Foreword

Foreword

Following the murder of George Floyd and amplification of inequalities by COVID-19, race equality is now on the agenda of NHS boards in a way it has never been before.

A real opportunity has presented itself but at the same time so has the urgency of the challenge. Despite successive initiatives in the NHS, the data still paints a stark and depressing picture of the ongoing racial injustice faced by staff as well as patients and service users.

This report provides an honest playback of member views on where their organisations are in the journey towards racial equality. Drawing on interviews with chairs, chief executives and non-executives and a survey across our membership, it provides a snapshot of where NHS boards feel they have made most and least progress, and what both NHS Providers and the national bodies can do to accelerate the pace of change. While there will be different views on these self-assessments, trust leaders recognise the scale of the task ahead: only 4% of our survey respondents judged race equality to be fully embedded as a core part of their board’s business.

Board members we spoke to recognised that race equality can no longer be the preserve of directors of workforce and equality, diversity and inclusion leads. It requires strong leadership by the whole board and a much greater sense of urgency, with all board members equally accountable for progress. This means boards taking very deliberate action to address some of the challenges highlighted in this report, to show that tackling race inequality is central to their organisations' core aims.

This report also highlights what trust leaders have told us about what works. That this is about being proactive: in engaging all staff, but particularly getting closer to the lived experience of ethnic minority staff and service users, being courageous about having difficult conversations and ensuring all colleagues know leaders are genuinely hearing their concerns and ideas for change. It is also about creating space for meaningful discussions to be had and ideas to be shared within organisations and across the NHS. Although the evidence base is not as strong as it should be, there is still more scope to learn from what is really making a difference.

Structural racism is an issue which, by definition, affects every sector of society, and NHS Providers of course is no exception. We recognise how important it is for us to also face up to and address how racial inequality shows up within our own organisation. We began a process of internal reflection last year with a starting point that we are not where we should be, particularly in the very low levels of ethnic minority staff represented at senior levels of the NHS Providers team. By commissioning expert advice and embarking on an internal review, we are approaching a position of much greater strength to embed a focus on race equality work within our support to members, and in our core policy and influencing work on trusts' behalf.

Our ambition is to get to a place where we are genuinely leading by example as an actively anti-racist organisation, and to effectively support trusts to do the same. We now know that making the business case for action is not enough. And we know that more data gathering is not a sufficient catalyst. It’s increasingly clear that it’s about a much more profound hearts and minds challenge: for us all to take personal ownership, to really interrogate our assumptions and behaviours, and to demonstrate that this time it’s deeds not words that will make this a time of real change.