Diversity, Inclusion, Leadership

Diversity Matters

Three and a half years after Roger Kline published the seminal ‘Snowy White Peaks’ report into the discrimination in governance and leadership in the NHS, Sir John Parker has published his Report into the Ethnic Diversity of UK Boards.  Both reports draw exactly the same conclusions which can be summarised into one sentence; the diversity of our most senior people in our country does not reflect our population, and we are the worse for it.

Diversity is a crucial part of an innovative and forward thinking organisational culture.  That is not just cultural, ethnic or gender diversity but also diversity of background, perspective and opinion.  As revealed by Chancellor in the Autumn Statement the UK economy has fallen out of the top 5 of world economies and so a move away from homogenous thinking on Boards, which can reduce the effectiveness of decision-making and as such stifle growth and innovation, is a key factor of in the commercial success UK organisations.

The Kline report’s opening statement was a stark warning to the NHS, “There is increasingly robust evidence that a diverse workforce in which all staff member’s contributions are valued is linked to good patient care.”  The report, which focussed on NHS Trusts in London, highlighted that in 2014 only 8% of Board members were from a black or minority ethnic (BME) background, which had reduced from 9.6% in 2006.  Similarly, the Parker Review found that in 2017 only 8% of FTSE 100 Directors are from a BME background and of those only 2% are UK citizens.  This is a shocking level of under-representation when 14% of the country are from a BME background.

So what is going wrong?

Looking at the latest NHS Workforce Race Equality Standard (WRES) results although there has been slight improvements in the recruitment of nurses and midwives, the NHS has not improved over the past three years with only 6.1% of non-clinical very senior managers being from a BME background.  The same report also shows that white candidates are 1.57 time more likely to be appointed from shortlisting and in some cases up to twice as likely. This suggests that panels are still recruiting in their own image and unconscious (or conscious) bias exists.  In a time when the NHS needs to attract the best talent to be at its most innovative and productive, it seems to be going in the wrong direction.  This will need to be quickly addressed if the NHS is going to realise the potential it has nesting inside its 1.2million strong workforce before it is too late.

The NHS staff survey shows every year that a high proportion of staff do not feel that there is equal opportunities to career progression and many staff cite this as reasons for leaving NHS organisations.   There is enough data telling us about the problem, what needs to be different is what we do about it?

What can we do to change?

If the NHS is to be serious about making a difference, it is time to take a radical and sustained approach to creating compassionate and inclusive cultures.  For this to make a difference notable change will need to be role modelled from the Board-level so as to ensure the right conditions are created throughout the whole organisation.

Taking an action-based approach that demonstrates commitment to improving this situation over a longer period of time will be the most visible and important thing that organisations can do.  Really paying attention to supporting the development of a pipeline of talent for individuals across the organisation from a range of diverse backgrounds that go further than race and gender so as to include social background, generational perspectives and different ways of thinking would be a step forward in creating the inclusive cultures that will foster talent across all levels of organisations.

The Parker Review makes three recommendations which can equally apply to the FTSE as well as the NHS:

  1. Increase the Ethnic Diversity of UK Boards – each FTSE 100 Board should have at least one director of colour by 2021; the same for each FTSE 250 by 2024
  2. Develop candidates for the pipeline and plan for succession – members of FTSE 100 and FTSE 250 should develop mechanisms to develop and promote people of colour within their organisations in order to ensure over time that there is a pipeline of Board capable candidates. This includes the recommendation of mentoring schemes and to grow internal talent through subsidiaries.
  3. Enhance transparency and disclosure – a description of the Board’s policy on diversity should be set out in the company’s annual report and should include description of company’s efforts to increase, amongst other things, ethnic diversity, particularly at Board level. Where the company does not meet the Board composition recommendations by the relevant date this should also be disclosed.

These sound easy but will take a change in attitude from current Boards and senior managers at the top of organisations, including the NHS.  Recognising that there are barriers to progression, seeking to understand these and take action to remove the things that get in the way will take a commitment and energy that previously has not been universally applied.

There are some examples of organisations, both public (including the NHS and Universities) and private sector, who have been at the forefront of striving to improve diversity published by The Royal Society as part of their campaign for developing diversity in science.  Within these case studies there are some great examples of mentoring schemes; flexible working approaches and development programmes that we could all learn from.

The NHS turns 70 next year at a time when it is going through its most difficult time, struggling to recruit and retain the staff needed to continue to deliver the high quality healthcare for our population.  The development of a compassionate and inclusive culture will be the single most important thing that NHS organisations can do to ensure that the NHS remains an employer of choice and continue for the next 70 years.

About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust, one of the largest integrated teaching hospital and community services trust in the NHS with 15,000 staff and £1.4bn turnover.

Sarah is passionate about creating a culture of compassion and inclusion in the NHS.

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Authentic Leadership, Diversity, Inclusion, Leadership, NHS Leadership

One conversation at a time – How to get more love into the workplace – part 7

We all dream of days at work that uplift, inspire and fill us with good feelings; however the reality is that they don’t come along as often as we would like. On 13th July, we had a day just like that, with 130 staff from all parts of our organisation, discussing how we create an organisation that is ‘fit to house the human spirit’. It created a positive energy and vibe that lasted throughout the day.

At Guy’s and St Thomas’ we have the highest staff engagement scores in the country, but we still have some dark spots. We’re focussing on shining a light on these key areas, one of which is improving staff feeling a sense of inclusion in the organisation. We have been running a series of Staff Engagement Inspiration Masterclasses, starting with Professor Michael West in May, and most recently we invited Eden Charles PhD to talk to staff about inclusion.

The amount of enthusiasm for the session was unprecedented. We had 100 places but were packed to the rafters with 130 staff wanting to take part. Eden delivered a key note speech and through the use of ZOUD – zone of uncomfortable debate – really got everyone to think about how we all have the ability to exclude others and to precipitate micro inequalities without even realising it. Leading on from Eden’s inspiring speech our Chief Nurse led a series of discussions both in thinking pairs and at a table level, to help participants to really engage with thinking about what they value about their own characteristics and how they might also lead them to accidentally exclude others both in the workplace and outside. This engendered a real energy and engagement of the participants really wanting to engage in thinking about how they could really start to understand others better.

In thinking about diversity overall, thought diversity emerged as a key topic; a conclusion of the Masterclass was that inclusion and understanding of others takes place “one conversation at a time.”

After only 2.5 hours of talking about inclusion, the atmosphere had changed and the energy carried out of the room with the participants. Some challenging points were raised such as ‘what will be different’ and the response is clear; “embracing diversity and being inclusive is everybody’s business”.

Having authentic conversations can often feel quite daunting; especially in the workplace. There are often cultural norms guiding what is considered appropriate and what is a taboo area, and if you are brave and do challenge the status quo it can often feel psychologically unsafe. This means that the culture prevails as people protect themselves by not challenging the norms, and those that feel differently will often leave as they do not feel comfortable or understood within the organisation. This leads to the unsafe practice of groupthink and can lead to poor decision-making and a stunting of the potential of an organisation to progress.

Moving to a place where diversity of thought is not only accepted but positively embraced is the way forward for the NHS and the wider public sector. We are living in a very uncertain and ambiguous time and therefore having a linear approach, based on the thinking that has always prevailed at the top of organisations, will not enable us to navigate the complexity of our new environment. We need a new way of thinking and being that will engender new, evolving conversations and inspire new approaches to enable us to re-invent our workplaces.

Back to the Masterclass; you could argue 130 staff out of our 15,000 is not many, however this is only the first step on the journey for us – a small step but an important one nonetheless. We want to start a completely different conversation in the organisation that encourages diversity and enables our leaders to create enabling environments that supports all our staff to bring their best to work every day. This will help us to continue to deliver high quality healthcare to the in excess of 2 million patients who access our services every year. We will do this one conversation at a time.

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Left to right: Sarah Morgan, Director of Organisational Development; Eden Charles PhD, People Opportunities Ltd; Yadveer Kaur, Staff Engagement Manager; Amanda Pritchard, Chief Executive; Dame Eileen Sills, Chief Nurse at Guy’s and St Thomas’ NHS Trust at the Inclusion Staff Engagement Masterclass held on 13 July 2016

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 Participants of the GSTT Inclusion Staff Engagement Masterclass 13 July 2016

 About the author

Sarah Morgan is the Director of Organisational Development for Guy’s and St Thomas’ NHS Foundation Trust and passionate about changing the world of work

 

 

 

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