Diversity - the new prescription for the NHS

Simon Fanshawe

Simon Fanshawe OBE explains how his recent report sets out a framework for change to ensure the conversation around diversity is motivated not just by compliance, but more by an understanding of the considerable value it can bring to the core purposes of the NHS. Simon will also be speaking about his report at our regional HR director network meetings over the coming months. 

‘Oh no, not another report on diversity!‘

That was the first response of most of the people I interviewed for this report. But when I explained what we were trying to achieve, they became more interested. Because the report’s aim is to reframe the debate about diversity in the NHS, for boards and execs of trusts, in terms of the dividends it can deliver for patient health, staff success and innovation in the design and delivery of services.

Diversity works so often, so brilliantly, in the NHS in wards and clinics. There are doctors and nurses and porters and auxiliaries and administrators using their languages, cultures, sexual orientation, ethnicity and gender to deliver even better patient-centred care. Gay men in sexual health clinics treating other gay men, having franker conversations that lead to more testing and better health outcomes. Black and Asian female nurses helping women who have little or no English through the labours of childbirth or the trauma of A&E. There are many examples.

But it is also striking that, while the NHS as a service is free at the point of need and doesn’t discriminate against those who walk through the door to receive care, it seems, from the evidence, to discriminate against some who walk through the door to give care.

The diversity deficits are really shocking. The Workforce Race Equality Standard (WRES) team has done a sterling job in supporting its co-founder, Roger Kline’s, contention that holding trusts to account through sound NHS-wide data is the starting point for change.
Some standout statistics from latest reports:

  • It is still the case that white staff (across all grades) who have been shortlisted are 1.6 times more likely than BME staff to be appointed to a job even once shortlisted.
  • The proportion of BME staff in Bands 8a-9 and Very Senior Managers is still only 10.4 per cent compared with 16.3 per cent in the workforce as a whole.
  • It remains twice as likely that BME staff, compared to white staff, do not believe there are equal opportunities for career development and progression.

And there is relatively little progress year on year. In 1964, Woody Allen made a joke. He said: “I have a tape recorder and when I talk into it, it just goes ‘I know, I know.’” Boards react like that to the reported diversity figures. Much wringing of hands about how bad it was and still more when the figures are again reported with no significant difference.

So this report set out to outline a framework for boards and execs to make change, to improve the prospects in the NHS for staff from groups who the data tells us are faced with a concrete ceiling.
The first step is to find real traction in the trust. Diversity must be linked specifically to the achievement of the trust’s strategic aims. No more ‘blah, blah’ general statements. And to follow that with a commitment to change the way they recruit and promote staff, to remove the bias that obviously exists in these processes. The report lays out the research and practice that can show how to achieve that change, and how to discuss and agree on what measurements will actually drive change.

Take a look at Diversity: the new prescription for the NHS

Simon Fanshawe OBE is co-founder of Stonewall and of Diversity by Design, a consultancy that has developed unique ways of ensuring that organisations and businesses can create the diversity of talent they need to perform better and more effectively. You can contact Simon at simon@diversitybydesign.co.uk , follow him on Twitter @simonfanshawe and @DiversitybyD and learn more about Diversity by Design at www.diversitybydesign.co.uk 

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