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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 more likely to feel discriminated against in their workplace sadly comes as little surprise, but it is no less shocking.

An official report was published this week specifically focusing 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 personally 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 opportunities for career progression.

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

To some degree, the WRES results are unfortunately a reflection of wider society, with complex causes that I won’t even attempt to go into.

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

But what gets me about this is that the NHS is so often held up as an example of a multi-cultural employer with a very diverse workforce. Around one in five nursing staff in the NHS are from a BME background and the diversity of backgrounds among NHS nurses has been one of the key arguments put forward by those fighting against the scrapping of the student bursary.

If the NHS cannot get it right, with its higher percentage of BME staff than most – if not all – employers in England and the UK, what hope for the rest of us. How do we break the glass ceiling on career development and create a fairer place to work for all?

In such a diverse employer, the leadership should be representative of its workforce. Let’s face it, the NHS is not at the moment. Most senior managers are white, as are most directors of nursing.

After all, the “Snowy White Peaks” was the adroit title of the seminal 2014 report by academic Roger Kline that helped drive the implementation of the WRES programme and shone a light on the fact that BME staff seemed to be treated less favourably than white staff during recruitment, disciplinary procedures and for career opportunities.

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, a panel of senior nurses set up in 2001.

In addition, the fact that the issue is being spoken about and that trusts must now publish data like that contained in this week’s WRES report can only be a good thing, though it’s a pity more organisations did not supply figures this time round. Must do better next time is the message for many trusts on coughing up the required figures.

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

There are also exceptions to the rule at local level like Heather Caudle, chief nurse at Ashford and St Peter’s Hospitals NHS Foundation Trust, who I had the pleasures of meeting recently at the Nursing Times Directors’ Congress.

But more clearly needs to happen. As a white, middle-class man myself, I perhaps lack the essential insight to find the answers but I know that something needs to change. I know there are similar problems within my profession, journalism.

Several years ago, the Nursing Times website was the victim of some trolling by a far right political party, which we had annoyed in some way that I cannot clearly remember. However, I do remember that one of the “trolls” described the Nursing Times team itself as “painfully white”. So I realise there is work to be done to put our own house in order.

However, this week’s report has also reminded me of a great piece of investigative journalism by a young Nursing Times reporter in 2011 that revealed a problem linked to this week’s broader themes. Simon Lewis found that black staff were 13 times more likely to be charged with offences by NHS anti-fraud investigators, sparking concerns black staff were being unfairly “targeted”.

This week, another white, middle-class man said the results of the WRES analysis provide “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”. I strongly agree with these sentiments from NHS England chief executive Simon Stevens.

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

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

In 2012 the trust, which has one of the largest concentrations of BME workers in the country, launched a three-year drive to address a lack of BME staff in senior positions at the organisation. 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 is a good start, with the naming and shaming of trusts where necessary, but as ever in nursing the spreading of best practice will be key, I believe.

From my point of view, tackling discrimination and improving diversity in senior positions will be better for staff, better for patients, better for the NHS – better for everyone.

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