The business case for diversity


27 / 04 / 2014

Strategic Health Authority


The organisation

University College London Hospitals NHS Foundation Trust has seven separate hospital sites providing general and specialist services. The FT has a £460 million turnover and provides 500,000 outpatient appointments and 75,000 inpatient appointments every year.  The trust employs 6,000 staff.

What we did and why 

The trust developed a hypothetical scenario to underpin its business case for workforce diversity.  It aimed to quantify the financial costs of not proactively managing diversity and conversely, the added benefits if it.

How we did it  

The trust's scenario starts with a classic NHS organisation:

  • 3,000 staff
  • a turnover of £150 million
  • treating say 500,000 patients each year 

What would the business case look like if it was to become an exemplary employer – how much would it save?

  • With its current reputation that discourages applicants and a working environment that means staff leave at a rate faster than those elsewhere  – high turnover and recruitment difficulties would means  £1 million in lost productivity extra advertising and agency costs.
  • Legal action taken out by staff has evidence of discrimination – say 10 per year – adds £0.3 million to the trusts legal fees and compensation payments. 
  • There is a direct impact on the quality of patient services when diversity is low on the agenda. Patients find services less accessible – faulty communication leads to inaccurate diagnoses and treatment plans. And as patients choose other providers, revenue drops and mistakes need rectifying, adding unnecessary costs. All this affects 5 per cent  of patients - another financial blow of £2m.
  • When talented staff do not get promoted, leadership and decision making is weaker as a result. Teams which value diversity are more productive and better places to work. Lack of teamwork is inefficient and increases unit labour costs, resulting in another cost of £.5 million.

At this unsuspecting trust – if it knew it would do something about it – the business case for equality and diversity would save it £3.8 million each year.

The results and next steps  

 The scenario develops further. As a result of the negative impact outlined above, the trust adopts a number of programmes and polices to support diversity for staff and patients. 

For staff, these include flexible working, confidential support, a policy on bullying and harassment, staff networks, staff roadshows and focus groups. Work around recruitment has led to: 

  • 40 per cent of the trust workforce is from a black and minority ethnic (BME) background, which shows an increase of 3 per cent.  Based on the UK 2001 census, the BME workforce representation exceeds the profile of the local population 
  • 71 per cent of the trust workforce is female - the NHS national average is 80 per cent female and 20 per cent male  
Developments for patients include a multi faith chaplaincy service, a language line 'interpreting service’ and patient representatives on different committees. 

These programmes support the trusts vision  ‘to deliver top quality patient care, excellent education and world class research' and become an ‘employer of choice’.

Underlining these actions are staff values which include:

  • Taking pride in caring for each patient as an individual 
  • Providing equal access for all patients 
  • Be open and approachable to all 
  • Delivering high quality outcomes, in partnership with others 
  • Responsiblility and accountability for what we do 
  • Valuing the contributions from all staff and develop their potential
The trust now manages diversity as a guiding business principle, integrated into its various business units.  Managing diversity is integral to business planning, of which workforce planning is a part.  Above all, it is critical to the performance - revenue and quality outcomes - and viability of the trust.

Contact details

Maureen Holas, head of workforce and trust diversity and equality lead, Specialist Hospital Board -

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