Race Equality roundtable: NHS England's equality, diversity and inclusion improvement plan
Race Equality roundtable event, held on 4 April 2024.
This interactive online roundtable event included:
- A plenary session from Barking Havering and Redbridge University Hospitals NHS Trust (BHRUT) and how they have tackled high impact action (HIA) six of NHS England's equality, diversity and inclusion (EDI) improvement plan through initiatives such as their 'No abuse, no excuse' campaign and their 'managers licence' programme.
- Facilitated delegate discussions to share and discuss interventions they have implemented against HIA6 and what objectives delegates have taken to meet HIA1 of the EDI improvement plan.
- A space to learn from others and build a network of peers working on race equality.
Find the presentation slides here.
Presentation on HIA6 by Janine La Rosa - chief people officer, BHRUT
BHRUT presented on their recently launched 'No abuse, no excuse' campaign, aimed at tackling violence and aggression against staff. This initiative has been staff-led, and posters are highly visible across the trust's multiple sites. The organisation has introduced a system of yellow cards (two written warnings) and red cards (time-limited ban on access to non-emergency care), as well as 60 body cameras, which are available to non-security staff and can act as a de-escalation technique. The yellow and red card system will be assessed after an initial pilot to see what changes may be required to the policy, and to analyse data and any emerging trends.
BHRUT also spoke about their managers licence programme, designed to ensure a base skillset for all members of staff taking on line management responsibilities. The programme is delivered in four stages, including a 'starting and leading well at BHRUT' module that is part of their induction, followed by foundation, intermediate and advanced levels. The programme has been developed with senior leaders and subject matter experts.
Breakout discussion key themes
Delegates were invited to join breakout groups to discuss HIA6 and HIA1. Key themes from these discussions are highlighted below:
- Attendees noted that violence and aggression has been a greater concern post-pandemic, and discussed the challenges of implementing a zero tolerance approach – particularly in emergency services – and how staff can be supported to ensure incidents are accurately recorded and reported to the police (where appropriate).
- Attendees discussed the use of hard hitting messages to make clear that these behaviours are 'not okay'. They also mentioned the need to help board members understand these experiences and their impact, particularly if they are not something they have experienced themselves.
- There was discussion of red and yellow card policies, and their effectiveness – it is key to ensure relationships are built between staff, patients and the wider local community.
- Attendees also spoke about patient vulnerability – particularly patients who have experienced homelessness, are care leavers or have experience of the criminal justice system. This does not absolve these behaviours, but attendees recognise there is a need to co-design interventions to reduce the number of incidents occurring in the first place.
- The inclusion of questions on sexual safety and unwanted sexual behaviour in the 2023 NHS Staff Survey have provided a stronger evidence base on these incidents and behaviours and allow for greater targeted action. Many attendees also noted the importance of the recently launched Sexual Safety Charter.
- Some attendees spoke about how their organisation has delivered active bystander training to equip staff with the skills needed to support colleagues who have experienced violence, aggression and/or abuse.
- Participants discussed the challenges of delivering EDI strategies in the current political and cultural environment. There was discussion of how a focus on race and ethnicity has sometimes led to feedback that other minoritised groups feel under-presented. There is clear evidence of poorer outcomes for ethnic minority staff and patients
- There is a need for targeted, data-driven and evidence based interventions, but the risk of working in silos must also be avoided.
- Attendees spoke of challenges specific to the ambulance sector, which often sees staff reporting worse experiences compared to other trust types across a number of metrics. The Association of Ambulance Chief Executives' (AACE) 'Work without fear' campaign was referenced as a helpful intervention.
- Attendees shared that the main challenge is ensuring board objectives are SMART (Specific, Measurable, Achievable, Relevant and Time-based) and have impact.
- Organisations have introduced a range of board objectives in support of HIA1 – some have adopted corporate objectives, others professional, and some personal. It will be important to assess the impact of these objectives over time.
- Some attendees reported that their organisations have shared their board's EDI objectives with all staff, while others who had not, noted there is a need for greater transparency with the wider staff body and not just among those who work closely with the board and are linked to EDI work.
- Many reported their organisations have executive and non-executive sponsors for staff network groups, and that anecdotally some networks have reported feeling better heard by the board since these relationships were introduced. However, other organisations noted that sponsorship of a staff network should not be the extent of a board member's EDI objective as part of HIA1 – if it is, the objective needs to explain what sponsorship achieves.
- One attendee shared that while they are held to account by their integrated care board, they are concerned this is not robust enough and they would like to see more from NHSE to ensure they are held to account on the plan's HIAs.
To access the full notes from the session, including learnings from insight calls with 'early adopters' of EDI improvement plan and NHS case studies, click the button below.
Read our EDI improvement plan briefing
Chair: Jenny Reindorp - co-director of development and engagement, NHS Providers
Speaker: Janine La Rosa - chief people officer, BHRUT