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How to become race champions

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Hertfordshire Partnership Foundation Trust is leading the way on race equality for patients and staff, reveals Victoria Hoban

When David ‘Rocky’ Bennett died while being restrained in a psychiatric ward in 1998, it threw up important questions about race equality in the NHS.

Seven years later, the government published Delivering Race Equality in Mental Health Care, in response to the Bennett inquiry, which contained an action plan for reducing inequalities in black and minority ethnic (BME) patients’ access to, experience of, and outcomes from mental health services.

But it is not just mental health service users at risk of racial prejudice. A Unison survey in 2007 of 2,000 black and minority ethnic NHS workers, including nurses, found that 69% had experienced racism working in the health service, with 61% reporting racist abuse from patients, and 39% from managers.

In the same year, the Healthcare Commission carried out an audit of all NHS trusts in England to ascertain how many were meeting their duties for race equality, such as publishing statistics on how many staff and patients have a BME background. Hertfordshire Partnership Foundation trust was one of only 35 trusts, out of 394 in total, to fully comply and were invited by the Healthcare Commission to take part in a further race equality review to identify good practice to share across the whole of the NHS.

‘We were surprised as the audit was only looking for the “bare minimum”,’ says James Holland, equalities manager at the trust. ‘Here at the trust we have done much more.’

The creation of Mr Holland’s full-time role in November 2005, developed in response to Delivering Race Equality, has been key to the trust’s commitment to improving race equality – not just for service users but also for staff. The trust now also employs equality development lead Kor Chand.

‘Both James and Kor are passionate about what they do and have been a catalyst for change,’ says Moira Port, a modern matron at the trust.

But the involvement of staff members such as Moira in the equality and diversity agenda have also been vital to the trust’s achievements. Moira is currently chair of the trust’s BME staff network and one of several equality trainers.

‘I’ve been a nurse and BME staff member for 34 years and have gone through personal experiences of racial discrimination. I wanted to help move things forward and use negative experiences to bring about positive change,’ she says.

The BME staff network enables all staff to talk about their experiences or any problems they are having and receive support and advice. The trust has also integrated Breaking Through, the nationwide programme aimed at supporting the development of a diverse leadership workforce, into trust practice. ‘If there is a job going, staff are not frightened to apply but feel equipped to deal with any assumptions or stereotyping. They are more confident to deal with race issues in the workplace and don’t feel disadvantaged,’ says Moira.

But improving race equality is not just about helping BME staff directly. Encouraging the involvement of all staff is crucial to bringing about a new mindset. The BME staff network holds regular workshops and debates which all staff are invited to attend. ‘Not everyone always agrees but we can come to a common understanding,’ Moira says.

Along with fellow equality and diversity trainers, Moira also delivers an introductory training programme for all staff covering all strands of equality. It has become one of the trust’s popular training courses. ‘People are encouraged to challenge any negative assumptions or stereotypes they may have of others,’ she explains.

The trust also chairs the Hertfordshire Delivering Race Equality Project Board. This is designed to ensure that all race equality projects developed and managed by the trust feed into a central ‘hub’ so that other trusts can share their experiences and the trust can get feedback on its performance.

‘We want to share more of what we do with other trusts, which may encourage those who might not be doing as much around race equality,’ says James.

The trust is currently looking at ways to improve how outcomes around equality and diversity are measured. This currently happens via training evaluations, patient and staff satisfaction surveys – which are already showing better response rates from BME staff and service users – and information such as the national annual Count Me In census.

The trust is also developing new projects such as the Clinical Race Equality Trailblazers Programme which will enable ‘experts in experience’ – such as service users and carers – to assess staff’s cultural competency across all services.

Race equality is not just about dealing with prejudice, however, but in celebrating diversity. To this end, for the last two years, the trust has celebrated Black History Month in October with a series of events including talks and poetry readings. ‘If you look back, no one would have even talked about celebrating differences, so these events are an important step forward,’ says Moira.

But she knows better than anyone that it is crucial to keep the momentum going. ‘I feel relationships between staff in relation to race issues are improving. But we can’t rest on our laurels,’ she stresses.

‘You need advocates in senior positions who can provide mentoring and coaching. The NHS is the largest employer of BME staff in the UK and we want to keep seeing more positive change.’

To find out more about the trust’s work, email james.holland@hertspartsft.nhs.uk

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