Case study: Yorkshire Ambulance Service NHS Trust

• Beginning work towards fostering a restorative, just and learning culture (RJLC) within the trust by supporting staff in key roles such as the head of people services, to participate in RJLC training, and to disseminate their learning across the trust.  
• Reviewing disciplinary and grievance policies and processes. This included the introduction of a 'gateway' process which takes place following the commissioning of an investigation, and again prior to a case being taken through to a formal hearing. It involves an independent member of HR, the commissioning manager and supporting HR representative. Within the process, the following are considered: 
  
  - Does the individual going through the disciplinary process pass a substitution test - the likelihood someone else in the same situation would behave in the same way given the circumstances? 
  
  - Were there any points of failure, for example an assumption that all new staff will be familiar with over 60 policies by the end of their probation period, or were they working within an operational context that made it difficult to adhere to the rules? 
  
  - Has the incident or any subsequent action taken to the gateway point been influenced by bias or discriminatory behaviours? 
  
  - Have all informal routes for resolution and learning been considered and exhausted before progression to the next stage of the process is considered?  
  
  

• Reskilling of managers via an internal 'compassionate leadership training' programme across the trust. This work is being led by the learning and organisational development (OD) team. 
• Delivering bespoke support (via the EDI and OD teams) for individual teams at the trust, where the leadership team have identified a need for support, based on intelligence from Freedom to Speak Up (FTSU). 

Ambulance trusts experience unique challenges in terms of cultural cohesion and staff wellbeing due to the nature of the work that they do. The sector has one of the highest percentages nationally for ethnic minority staff experiencing discrimination at work from other staff in the last 12 months.

YAS is implementing RJLC as a key approach to improving its culture and addressing some of these challenges within the organisation.

YAS began its journey to implement a RJLC in November 2019, with a proposal to support an initial cohort of staff to receive RJLC training. The RJLC programme is delivered by Mersey Care NHS Foundation Trust in partnership with Northumberland University. The board recognised the need to move to a more compassionate, person-centred decision-making culture, and has championed this work by actively supporting the interventions recommended by the head of people services and supporting decisions made in this model when challenged.

On completion, these trained staff members led engagement on the benefits of a RJLC culture across the workforce with a particular focus on the senior and operational leadership teams. The trust is taking a phased approach in applying a RJLC across trust-wide processes with the revised disciplinary, grievance, managing absences and dignity, civility and respect at work processes being implemented in 2023.

In 2023, despite the increased likelihood of ethnic minority staff entering the formal disciplinary process in comparison to their white colleagues, the trust noted that all disciplinary cases for ethnic minority staff had a case to answer, and therefore formal disciplinary had been an appropriate route of action. Overall, the gateway process has resulted in fewer cases being taken through the formal disciplinary process and reaching an outcome of 'no case to answer'.

The gateway process and ongoing engagement combined with the reduction in cases has led to greater understanding of the benefits of applying a RJLC lens. Feedback from line managers suggests issues are now being resolved through more informal routes and related dialogue has been more person-centred. Both staff and managers have reported greater assurance that learning has been applied and will be acted upon.

The trust has seen an increase in the number of incidents being reported to the FTSU guardian and recognise that this could indicate staff feeling safer to raise concerns. The trust has recently appointed a second FTSU guardian in recognition of the increased reporting and to demonstrate their commitment to acting on staff concerns.

Some of the greatest challenges have been around having the capacity to implement solutions and the low number of staff who are trained in RJLC. A wider rollout of training is anticipated to foster increased buy in from trade union partners and managers, as well as provide increased capacity to support case management, provision of advice and guidance, and the ongoing application of RJLC principles to wider HR processes.

The trust recognises the importance of engaging managers in adopting the gateway process. There was an initial challenge from managers, who perceived this work as an erosion of their decision-making autonomy and judgement on their capability. Similarly, some trade union partners felt the decision-making should remain with managers and free of 'HR intervention'. Increased understanding of how a RJLC supports staff and managers to navigate the disciplinary and grievance process, and identify organisational learning, has improved confidence in the revised processes.

Whilst progress has been made through improved processes and the adoption of a more person-centred approach, in their most recent WRES data submission (June 2023), metric three continued to increase, with ethnic minority staff being 2.4 times more likely than white staff to go through a formal disciplinary process. This equates to six cases overall, all of which were found to have a case to answer. The trust is undertaking further work to understand these cases and to maintain an iterative approach to reviewing relevant processes.

The board recognises that cultural change is everybody's business and needs to be led from the top and with the engagement of diverse staff groups. As such, the interim chief executive officer engages with the trust's networks by regularly meeting with staff network chairs, actively participating in network events and supporting an increase of protected time for networks.

There is increased messaging from senior leaders on the importance of a diverse workforce and inclusive culture across the trust. This, coupled with a greater focus on longer term WRES interventions, is key to making sustainable improvements to the experience of all staff and addressing specific disparities in the experiences of ethnic minority staff. Whilst impact may take longer to become measurable, there are often earlier, more cultural benefits to be had, including increased buy in and engagement from staff.