Organisation introduces a programme to reduce gaps in experience for BME staff, increasing the proportion of very senior managers from BME backgrounds to 6.8 per cent

Synopsis:

We are the team responsible for implementing the Workforce Race Equality Standard (WRES) in the NHS; a requirement for commissioners and provider organisations.

Ambition:

The NHS workforce is more diverse today than at any time in its history; yet from evidence, we know that not everyone receives the same opportunities or have the same experiences. At the most senior levels, the leadership of organisations do not reflect the workforce in the wider NHS.

Research and evidence tell us that engaged staff leads to better outcomes for organisations, staff and all patients. Improved staff morale increases efficiency and savings by reduced agency costs, better patient care, and experience. For these reasons, the Workforce Race Equality Standard (WRES) programme was introduced to the NHS in April 2015. It aims to ensure black and minority ethnic (BME) employees have equal access to career opportunities and fair treatment in the workplace.

The WRES measures nine indicators; BME appointments and career progression, experiences in bullying; by colleagues, managers, patients and the public, disciplinary action and board representation. The WRES team at NHS England oversees the strategy and implementation of the programme; engaging with all NHS trusts, clinical commissioning groups (CCGs), independent healthcare providers and national healthcare arm’s length bodies (ALBs). In its work, the team embodies and lives the five key values of the NHS constitution: Everyone counts, dignity and respect, working together for patients, compassion and commitment to quality. 

Outcome:

Since the inception of the WRES, there have been improvements in closing the gaps in workplace inequality across NHS trusts in England, e.g. in the likelihood of BME appointments from shortlisting and entering formal disciplinary action compared to white colleagues continuously over the last three years.

Some key examples of WRES led improvements in 2018 across the NHS are as follows:

The proportion of very senior managers (VSMs) from BME backgrounds increased to 6.8% in 2018 compared to 5.7% in 2017– an additional 44 For nursing Agenda for Change bands 6 and above, there is a sustained increase in BME representation, an increase of 2,224 compared to 2017.

There has been a decrease in the number of trusts with no BME representation on the board, from 98 in 2017 to 96 in 2018. In 2018 there were 29 trusts with three or more BME board members compared to 16 in 2016.

Spread:

The WRES programme focusses on the NHS and beyond; across health and social care and across the wider public sector e.g. across Greater Manchester devolved powers. To help support organisations, the WRES team shares best practices from organisations that have made sustained improvements in each indicator to help those who need added support. Over time, WRES data had suggested; London as a region, the nursing, midwifery and health visitor workforce and the ambulance sector need added support.

These continue to be priority areas for the WRES team and are showing signs of sustained improvement. In addition, to help NHS organisations embed inclusivity, diversity and reduce the gaps in experience for BME colleagues, the WRES team developed an expert development programme, with participants drawn from all sectors of the NHS.

The programme has created a diverse network of experts that share their knowledge and expertise to help ensure the sustainability of the WRES initiative across the healthcare system. At the end, participants have an in-depth understanding of the WRES, as well as the skills, knowledge, and expertise in race equality to work confidently with this complex agenda, within their own organisation and across their regional healthcare footprint. They will also develop their capability as system leaders and advocates for change. After a very successful first cohort of 42 participants, there is the second cohort of 42 underway.

As part of the NHS Long Term plan and to improve diversity in NHS leadership, the WRES team has published A model employer strategy to increase black and minority ethnic representation at senior levels across the NHS. For the first time in the NHS, this strategy sets out ambitious aspirational targets and plans for NHS organisations to reflect their BME workforce by 2028. This will ensure the NHS utilises the large reservoir of BME talent, whilst making the NHS a more attractive employer to people of diverse backgrounds.

The WRES team also works closely with No.10 and the Cabinet Office, in realising the prime minister’s commitment made in 2016 to collect and publish government data on disparities in treatment and outcomes in public services for all ethnic groups.

Supporting the Race Disparity Unit, the WRES team leads on the workforce strand for the NHS and healthcare to publish annual data, analyse any improvements and advise on any opportunities to improve. With the NHS leading the way in increasing workforce race equality, the WRES team has also supported and shared best practice across government departments and public sector organisations. For example, the Ministry of Defence, Ministry of Justice, The Department of Education, police forces through the Police Superintendents’ Association. Other government agencies have approached the WRES team for advice and expertise. 

Value:

Through joined-up working and evidencing outcomes, the WRES team has published several evidenced-based reports and guides to help organisations better understand and engage with their workforce. For example, guides to developing and growing effective staff networks, staff engagement, open forums and other channels of feedback and support.

Such initiatives and the financial benefits of higher staff morale, better patient experience and outcomes have been evidenced. For example, a report, ‘Links between NHS staff experience and patient satisfaction’ shows that an engaged workforce at an average trust increases patient satisfaction and an increase of staff engagement by 1% reduces sickness and absenteeism, resulting in an annual staff cost saving of £1.8million pounds.

To help further improvements, the WRES team has worked with the Institute of Health Improvement, an international think tank, to develop a unique NHS focussed quality improvement methodology, piloted by five NHS trusts across England. This brought together, best practices and ways of working from across the globe and international standards, tailored to meet the needs of the NHS.

There is a huge reservoir of untapped talent in the NHS. Valuing, developing, progressing and retaining the existing workforce would not only improve the care provided, but it will also reduce staff turnover, recruitment costs and will make the NHS an employer of choice. 

Involvement:

During 2014 /15, the WRES team carried out an extensive period of engagement with key stakeholders on the purpose and content and of the WRES. This included NHS staff and staff side across the country, think tanks and academics from the UK and across the globe. As part of the engagement with organisations, staff from all backgrounds are actively encouraged to complete the staff survey as a rich and well-informed survey provides a clearer and more accurate picture of workforce experience and opportunities.

As part of the evaluation of the impact of WRES, a frontline staff forum has been developed in the form of a focus group. It offers frontline staff from across the NHS, an opportunity to look at how the WRES programme is impacting on them and their experiences within the workplace, what improvements they have seen or felt, what more can be done and to provide a varied insight into the different cultures, approaches, and practices at trusts.

In addition to creating a space in which to give voice to their experiences as individuals, many group members have been able to establish or gain access to platforms from which they would otherwise not have, sending a powerful, positive message to other staff who feel marginalised, unseen and unheard. The WRES team also supports organisational leadership, by directly engaging and providing direct support to boards and executive teams across healthcare providers. Some engagements are requested, and others are identified by need, based on data and where further support is needed.

In the last 12 months alone, the WRES team has directly engaged with over 160 NHS trust boards, senior leaders and staff groups across the country. The WRES team also supports academics and universities, engaging with nursing and medical students on this critically important agenda even before they begin their careers in the NHS.

To set and agree on the strategic direction of the programme, the WRES programme is overseen by the strategic advisory group, which is made up of senior leaders from NHS trusts, ALBs, academics and social partnership forums (including unions). The members are passionate and demonstrate commitments to race equality, at local, regional and national level. As system leaders, they encourage and support their peers within organisations which appear not to be doing well on this agenda, through visible and demonstrable leadership on workforce race equality.