Following the introduction of the NHS Workforce Disability Equality Standard (WDES), it’s important that employers look to improve disability declaration rates and build a more accurate picture of the diversity of their workforce.
Following the introduction of the NHS Workforce Disability Equality Standard and the mandated requirements that trusts are now subject to, it is perhaps more important than ever that the NHS is inclusive and welcomes disabled people. A positive and proactive approach by employers towards disability, both during the recruitment process and as part of everyday management, is key to creating an inclusive and open culture.
The NHS Long Term Plan and NHS People Plan, published by NHS England and NHS Improvement, set out an ambition for the health and social care sector to recruit from a wider cross-section of the community. The Workforce Disability Equality Standard (WDES) has been developed to help NHS organisations monitor and measure whether they are effectively doing this in respect of disabled people.
The WDES requires NHS organisations to implement evidence-based actions in response to issues identified through their WDES metrics data, so it is important that employers look to improve disability declaration rates and build a more accurate picture of the diversity of their workforce.
Nationally there is an under-reporting of disability information:
- Around 15 per cent of NHS staff actively choose not to share whether they have a disability or not, and for another 15 per cent of staff there is no information held on their employment record.
- Only three per cent of NHS staff have declared a disability through the NHS Electronic Staff Record (ESR) system. This compares to about 20 per cent of NHS Staff Survey respondents identifying themselves as disabled.
- The Office for National Statistics data indicates that a similar percentage (around 20 per cent) of people in employment across the UK are disabled.
In addition, many people do not consider themselves to have a disability or long-term condition as defined by the Equality Act 2010. For example, staff may be unaware that cancer and mental health conditions are recognised as disabilities, and so affected staff may not report it as such.
Employers should seek to improve their data and reduce the amount of missing information by encouraging staff to speak about their lived experiences to their managers and identify and record their disability on ESR.
This briefing provides guidance and tips for employers on how they can improve their disability data locally by using the recruitment process, manager engagement and data collection more effectively.
Taking steps to be more inclusive with your recruitment
The recruitment process is a crucial first point of contact between an employer and potential employees. It provides an opportunity for employers to demonstrate they are inclusive, to build trust and to give disabled people the confidence and opportunity to say that they have a disability. This information can then be captured early on in the process and recorded on ESR.
Encouraging existing staff to share their disability
Staff will only feel comfortable and confident to talk about their disability if they believe their employer will respond positively and proactively. Organisations should consider incorporating some of these actions into a wider programme of work that can help create a compassionate, inclusive and welcoming workplace where disabled staff - and indeed anyone who might consider themselves to be in a minority group or disadvantaged in any way - feel safe and secure to share their disability status, or other equality information.
There is an intersection between age and disability, as the older you get the more likely you are to acquire a disability. According to The Centre for Policy on Ageing: ‘By far the largest proportion - 36 per cent - of over 50s who stay in employment after acquiring a disability are in public administration, education and health.’
A 2018 report by the Royal College of Nursing stated: ‘In 2013, around one in six nurses were aged 56 or over, compared to almost one in five (19 per cent) in 2018’. It’s therefore important for employers to recognise that existing staff may acquire or may have already acquired a disability during their employment, but may not have reported this. Employers should foster an open culture for staff to share this information and emphasise the benefits this brings.
- Use positive visual workplace images of disabled people in any recruitment and induction materials.
- Use quotes and short case studies directly from currently employed disabled staff, talking about their experience of working in your organisation.
- Include clear written statements in recruitment materials about how accessible materials can be obtained in different formats such as braille or large print.
- Use clear statements at recruitment events, as an introduction to an interview, or during inductions, about the organisation’s commitment to create inclusive workplace cultures that welcome disabled people.
- Share information in your recruitment materials about how the organisation supports disabled people and what they can expect when they join. For example, access to a disabled staff network/peer support group and opportunities to sign up to targeted career development opportunities.
- Provide clear information about the organisation’s commitment and approach to reasonable adjustments.
- Make sure interview candidates have an opportunity to share information about any disability that they may have and whether they require any support, such as reasonable adjustments for tests, interviews and any other part of the recruitment process.
- Make a commitment to recruit more people with learning disabilities.
- Consider introducing internships and work experience placements for people with disabilities and learning disabilities, using schemes such as Project Search and Project Choice.
- Join the national Disability Confident scheme, which encourages employers to think differently about disability and how they recruit, retain and develop disabled people.
Be clear about why you are collecting the data
Sharing data on disability or long-term conditions can be difficult for many reasons. There are benefits for both staff and the employer in building better quality data on disability. For staff, the benefits in sharing data include:
- prompting a discussion with their employer about reasonable adjustments or other workplace support that they might require
- receiving targeted information about support or positive action initiatives, such as career development programmes or disabled staff networks
- contributing to a pool of information that will help the employer monitor its workforce and meet the diverse needs of staff, for example in relation to provision of accessible estates and facilities.
- Be clear in your communications as to why the data is being collected, how the data will be used, who will have access to this information and the benefits it will bring. For example, a staff member may share their disability and reasonably assume that this will prompt a discussion about disability support, when in fact the data is only being used for anonymous monitoring purposes.
- When starting a conversation with a member of staff about reasonable adjustments, give them the opportunity to talk openly about their disability and encourage them to record this on ESR.
- Proactively use the disability monitoring data to build a better understanding of any barriers in the recruitment and selection process that may disadvantage disabled applicants.
- Equally, use the data to understand the workforce profile and identify interventions that may support disabled staff to progress their careers.
Dedicating time to audit and cleanse data
Scheduling time to undertake data verification exercises is crucial. It provides an opportunity to interact with staff, reminding them why data is being collected, how it will be used and stored, and the importance of recording their disability on ESR. The data received will allow you to better understand the needs of your workforce and take positive steps to improve the working environment and workplace culture for your staff.
- Audit your current data sets and undertake a data cleansing exercise.
- Promote information through internal communications channels, such as intranet sites or staff newsletters, inviting existing staff to check that all their personal data held on ESR is accurate, and then update accordingly. This could be done annually, with quarterly reminders. It could also form part of mid-year and annual appraisal meetings.
- Use the updated information to provide personalised support, for example by introducing reasonable workplace adjustments.
- Consider introducing the self-service element of ESR so that staff can update their own records more easily. Having this control may encourage more staff to report their information.
- Compare your disability declaration rates data to that published in the WDES annual report. This report includes comparisons of data by trust types and regions. Reviewing data will help employers to identify whether there is more they need to do support staff to share their disability.
Encouraging line managers to start a conversation
Some staff may not feel confident and not want to talk about their disability. They may feel that it would have a detrimental impact on their jobs and careers. Demonstrating inclusive, kind, compassionate leadership can lead to staff feeling more supported and empowered to discuss and share their disability.
Manager behaviours can have a huge impact on disabled staff experience. By starting a conversation, a manager can gain a better understanding of concerns their staff might have about sharing details of their disability on ESR. It’s also an opportunity to talk about any support the individual needs with a view to making reasonable adjustments in the workplace.
- Think about the terminology - try to avoid terms like ‘disclosure’ which can be seen as negative and feel daunting, embarrassing, formal and legalistic. Instead, adopt for more friendly language that will help foster trust and inclusion, and will encourage people to feel able to open up about their disability. For example, ask people to ‘share’ or ‘tell’.
- Get a senior leader to support the campaign and host online chats or webinars where they lead on the benefits to staff of sharing their disability. A good example of this is a podcast by Deborah Lee, a chief executive of an NHS trust who has opened up about her disability and the positive impact this had.
- Widen the campaign - include social media messaging that will help reach the public and local communities. Consider linking this to a recruitment campaign to encourage more applications from disabled people in your local area.
'Demonstrating inclusive, kind, compassionate leadership can lead to staff feeling more supported and empowered.’
Running a communications campaign
Consider launching a positive and proactive communications campaign to engage with staff, with the aim of encouraging conversations around disability and the importance of recording this information on ESR.
The campaign could take the form of posters that promote role models, articles in staff newsletters or blogs written by the organisation’s disabled staff network members.
- Incorporate into line manager training the importance of ensuring disability equality in the workplace, their responsibilities as a manager and how they can play an active role in supporting disabled staff.
- Have conversations about disability within an overall message of creating inclusive and compassionate workplaces for all staff.
- Encourage managers to be proactive and start a conversation with both new and existing staff during regular supervision, one-to-one meetings, appraisals and return-to-work interviews.
- Take an inclusive approach to conversations. For example, consider using principles from Making Every Contact Count (MECC). Whilst MECC is patient focused, it can also be applied to conversations with staff about disability.
- Consider whether a member of staff is stressed or experiencing a mental health condition. The mental health charity Mind and the Chartered Institute of Personnel Development (CIPD) have developed a good practice guide for managers to help them manage mental health issues at work.
- NHS Employers has developed an interactive emotional wellbeing toolkit How are you feeling today? to help start conversations.
- Read a report by disability charity Scope Let’s talk: improving conversations about disability at work, which includes tips for employers to encourage staff to share information about their disability or health condition.
Engaging with staff networks and communications colleagues
Employers should proactively seek to work with staff networks and trade unions in any campaign or initiative to improve declaration rates. This approach is supported by the ethos of ‘nothing about us without us’ and means involving disabled people in any decisions that you make that will have an impact on disabled people.
Working with these key stakeholders will allow you to connect, understand concerns, gain buy-in and improve staff engagement.
- Take steps to engage with both disabled staff and trade unions at every opportunity.
- Consider a joint campaign with staff side to encourage staff to share their disability to support both their employment and union records.
- If your organisation hasn’t already established a disabled staff network it is worth considering if there is an appetite for one. Invite staff to share their views on whether a network should be introduced.
- Proactively consider and discuss the likelihood of undeclared disability when dealing with employment relations cases.
“Take steps to engage with both disabled staff and trade unions at every opportunity.”
Examples of good practice
Following the introduction of the WDES, many trusts are looking to improve their disability declaration rates. The examples below highlight some of the approaches that NHS organisations have taken.
Blackpool Teaching Hospitals NHS Foundation Trust
The trust engaged with staff through regular communications, explaining why the protected characteristics information on the ESR system was required and that this information would be used anonymously.
In addition, messaging was reinforced during equalities training. The trust engaged with the staff equality diversity and inclusion ambassador group and developed an exhibition stand that they were able to use to engage with staff and encourage conversations around disability.
Barts Health NHS Trust
Through their disability staff network, BartsAbility, the trust has rolled out several initiatives to help increase staff disability declaration rates. The trust focused on changing the narrative and language used to encourage staff to share their disability information in the workplace and implemented a Closing the Gap campaign, which shared information on how staff can update their details on the ESR system.
Warrington and Halton Hospitals NHS Foundation Trust
The trust developed an organisation-wide communication to encourage staff to check and self-report their disability and equality monitoring information on the ESR system. Staff were provided with guidance on how to update their details and on the benefits they would receive in terms of support as a result of sharing the information. The trust also benefits by having up to date and accurate equality monitoring data. Data can be analysed to better understand the profile of the workforce diversity and the trust can to take a more informed approach to targeting interventions to support staff in their workplace and career experiences.
Dorset HealthCare University NHS Foundation Trust
Dorset HealthCare Hidden Talents Group comprises of staff employed by Dorset HealthCare who have experienced a mental health illness some time in their life, or who live with a mental health condition or emotional distress. Working in partnership with the corporate equality lead, the group reviewed the organisational data collection processes and IT systems for collecting data on staff disabilities.
The group secured line management support and presented a case to their board in order to get senior level buy-in. This led to an awareness-raising campaign among staff, using a variety of video and poster-based materials, which ultimately led to the development of a health passport scheme. The group now also delivers training on how to line manage staff with disabilities.
East Sussex Healthcare NHS Trust
The trust started its campaign by asking staff about disability at work in order to understand why some people were unwilling to declare their disability and what their concerns were about data privacy and security. This led the trust to run a series of campaigns to raise awareness around disability declaration rates in conjunction with their disability forum. These campaigns emphasised the benefits of declaration and why it was important to the organisation and how the organisation would use the data.
The trust engaged peer mental health support workers to help colleagues who were struggling at work. They also implemented a three-month job taster programme offering work experience across a variety of roles for disabled service users. This also provided an opportunity for the service users to secure a role within the trust. They also arranged staff MOT days, which focused on wellbeing and demonstrated the support that was in place for all of the workforce, including disabled staff.
Through visible senior leadership and engagement with disabled staff and networks, employers will see increasing confidence of both staff and managers in having conversations about the issue of workplace disability equality. Job applicants and disabled staff will also feel more empowered to be open about their lived experiences and what support they may need to achieve their full potential.
Access further information on supporting disabled staff in the workplace and embedding the NHS Workforce Disability Equality Standard.