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Conquering the snowy white peaks: diversity in NHS leadership benefits us all

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The fact that black and minority ethnic nurses are more likely to feel discriminated against at work sadly comes as little surprise, but it is no less shocking.

A report published this week specifically focused for the first time on data collected by trusts about how their BME workforce feel they are treated.

It revealed that at eight of 10 trusts in England more BME staff report having experienced discrimination from a manager or colleague than their white counterparts. In most trusts, more BME employees than white staff also reported being harassed, bullied or abused by a colleague, and felt they were not offered equal career opportunities.

“More BME employees than white staff also reported being harassed, bullied or abused by a colleague”

These concerning findings come from data submitted under the Workforce Race Equality Standard, which came in to force in April 2015 and requires trusts to provide data on nine indicators, including the likelihood of BME staff entering a disciplinary process compared with white colleagues and the proportion in senior positions.

To some degree, the results are a reflection of wider society. But what gets me is that the NHS is so often cited as an example of a multi-cultural employer. Around one in five NHS nursing staff are from a BME background and the diversity of backgrounds has been a key argument of those campaigning against scrapping the student bursary.

“How do we create a fairer place to work for all?”

If the NHS can’t get it right, with its higher percentage of BME staff than most – if not all – UK employers, what hope for the rest of us? How do we create a fairer place to work for all?

In such a diverse employer, the leadership should be representative of its workforce. But most senior managers are white, as are most directors of nursing. Of course there are exceptions, like Heather Caudle, chief nurse at Ashford and St Peter’s Hospitals Foundation Trust, but as the saying goes, the exception proves the rule.

After all, academic Roger Kline’s astutely titled Snowy White Peaks – the seminal 2014 report that helped drive the implementation of the WRES programme and shone a light on the less favourable treatment of BME staff compared with white colleagues.

“The issue is being spoken about, and trusts must publish data on it”

On the positive side, there is some action at national level. In October last year, the NHS Leadership Academy set up its Next Generation Career Acceleration Workshop, an initiative to support leaders from under-represented groups and the chief nursing office for England meets regularly with her BME advisory group. And at least the issue is being spoken about, and trusts must publish data on it – though it’s a pity more did not supply figures to the WRES this time round. Must do better next time is the message for many.

But more clearly needs to happen. As a white, middle-class man, I perhaps lack the insight to find the answers, but I know something needs to change. And perhaps hard evidence means they will. Another white, middle-class man – NHS England chief executive Simon Stevens – said the WRES analysis provides “unvarnished feedback” to every NHS trust about the experiences of their BME staff, which in many cases were “deeply concerning and a clear call to action”.

“As a white, middle-class man, I perhaps lack the insight to find the answers”

Those needing to take action should perhaps take note of ideas being pioneered by North East London and Essex Foundation Trust.

In 2012 the trust, which has one of the country’s largest concentrations of BME workers, launched a three-year drive to address a lack of BME staff in senior positions. Under its latest plans, the trust’s director of nursing will be “reverse mentored” by a junior member of BME staff, as part of efforts to tackle discrimination.

Shining a light on the numbers, and naming and shaming trusts where necessary, is a good start, but as ever in nursing the spreading of best practice will be key.

Tackling discrimination and improving diversity in senior positions won’t just be better for staff; it will be better for patients, better for the NHS – better for everyone.


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