Introduction
Berkshire Healthcare NHS Foundation Trust (Berkshire Healthcare) is a community, learning disability, and mental health trust providing a wide range of services to people from across 60 sites and in their homes. The trust employs approximately 5,000 staff, of which 30% are from an ethnic minority.
As a relatively new area of reporting, with a minimal ability to benchmark across trusts, Berkshire Healthcare's initial experiences with Ethnicity Pay Gap (EPG) reporting are likely to resonate with many NHS organisations. However, Berkshire Healthcare took a proactive approach to the EPG, and now in its second year of reporting, is able to benchmark internally against data from the previous year and also introduced intersectional reporting in 2024.
The trust reported a moderate rise in its median EPG from 3.59% to 3.92% between 2023 and 2024 (Berkshire Healthcare NHS Foundation Trust, 2024a), meaning their white staff earn £0.71 more than those from an ethnic minority. The mean pay gap for white staff was -£0.70 (-3.36%) less than those from an ethnic minority when reported collectively. However, disaggregation of the data highlights that white staff's mean hourly pay is £0.41 more than that of black staff. Like many trusts across the country, ethnic minority representation at Berkshire Healthcare decreases as you proceed to higher pay quartiles. The trust still finds itself well placed to redress this challenge, and its anti-racism action plan aims to address this imbalance.
Interventions
The trust has implemented several interventions that will contribute to the reduction of the ethnicity pay gap by tackling systemic inequalities within processes:
- Disaggregation of the data to enable granularity in analysis and identification of wider intersectional patterns.
- A flagship Unity Against Racism programme that prioritises the need to take an 'active role in identifying and addressing all types and impacts of racism', including the career journey and outcomes for ethnic minority staff.
- An anti-racism taskforce and workstream created to drive racial equity, with a responsibility on executive leads and taskforce members for reporting on the progress of associated initiatives, for example a recruitment reflective checklist, and creating pathways to raise concerns.
- Developing talent management systems, that incorporate both formal and informal mechanisms to support the development and progression of staff. This includes in depth reviews of recruitment, and development and training practices to support competency-based progression, with pathways visible for ethnic minority staff.
- Maximising the use of the Workforce Race Equality Standard (WRES) data findings to inform interventions taken. This has resulted in anti-racism workshops co-created by trust leaders and the trust's staff Race Equality Network.
- Increased messaging on anti-racism and tackling inequalities via a range of internal communication channels, including newsletters, executive videos, virtual notice boards, intranet, spotlight articles, emails from senior leadership or briefing packs for managers. This has been part of an 'underpinning education and engagement' workstream, and both the content and engagement method have been refined based on impact.
- Encouraging self-declaration of ethnicity by the workforce within the electronic staff record (ESR), the national staff survey and internal data sets to better inform interventions.
Impact
A distinctive thread that runs through Berkshire Healthcare's approach is how they have incorporated EPG data and analysis into their wider approach to creating an enabling culture; one that encourages staff to feel empowered to contribute to the organisation's success. This has allowed leaders and managers to see the EPG for their business area as a part of local workforce dashboards, and support equality impact assessments for any change activity.
Based on Berkshire Healthcare's approach there are five areas that trusts can focus on to improve their EPG reporting, and make a greater impact:
Start somewhere and own where you are
The unmistakable enthusiasm in wanting to address the EPG has been evident in the fact that Berkshire Healthcare is in its second year of reporting. The trust emphasised the need to start somewhere and recognised that initial data and findings will not be where you would like to be. However, they recognise a need to be honest about this position and stress that it does at least provide a starting point for action. This culture of transparency has provided a springboard for concrete actions, with respective workstreams that are led by executives. For example, a guaranteed interview scheme for roles at Agenda for Change pay band 8b and over for ethnic minority candidates who meet the essential criteria.
The ability to disaggregate data, and dive deeper, has helped Berkshire Healthcare group action and identify synergies with its wider work on equality, diversity and inclusion (EDI). This is the first year the trust has applied an intersectional lens to pay gap reporting, helping to identify where there is a double disadvantage. For example, where gender intersects with race, the trust identified that white males have a £4.25 pay gap advantage compared to black female staff.
Berkshire Healthcare have used dashboards that can filter by demographics across existing staff, leavers, teams and departments.
The granular detail within the trust's EDI dashboard has permitted localised 'people action planning' at team and directorate level. All teams are required to set team objectives on anti-racism and use the dashboards to evidence and discuss priorities, such as a talent pipeline for allied health professionals. It can also support broader interventions such as using disaggregated leavers data to support retention efforts, and understanding of employee relations incidents, including those of discrimination, bullying and harassment in the workplace.
Make [the data] relevant at the ground level...and [show] what this means for workforce colleagues.
Head of inclusion and organisation experience
Accountability and robust follow through
Berkshire Healthcare's Unity Against Racism programme (a programme of activity centred upon addressing inequalities in access, experience and outcomes in health services) is intentionally led by white allies on the board, the chair, the chief executive and the deputy chief executive - in recognition of the double burden that this would place on ethnic minority staff and leaders (who are often expected to/ left with leading on EDI and race equality work). Anecdotal feedback from the trust's ethnic minority staff is that this proactive leadership and commitment to anti-racism has supported staff to better engage with the Unity Against Racism workstreams. The trust also identified through their engagement that they had previously omitted to close the feedback loop on occasion. How the trust shares and communicates the actions being taken and progress made to their staff and communities is now more actively considered and planned for.
All executives at Berkshire Healthcare lead on one of five workstreams as part of the organisation's wider anti-racism strategy, helping ensure robust and clear leadership and accountability structures are in place. One of these workstreams has a focus on recruitment, retention, employment conditions and progression. The group has used the WRES, ethnicity, disability and gender pay gap, Workforce Disability Equality Standard (WDES) and NHS staff survey metrics to inform policies targeted at improving the outcomes and experience of ethnic minority staff.
Take full advantage of a receptive board
A result of the board's commitment to developing both their personal and professional understanding of race equality and anti-racism, has been the development of a more inclusive and compassionate culture at Berkshire Healthcare. However, as part of this they had to lead with humility and challenge themselves to have the sometimes 'uncomfortable' conversations. This has facilitated both stronger interest in and calls for richer, more intersectional data; as well as increased curiosity to explore the causes of pay gaps and other areas of disparity. As a result, action planning is better informed and with a commitment to delivery invested in by the board.
The trust was awarded the Race Equality Matters (REM) Silver Trailblazer Status in July 2024. This provided the board with a sense of validation that their interventions and ongoing commitment to anti-racism was judged by an external panel to be having a tangible impact for their staff.
Use EPGs as a catalyst to bolster recruitment, retention and talent management pipelines
Identifying EPGs can serve as a catalyst for supporting ethnic minority staff. Berkshire Healthcare has used its engagement with workforce staff and specifically the voice of ethnic minority staff, to inform the support offer to improve employee experience and career development opportunities. For example, they have implemented initiatives that embed talent or 'ready to progress' coaching conversations as part of mid-term appraisals to support retention and progression for all staff. The trust has seen an improvement in ethnic minority staff reporting that "the trust provides equal opportunities for career progression or promotion" in the NHS staff survey. This has improved from 45.7% of ethnically diverse staff believing this to 53.3% in 2023/24.
Placing EPG in its wider context including the WRES
Berkshire Healthcare's early insights into addressing their EPG highlight the advantages of taking a holistic approach, as part of the wider race equality agenda. As a systemic issue that is inherently multifaceted, addressing the EPG requires long-term approaches and support for ethnic minority staff.
Consequently, an immediate return on investment (if seen through the lens of EPG alone) is unlikely across a year of reporting, but rather will be demonstrated through multiple years in improved employee experience and retention of ethnic minority staff. Berkshire Healthcare has made use of its performance against the WRES metrics (in which the trust has shown improvements in seven out of the nine indicators) to build a more complete picture for concerted action. However, the trust emphasised the importance broader qualitative work has played in improving lived experience of staff. For the trust, a focus on metrics alone would not have achieved this.
To truly be a 'great place to work', we have to be outstanding for everyone.
Deputy chief executive
Learnings for the board
- The role of the board in leading this work cannot be underestimated as this is a key enabler for the wider leadership team and staff to lean into work on race equality, with a sense of urgency. However, it requires work from the board leaders themselves, both collective and individual, to build their confidence and competence on the topic of race.
- Treat this as a change programme. Start with the data, both quantitative and qualitative, to understand what lies behind the disparity rather than the outcomes. Be prepared to ask why, have uncomfortable conversations, and explore the systemic barriers that may be present.
- Consistently ask how your data speaks to staff and then follow through with engagement that can provide a fuller picture. In other words, bring your quantitative and qualitative findings to life.
- Don't forget the positive role external accreditation can have on building momentum, credibility and reassurance, internally and externally for a trust, as demonstrated by Berkshire Healthcare's accreditation by Race Equality Matters.
[It is] not just a case of being a safe space but being a central space to discuss race equality issues.
Deputy chief executive