Delivering high quality care with
PRIDE
WORKFORCE RACE EQUALITY STANDARD
ACTION PLAN 2016
WORKFORCE RACE EQUALITY STANDARD ACTION PLAN 2016
Contents
Page number
Introduction from the Director of People and OD
2
Foreward from the CEO NHS England
2
Background
3
Why valuing our BME people matters
3
NHS Standard Contract and CQC
3
Our commitments as part of WRES
4
WRES Indicators
4
Action Plan
8
Closing Comments Joan Saddler, Non Executive Director
9
1
INTRODUCTION FROM THE DIRECTOR OF PEOPLE AND OD
Welcome to our first action plan developed in response to our local NHS Workforce
Race Equality Standard (WRES) analysis 2016.
As Executive lead for Workforce Equality, Diversity and Inclusion I welcome the
challenges our WRES analysis presents. Meeting these head on will contribute to
making 2016/17 a great year for our work in these areas.
WRES shines a light on the experience of our BME colleagues. The actions in this
plan have been identified through a series of conversations with our people to
ensure these address their experiences and make a real difference. The plan complements our annual
Workforce Equality and Diversity Report 2015/16 published in March 2016 which sets out our partnership
and co-design with our people principles for all our work on equality, diversity and inclusion.
Completion of the WRES has been mandated by NHS England to ensure we are hospitals that embrace and
act on equality, diversity and inclusion for our black and minority ethnic (BME) colleagues.
Valuing the diverse ethnicity of our people is also fundamental to realising our vision to be an employer of
choice. I have included in this plan the foreward to the national WRES Guidance from the CEO NHS England
as this clearly sets out the importance of the WRES to us locally and the wider NHS.
Deborah Tarrant
Director of People and OD
FOREWORD FROM THE CEO NHS ENGLAND
The Five Year Forward View sets out a direction of travel for the NHS which depends on ensuring the NHS is
innovative, engages and respects staff, and draws on the immense talent in our workforce.
The evidence of the link between the treatment of staff and patient care is particularly well evidenced for
BME staff in the NHS, so this is an issue for patient care, not just for staff. Yet it is strikingly clear that the NHS
still has an immense amount to do to genuinely act on this insight. The lessons of previous efforts to tackle
this challenge show that a focussed natural and local effort will be essential if we are to make the progress
we need.
That is why, although we hope and expect NHS organisations will make the changes that research evidence
and best practice suggest are needed, the Equality and Diversity Council - representing the major national
organisations in the NHS - proposed the Workforce Race Equality Standard, which supports and requires
organisations to make these changes.
The “business case” for race equality in the NHS, and for the Workforce Race Equality Standard, is now a
powerful one. NHS England, with its partners, is committed to tackling race discrimination and creating an
NHS where the talents of all staff are valued and developed – not least for the sake of our patients.
We cannot afford the cost to staff and patient care that comes from unfairness in the appointment,
treatment and development of a large section of the NHS workforce. We also know that research shows that
diverse teams and leaderships are better for innovation and increase the organisational effectiveness the
NHS needs. We know that we do best when healthcare organisations’ leadership broadly reflect the
communities we serve.
I welcome the support the Workforce Race Equality Standard has received and look forward to seeing the
changes it seeks to achieve.
Simon Stevens
CEO NHS England
2
BACKGROUND
The WRES was mandated from April 2015 and its main aims are to:




improve workplace experiences and employment opportunities for BME people
address race inequalities in the recruitment process
improve BME representation at Senior Management and Board level
provide better working environments for the BME workforce
The WRES is a tool that identifies gaps between the experience of our BME and white colleagues in the
workplace. This is measured through a set of metrics that identify gaps and lend themselves to identifying
local actions to address these. The aim is to provide an environment in the NHS where all are valued and
supported to deliver and contribute to high quality patient care and improved health outcomes for all.
The WRES also supports achievement of our NHS Equality Delivery System2 (EDS2) goals in relation to a
representative workforce. We also set our EDS2 goals in collaboration with our people and key stakeholders.
WRES particularly supports outcomes 3 and 4 of the EDS2 to ensure a representative and supported
workforce and inclusive leadership. A separate complementary local action plan for EDS2 will also be
published in 2016.
WHY VALUING OUR BME PEOPLE MATTERS
Delivering high quality care
It is well evidenced that organisations provide better services where they reflect the diversity of their
service users. In the delivery of healthcare it is also supportive of all people, those who work here and
those receiving treatment here (often one and the same). We need to understand, embrace and respond
to different needs and perspectives. The more sophisticated we become in embracing the humanity of
both working relationships and caring ones, the more successful we can expect to become.
Becoming an employer of choice
We want to attract and retain the very best people to work with us, developing and supporting them to
flourish and deliver excellent performance whatever their role. This has benefits for the consistency and
productivity of the care and service delivery we are capable of providing as well as increasing the
potential for sustained, positive cultural change.
Resilience and Sustainability
Successful organisations are those in which diversity is celebrated and every person feels valued on the
strength of their contribution.
The priority in 2016/17 for our people, as with our services, is to develop resilience for sustainability and
growth.
Firstly, there is a need to continue to improve our operational performance – resilience. Secondly, as the
NHS Five Year Forward View sets out, the longer term sustainability of the NHS will require us to develop
more fundamental changes to our current model of care delivery. We know that both our workforce and
communities are highly diverse and we must continue to grow to understand and reflect this in our
organisation.
NHS STANDARD CONTRACT AND CQC
The NHS standard contract 2015/2016 includes the new WRES, which will require all NHS providers of NHS
services to start to address issues highlighted by this. It states at Service condition 13:
The provider must implement EDS2 and implement the national Workforce Race Equality Standard and
submit an annual report to the co-ordinating commissioner on its progress implementing the standard.
3
The CQC will also consider the WRES in their assessments of how “Well Led” NHS providers are from April
2016.
OUR COMMITMENTS AS PART OF WRES
We are committed to acting on our WRES analysis which supports compliance with the Equality Act 2010.
The Act protects people from being treated less favourably because of their race, religion or belief as well
as age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, sex and
sexual orientation.
A requirement of the Act is that public sector organisations have a duty to ensure that equality, diversity
and human rights are embedded into all our functions and activities. This is also required of us by the
Human Rights Act 1998 and the NHS Constitution.
The equality strategy “Building a fairer Britain” 2012, sets out the Government’s vision for a strong,
modern and fair country built on the two principles of equality: equal treatment and equal opportunity. As
a provider of health care services and as an employer we must make a significant contribution to realising
these principles in our area and actions identified as part of WRES support this.
WRES INDICATORS
Data sources in this report
Data
Ethnicity
Source
Our workforce data is drawn from our national NHS Electronic Staff Record. This
is a national personnel and payroll system. Please note that 98% of the people
who work for us have declared their ethnicity. Figures have been rounded up for
ease of reference.
Formal disciplinary
investigations
We log our employee relations activity onto a centrally maintained
database.
Reporting
conventions
Data covers financial years or provide a snapshot as at 31 March 2015 and
31 March 2016.
56% of our workforce are white compared to 44% who are black and minority ethnic
The method of measuring progress and action against the WRES is through the following nine metrics which
include our recent analysis.
Indicator 1: percentage of staff in each of the AfC Bands 1-9 and VSM (including executive Board
members) compared with the percentage of staff in the overall workforce.
The following tables follow the national WRES Indicator conventions. They show the % of white and BME
staff as at March 2016. In line with WRES recommendations the breakdowns differentiate between clinical
and non clinical roles.
4
REPORTING YEAR 2016
90
80
%
of
staff
in
band
70
60
White clinical
50
BME clinical
40
White non clinical
30
BME non clinical
20
10
0
1
2
3
4
5
6
7
8a, b , c Medical
grades
Agenda for Change Band/Medical
Detailed breakdown by band/grade 2016
CLINICAL
NON CLINICAL
White
BME
AfC Band/grade Number % Number
2
517 55 375
3
128 66
62
4
73
77
22
5
375 38 589
6
424 40 587
7
302 54 243
8a, b and c
130 61
77
Non Consultant
Medical grades
215 33 374
Grand Total
2164 46 2329
AfC Band
1
2
3
4
5
6
7
8a, b and c
Grand Total
%
40
32
23
59
56
43
36
58
50
CLINICAL
White
Number
2
151
270
296
101
50
50
69
989
BME
% Number %
40
3
60
80
30
16
78
69
20
82
58
16
71
41
29
75
16
24
68
22
30
62
40
36
77
279
22
White
Number
5
8
13
26
BME
Number
0
2
3
5
NON CLINICAL
White
BME
AfC band/grade Number % Number %
Band 8d
5
63
3
38
Band 9
9
75
2
17
Consultant
108
34
180
56
Grand Total
122
36
185
54
Very Senior
Managers
Band 8d
Band 9
Non AfC VSM
Grand Total
%
100
80
65
74
%
0
20
15
14
PREVIOUS YEAR 2015
%
of
staff
in
band
100
80
White clinical
60
BME clinical
40
White non clinical
20
BME non clinical
0
1
2
3
4
5
6
7
8a, b , c Medical
5
Detailed breakdown by band/grade 2015
CLINICAL
NON CLINICAL
AfC Band/grade
2
3
4
5
6
7
8a, b and c
Non Consultant
Medical grades
Grand Total
White
Number
472
125
73
370
408
304
124
181
2057
%
55
69
79
37
40
55
62
30
46
BME
Number
351
54
19
603
569
231
71
360
2258
60
50
%
40
80
78
84
81
70
70
68
79
BME
Number
3
39
62
47
22
17
17
30
237
%
60
17
20
13
19
30
28
30
19
NON CLINICAL
CLINICAL
AfC
Band/grade
8d
9
Consultant
Grand Total
%
41
30
21
60
56
42
36
White
AfC Band
Number
1
2
2
180
3
238
4
296
5
96
6
39
7
43
8
67
Grand Total
961
White
Number
3
6
108
117
%
43
86
34
35
BME
Number
3
1
176
180
%
43
14
56
54
AfC Band
8d
9
non-AfC VSM
Grand Total
White
Number
3
5
9
17
%
100
83
53
65
BME
Number
0
1
4
5
%
0
17
24
19
BME representation in non clinical roles across all bands is not reflective of our BME workforce.
Our overall staff Equality Diversity and Inclusion (EDI) aim in 2015/16 was to bring to life conversations about
equality, diversity and inclusion in our hospitals. At the beginning of the year we secured a London
Leadership Academy Bursary and used this to co-design bespoke workshops with Capital People on holding
open and honest conversations with our staff. Harjinder Bahra of Capital People and FREDA Consultants
delivered the conversations.
We held six “conversations” in August 2015 attended by 62 of our people. A bespoke session was also
delivered on our annual Nurses Development Day on the 18 September 2015 with 25 attendees.
EDI was a deteriorating theme in our 2015 Annual NHS Staff Survey responses. The findings have informed
our OD Programme for 2016/17 within which we commit to being explicit about EDI in all facets of this. Our
responsive planning approach to local findings has resulted in actions being identified at divisional and
directorate level including requests for bespoke training to address poor staff experience.
We celebrated NHS Equality, Diversity and Human Rights week 16-20 May with a series of open
conversations facilitated by external subject matter experts including one with a specific focus on ethnicity; a
follow up workshop identified the need to introduce initiatives that have delivered improvements for BME
staff elsewhere with pace eg BME staff on all interview panels for 8a and above posts, senior BME staff to
mentor band 5 BME staff, each Executive reverse mentored by a BME member of staff.
Indicator
Data for
Data for
Commentary
reporting
previous
year 2016
year 2015
2. Relative
White staff
White staff
The data is consistent with a significantly lower and
likelihood of staff were 1.9
were 1.5
deteriorating % of BME staff believing the Trust
being appointed
times more
times more
provides equal opportunities for career progression
from shortlisting likely to be
likely to be
(NHS Staff Survey 2015).
across all posts.
appointed.
appointed.
We analysed our BME staff responses to the 2015
Annual NHS Staff Survey; this gave a clear mandate for
action in our hospitals to improve the deteriorating
6
3. Relative
likelihood of staff
entering the
formal
disciplinary
process,
measured by
entry into a
formal
disciplinary
investigation.
This indicator is
based on data
from a two year
rolling average of
current and
previous year.
4. Relative
likelihood of staff
accessing nonmandatory
training and CPD.
theme of equality and diversity.
We will undertake an analysis from our TRAC
recruitment system on reasons for candidates not
being shortlisted by ethnicity and use this evidence
base as part of our unconscious bias training.
BME staff
BME staff
In 2015 there was a significant reduction in formal
were 1.5
were 1.8
disciplinary processes as a result of alternative routes
times more
times more
such as informal approaches and informal warnings
likely to enter likely to enter being used to address concerns; this will be further
a formal
the formal
promoted and consolidated throughout the year.
disciplinary
disciplinary
Research has acknowledged the informal stage of the
investigation. process.
disciplinary process is critical in sorting out minor
issues and some NHS managers lack confidence in
applying informal strategies with BME staff (Archibong
and Darr, 2010). Learning from the above
conversations was that there must be honesty and
fairness for all staff when dealing with concerns.
0.63
0.66
Key Finding 13 of the annual NHS Staff Survey on
Quality of non-mandatory training, learning or
development provides useful intelligence that
complements this indicator. In 2015, on a scale
summary score, 3.97 of white and 4.23 of BME
respondents were satisfied with the quality of non
mandatory training, learning or development.
National NHS Staff Survey Indicators
Indicator
Data for
reporting
year 2016
5. Key Finding 25: White 33%
% of staff
BME 33%
experiencing
harassment,
bullying or abuse
from patients,
relatives or the
public in last 12
months.
6. Key Finding 26: White 31%
percentage of
BME 31%
staff
experiencing
harassment,
bullying or abuse
from staff in last
12 months.
Data for
previous year
2015
White 29%
BME 34%
White 30%
BME 32%
Commentary
Our responsive planning approach to the 2015 Survey
findings has resulted in poor key finding scores being
addressed at divisional and directorate level. Actions
include requests for bespoke training to address this
experience which are incorporated into annual People
and OD Plans. The People & OD Business Partners
have led this work and each of our clinical divisions
now has a clear engagement plan designed to meet
the specific needs derived from local survey results.
We want to make our hospitals great places to receive
care and work; our goal is to be an employer of
choice. Towards the end of 2015 we piloted “Dignity
at work” workshops building on our Trust PRIDE
behaviours. This was in response to a cultural audit we
carried out in Autumn 2015. We subsequently held
two workshops. 40 staff attended. The workshops are
now part of our standard "Elements" training for
managers and three cohorts have been arranged for
2016/17. We will also offer an adapted bespoke
version to specific areas with particular needs.
7
7. Key Finding 21:
% believing the
trust provides
equal
opportunities for
career
progression or
promotion.
8. Question 17: in
the last 12
months have you
personally
experienced
discrimination at
work from
Manager/team
leader or other
colleagues.
White 82%
BME 64%
White 84%
BME 69%
The conversations referred to above enabled staff to
share their experiences which in turn have identified
actions to address this to be delivered with pace.
These actions have been co-designed with a broad
stakeholder group.
White 9%
BME 18%
White 7%
BME 15%
Ensuring dignity at work is a key theme within all our
management and leadership programmes; we have
also scoped a new approach to addressing
unacceptable behaviour that complements these. This
is a new and innovative approach based on restorative
practice that also has the potential to improve
engagement and positively influence our culture, both
of which are fundamental aims of our OD Programme
within which responsibility for workforce equality
diversity and inclusion sits. We will roll out a
programme of work relating to this in 2016/17.
Indicator 9: percentage difference between the organisations Board voting membership and overall
workforce: 46% of our Board voting membership are BME compared to 44% of our workforce.
ACTION PLAN
Our responsive planning approach to the 2015 Survey findings has resulted in poor key finding scores being
addressed at divisional and directorate level as detailed at 5 above. The findings have informed our OD
Programme for 2016/17 within which we commit to being explicit about EDI in all facets of this.
In recognition of our poor performance in the Equality and Diversity theme of our 2015 annual NHS Staff
Survey findings, we have committed to make equality, diversity and inclusion (EDI) explicit within every
strand of our OD programme. For example, we are developing a Leaders’ Agreement rooted in the context
of the leadership required in our organisation today.
We are co-designing this agreement through a large-scale participative methodology to reflect all voices
within the organisation. In establishing the context for the leadership we need, we are explicitly referencing
our survey feedback around EDI. The development planned for our leader cohorts this year not only seeks to
emphasise the characteristics identified through this Leaders Agreement but also provides specific training
and development in the theory of unconscious bias.
In response to the poor findings on EDI in the Survey as part of NHS Equality Diversity and Human Rights
Week in May 2016 we held a series of conversations with our people facilitated by external experts,
including one with a specific focus on ethnicity.
At a follow up workshop to continue the momentum in June 2016 with staff who joined the conversations
priorities and governance arrangements for our work were agreed. It was also agreed to introduce an
overarching Steering Group reporting to the Board to oversee and assure our EDI work. This will be known
as the “Inclusion Group” and the first meeting was held on the 28 July 2016. A clear mandate was also given
to set up a BME Network with clear annual objectives that will measurably advance progress and this is being
taken forward. The first meeting of this will be on the 7 September 2016.
At the same workshop the following immediate actions were identified as a priority for our BME people in
2016/17:

multi-stakeholder “Inclusion Group’ to have a Non-Executive Director as Chair and staff member as
Co-Chair
8




the “Inclusion Group” will report to Trust Board via the Trust Executive and People and Culture
Committees
sub-groups/Networks relating to the three core objectives to be established and feed into the
Inclusion Group
external mentorship from NELFT to guide the establishment of the Group and its networks
a Board Development session on Inclusion to be arranged in collaboration with the Inclusion Group
We will deliver the Board Development session in year to be arranged in collaboration with the Inclusion
Group. “Dignity at work” workshops have been designed, piloted and implemented as part of our new
“Elements” people skills for Managers offering throughout 2016/17; complementary approaches will be
planned within all our internal leadership development programmes from Board to floor. The WRES
analysis will form part of these to highlight the experiences of our BME colleagues to all.
A framework is now in place to progress the above actions.
CLOSING COMMENTS
In April 2016 I welcomed the honesty of our hospitals Annual Equality Diversity and Inclusion Report. I now
welcome actions in this complementary report which sets out our specific commitment to getting equality,
diversity and inclusion right for better patient outcomes and for our workforce that includes black and
minority ethnic colleagues.
We need to move beyond simple data collection. We need to lead and act decisively to improve
experience. The actions detailed in this report, co designed with people delivering or services support this.
Delivering the actions will in turn make our hospitals better places to work and receive care. I am
committed to drawing on my own experience and influence and working with you to achieve our goal of
hospitals that are truly inclusive.
Joan Saddler OBE, Non Executive Director
August 2016
9