A top nursing professor, who was recently honoured by the Queen, has said that to truly stamp out race inequalities within the NHS will require “bravery” and the commitment of leaders from all backgrounds.
Laura Serrant told Nursing Times that lasting change could not be achieved by the will of black and minority ethnic (BME) campaigners alone.
“Any real change will require more than just BME people to actually engage with the agenda and to drive forward”
The 54-year-old received an OBE last month for her services to nursing and health policy both in the UK and across the Commonwealth.
The focus of her work has been around sexual and reproductive health and acting as a champion for marginalised groups.
In an interview with Nursing Times, Professor Serrant said her professional endeavours had been “completely grounded” in her Dominica heritage.
Fittingly, Professor Serrant was handed the medal from Prince William on the last day of Black History Month and in the same week of the 40th anniversary of Dominica independence.
“We are going in the right direction but we do need some clear decision making and some bravery and to shift the pace of change”
After the ceremony at Buckingham Palace, a celebration was held at the Dominica High Commission in London, which was attended by high-profile figures in the world of nursing and midwifery including Professor Dame Elizabeth Anionwu, Baroness Watkins of Tavistock and Professor Jacqueline Dunkley-Bent.
Dominica high commissioner Janet Charles was due to fly out to the Caribbean the day before the event but delayed the trip so she could be there to congratulate Professor Serrant. Seth Ramocan, the high commissioner of Jamaica, was also in attendance.
Professor Serrant, 54, said she was “shocked, surprised and humbled” to receive the OBE.
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She added: “It meant a lot not only because what it means being a nurse getting that award, but it means quite a lot because my work has focused on the marginalised populations.
“So it’s not always front and centre and I think, particularly, in the early days around policies around HIV and AIDS at a time when it was quite stigmatised,” she noted.
“I think it’s about working with marginalised groups on a whole range of bases, whether they are marginalised because of their ethnicity, their gender, their sexuality, but I think that’s what was more important, recognition of the importance of that work,” she added.
In 2001, Professor Serrant worked on the creation of the first national strategy for sexual health and HIV for England.
She was also a key player in the development of the latest nursing and midwifery strategy called Leading Change, Adding Value, launched in 2016.
Professor Serrant is currently chair of the chief nursing officer for England’s black and minority ethnic (BME) strategic advisory group.
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While acknowledging that good progress on diversity issues had been made thanks to initiatives such as the NHS Workforce Race Equality Standard (WRES), she said there was still much more to be done.
“We are going in the right direction but we do need some clear decision making and some bravery and to shift the pace of change,” said Professor Serrant, who is currently a professor of nursing at Sheffield Hallam University but in December will start a new job as head of nursing at Manchester Metropolitan University.
The latest WRES report in 2017 showed BME staff still were 1.37 times more likely to enter a formal disciplinary process in comparison to white colleagues, and were more than twice as likely to experience discrimination at work.
“One of the things that’s important to me and that’s important to the profession is maintaining diversity of the workforce”
White staff are 1.60 times more like to be appointed for a job from a shortlist than BME candidates, and just 7% of very senior managers in the NHS are from BME backgrounds, despite representing 18% of the overall workforce.
Following the Windrush scandal earlier this year, Professor Serrant said people were more aware of the challenges and receptive to change but she added that in order to for the agenda to succeed everyone needed to get on board.
“Of course, the thing is any real change will require more than just BME people to actually engage with the agenda and to drive forward, because historically we are not and have not been at every table,” she said.
“And, if we are not at the table where discussions are being made around healthcare or policy in general, then we need to then move to a place where there are people at the table who will raise those issues irrespectively of their own ethnicity,” said Professor Serrant.
Asked what success would look like, she said not having to ask the question, because race equality would be a routine part of the conversation.
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Professor Serrant’s parents emigrated from Commonwealth of Dominica in the 1960s. She has worked closely with the country’s nursing community and in 2011 was asked to give a speech at a nurse graduation ceremony there.
Professor Serrant, who qualified as a nurse in 1986 and was one the first to complete a four-year nursing degree, studying at Sheffield City Polytechnic, said her Dominica heritage had informed much of her career choices.
“Growing up in the UK in the 60s and 70s at a time when there was a lot of more direct racism and direct exclusion, that shapes you, but also I think certainly from my heritage being from such a small island, the ethos of working hard and education and actually nurses are held in such high esteem there that it’s a real honour to do the role,” she said. “That’s something that comes very much culturally.
“Nurse itself in the Caribbean is a given title in the same way you call someone a doctor, they will call you nurse,” she said. “It’s actually seen as a very revered profession.
“On all accounts, whether it’s my work as a nurse or my work around inequalities and making sure that we have much more equity in healthcare, I think both are completely grounded in my cultural background and my pride as someone from Dominica,” she noted.
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Speaking to Nursing Times, Professor Serrant also raised concerns about the impact of Brexit on the diversity of the workforce.
Latest figures from the Nursing and Midwifery Council show the number of registrants from the European Economic Area has fallen 13% from 38,992 in September 2016 to 33,874 in September 2018.
“We, not just nursing but generally, are turning to a time of a little bit of uncertainty with Brexit and everting else, and I think that one of the things that’s important to me and that’s important to the profession is maintaining diversity of the workforce that we have, and that will be one of the challenges that we have,” said Professor Serrant.
“In the UK, we are serving a diverse society, diverse patients, diverse service users, and have to be able to reflect the diversity within our workforce as well,” she said. “We need to actively aim to maintain that in the face of Brexit and in the face of other things that challenge us and we need some bravery to be able to do that.”
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