we have included the actions we need to stop racism across the Midlands in this plan.

Health and social care workers should:

  • Understand what racism is and how it affects people
  • Understand the difference between day to day racist behaviour and culture of racism that is part of how an organisation is run – this is sometimes called institutional racism
  • Take action to stop racism
  • Understand their rights to be protected (from racism or racists)
  • Work together in peace and harmony
  • Get good support from their managers and colleagues when they experience racism
  • Feel safe to speak up and tell the truth
  • Get recognition for their skills
  • Have a fair chance to get a new job and get promoted

Action Point 1: Health and wellbeing support for everyone

A recent report said over 60% of BME people believe white people get more protection than they do from the NHS.

Covid-19 has had a big impact on BME groups and on BME workers – the number of BME NHS staff that have lost their lives from COVID-19 is much higher than white NHS staff.

BME NHS workers are still worried about their safety, health and wellbeing in the Midlands. Nearly two-thirds (64%) of Midlands BME staff said they did not feel safer after a risk assessment by their manager.

This plan looks at a number of actions including:

  • Making managers more aware of what stops BME staff from having good health and wellbeing
  • Ways to decrease the risk and impact of COVID-19 on vulnerable groups including BME staff
  • Ways that organisations can offer health and wellbeing support for BME staff

Nurse smiling

Two colleagues talking

Action Point 2: Get more BME staff to speak up

Feedback from people across England and the People Plan revealed that BME staff do not use the Freedom To Speak Up Guardian Service very often. For the service to work properly BME staff must trust the service

What do you think?

Do you use the Freedom to Speak Up Guardian? The Francis report said that many staff in the NHS were too scared to speak up about bullying, harassment and discrimination. That means vulnerable groups including BME staff were much less likely to raise their concerns, which could mean racism and discrimination is going unreported or under-reported.

Our plan will look at:

  • How big this problem is in the Midlands
  • How we can improve trust for workers to speak up
  • How senior leaders will tackle these issues

Find out more

You can read more about the detailed action points of this strategy that seek to remove barriers to help staff speak up here.

Action Point 3: Stop racism when staff are disciplined

Both the NHS Staff Survey and Workforce Race Equality Standard (WRES) reports tell us that BME staff are treated worse than other groups.

This affects BME staff when they apply for jobs, try to get a better job or they get treated more unfairly than white staff for something they might have done wrong at work.

According to the 2019 WRES data, the Midlands and the East of the England disciplined more BME staff than other regions, so we are going to:

  • Question the need for formal disciplinaries
  • Get an independent organisation or person to see if racism is the reason for the high number of disciplinaries
  • Train managers to better understand their biases when they discipline staff
  • Take action if disciplinaries are found to be biased

Find out more

You can find out more about the strategy’s detailed actions on tackling racism and bias when staff are disciplined here.

Man holding pen, applying for job

Action Point 4: Stop racism when people apply for jobs and get promoted

There is a lot of evidence that suggests racism is preventing BME staff getting promotion. Often the skills and qualifications of BME staff are not fully utilised.

This is more obvious with senior leaders in the NHS. For example, 23% of all Midlands staff are BME (July 2020) yet only 10% work at Board level.

To stop racism when people apply for a job or get promoted we are going to:

  • Find out the skills of all BME staff and remove barriers for them to progress
  • Make job interviews fairer to avoid racism
  • Make sure that the right number of workers from BME backgrounds are represented at all levels

Find out more

You can find out more about the strategy’s detailed actions to stop racism when staff apply for jobs or get promoted here.

Action Point 5: Be honest and take responsibility

The NHS is not very good at owning up to mistakes or speaking up when things go wrong. What Midland staff tell us is in line with the Francis report, they think the pace of change is slow and they do not see discrimination being stopped.

This plan will only be a success if everyone takes responsibility for what they do, and what they do not do. This means:

  • We need to challenge each other about why there is slow progress
  • Give staff network groups the power to bring about change
  • Agree and set penalties when progress is not made

Find out more

You can read more about how the strategy will seek to build accountability here.

Two women talking at table

Working together

Working across the Midlands

Changes will need to be made to offer high quality services for everyone in the local community.

Health and social care organisations need to work more closely together to understand equality issues with a focus on racism. Any action in the plan must be applied across health and social services because we recognise that this is not just an NHS issue.

So the plan suggests three things that must be done:

  • Create a People Board that looks like staff in the Midlands, uses its power to tackle racism and challenge leaders when they do not do what they say they are going to do
  • Start up an Equality, Diversity and Inclusion Subgroup overseeing the work of the 11 health and care organisations/systems in the region
  • Create a Race, Equality and Inclusion Panel with an independent chair

Find out more

You can find more detail on the new structure here.

Awards

Although we have a long way to go it is easy to forget the good work being done. So, we should be positive that change will come.

We want to celebrate and share the good work that people are doing and to do this we will:

  • Create a website for people to find out about and share good practice
  • Create an awards system
  • Encourage feedback to promote and try out new ideas

Find out more

You can read more about how we will celebrate success here.

Get involved

Would you like to share your story about anything you or your team have done to make things better for staff that would help the plan to succeed

Would you like to share any examples of things your department, division or section is already doing? For example:

  • Are you already doing something that is helping to make services fairer and you are getting good staff or patient feedback?
  • Have you have tried something out to make services fairer, but it did not work or you stopped? We still want to hear from you.
  • Do you have any new ideas that you or your team have not tried out yet? We definitely want to hear from you!

Nurses talking to each other

What works

How do we know change is happening?

In the NHS we have a lot of information from BME workers about their negative experiences. The NHS staff survey and WRES reports help us to find out if things are getting better.

This information is useful but  this does not tell us the whole story. This is because the survey does not capture staff stories. Racism also stops people from speaking up so we need to have safe spaces for people to speak openly.

An organisation that is fair for everyone will gather lots of different information that shows how they are getting better. This should be done in an open and honest way by:

  • Reporting on things that are working well
  • Finding out what is stopping things from getting better
  • Reporting on things that are not working

Sharing good practice 

We need much more information to find out what is working and what does not work so we need to share more good practice across the Midlands.

If you have any examples of good practice in your team please email gurwinder.singh@nhs.net.

About

About the Midlands Race Equality Plan

This Midlands Race Equality Plan was written in response to the People Plan by Kuvy Seenan, Head of Equality and Inclusion in the NHS England and NHS Improvement Midlands team.

This plan has been written with the following key partners:

  • Derek Jones – a passionate White ally and an ex-NHS Leader and practice educator
  • Regional NHSE&I Midlands workforce and OD team
  • Representatives from a wide range of stakeholders across the 11 systems including:
    • Staff involved in engagement sessions
    • WRES Experts
    • Staff Networks leads
    • ED&I leads
    • Health and wellbeing leads
    • Freedom to speak up guardians
    • Chief Executive Officers
    • Human Resources Director
    • System Workforce leads

This website version of the Midlands Race Equality Plan will show how the region is moving towards a health and social care service for everyone – staff and patients.

If you work in the Midlands region and would like to, discuss any equality issues, share any lived experiences of equality issues or share any stories about racism or race equality, please email gurwinder.singh@nhs.net