Mersey Care NHS Foundation Trust (MCFT) have been enabling conversations about race and racism to empower their internationally educated workforce (IEW). By addressing bullying, harassment, and workplace incivility, MCFT aim to challenge poor behaviours and achieve their perfect care goal.
MCFT provides physical and mental health services in the North West and are commissioned for services covering North Wales and the Midlands. MCFT employ over 11,000 staff and 2,000 bank workers, with a combined ethnic diversity of 8.1%. This workforce serves a population of over 1.4 million across 170 sites.
MCFT have been developing a restorative just and learning culture (RJC) within their organisation over the last seven years. RJC provides a framework of fairer systems and processes within the organisation, creating an environment where all staff feel supported and empowered to learn when things do not go as expected, rather than feeling blamed. In the case of an adverse event, this culture prompts one to ask what was responsible, not who is responsible.
MCFT has been focussing on how to apply an equality, diversity and inclusion (EDI) lens to RJC processes. They launched their anti-racism strategy in July 2022 as part of achieving their 'perfect care goal' and not accepting discrimination of any kind.
MCFT have several interventions to support their IEW as part of their RJC. Some examples are:
- Working with partners across Cheshire and Merseyside to support new international workers. MCFT works within a collaboration of trusts (CIRC) which in turn collaborates with several agencies and test centres to ensure the IEW recruitment project runs smoothly. This ensures international recruits arriving into the country have adequate plans in place in relation to flights, accommodation, objective structured clinical examinations (OSCE) exam preparation and booking of OSCE exams.
- Holding regular meetings where feedback is shared so the CIRC can ensure the provision of support to a high and uniform standard across the trusts.
- Recruiting a practice education facilitator, to support international workers.
- Introducing all IEW staff into their ethnic minority staff network.
- Developing clear and consistent messaging over the last 12 months about their commitment and desire to work with their ethnic minority staff, to embed accountability, and listen to all staff groups to achieve their perfect care goal.
The interventions to support the IEW are at an early stage and are continuously under review. MCFT use the induction process to discuss the impact of racism and encourage their IEW to speak up and raise concerns via existing routes, including the freedom to speak up guardian. MCFT reports that there has been support provided to the individual teams hosting the IEW and that no incidents of bullying and harassment have been reported. Where learning is identified, this has been reflected upon and built into support measures for the next cohort of the IEW. The trust recognises retention and progression amongst their IEW as early measures of success in the implementation of their anti-racism strategy.
MCFT was awarded the NHS Pastoral Care Quality Award in July 2023.
Image supplied by Mersey Care NHS Foundation Trust.
Hear from the trust
The Race Equality programme spoke to Amanda Oates, executive director of workforce, and Joe O'Grady, head of equality, diversity and inclusion, at MCFT about implementation of these interventions, the challenges faced, their impact, learning for the board, and advice for board members looking to support their IEW.
It's far better…if you don’t break something you don’t need to restore it…
Executive director of workforce, MCFT
The importance of senior commitment and support to fully embed anti-racism within RJC is paramount to the board. Education is also key and must underpin all work done at board level and MCFT.
There is recognition that the journey towards improvement is not solely reliant on leaders, and that everyone at MCFT must create a better learning environment. As a result, RJC learnings are shared regularly and extensively across the trust, with specific sessions for their IEW.
MCFT acknowledged that improvement for IEW experience is an ongoing process, where leaders need to address challenges and use open communication to ensure continuous learning and success.
- Acknowledge the experience of the IEW within the organisation and increase awareness of the challenges they face. MCFT holds monthly internationally educated workers engagement meetings, where members are encouraged to share their experiences within the organisation and the wider community. The staff are also encouraged to raise any concerns/ challenges they may have experienced. These are subsequently shared with the wider workforce such as ward managers, the organisational effectiveness team, the cultural awareness team, and preceptorship team to be addressed and hopefully resolved.
- Hold cultural awareness training for staff working with the IEW. The trust is in the process of sending all ward managers and staff involved with the IEW on cultural awareness training. This training will provide an insight into the many challenges the IEW may face and equips staff with the skills and knowledge to be able to manage these challenges.
- Foster open honest communication with the IEW to understand their experience, engaging them through surveys and direct communication.
- Take proactive evidence-based actions to address the specific needs of the IEW, based on insight and acknowledging their unique perspectives and backgrounds.
- Learn from the experiences of previous cohorts and apply those learnings to new cohorts to ensure continuous improvement. The trust regularly conducts evaluations of the IEW experiences and applies the feedback from these evaluations to improve the experiences of subsequent cohorts. An example is the action taken in response to feedback obtained from the IEW induction programme, where initial cohorts wanted more information in relation to flexible working arrangements and pensions. MCFT have since included these topics in subsequent induction programmes.