Anti-racism at NHS Providers

NHS Providers has committed to becoming an anti-racist organisation. This has been a dedicated area of focus for us since the summer of 2020, following the murder of George Floyd, and the renewed sense of injustice that followed, combined with the racial disparities exposed by the Covid-19 pandemic. These events put race equality on the agenda of NHS boards in a way it has never been before. They prompted us to reflect on how racism affects us as an organisation, our staff and our members, and to consider what improvement we need to make and how we can better lead by example.

We began an internal programme of work on anti-racism, commissioning an internal report to understand how our culture and systems operate with regards to race equality. This formed the basis for open, honest and challenging discussions at all levels of the organisation, which in turn led to the production of a race equality action plan.

Being actively anti-racist in all that we do means we acknowledge the impacts of racism in our own organisation, in the NHS and in the world in which our members operate, and are conscious in how institutions can perpetuate structural racism. It means we will never tolerate racism where we see it, and we will challenge and proactively change policies, behaviours and beliefs that perpetuate racist ideas and actions.

We do this wherever we can – internally, in our work supporting our members, in how we work with other organisations, and in our external communications. We benefit as an organisation and our work improves if we create an open culture in which we celebrate diverse perspectives in everything we do.

This is a top priority and long-term commitment for NHS Providers. We continue to be tenacious in our work on it. We recognise that we have been late in taking decisive action on race equality: we have not done enough to support staff who have experienced racism at work and beyond, and who have suffered the effects of structural racism. We apologise for this, and are committed to making the improvements we need to as an organisation, and as individuals. We are a work in progress: we will reflect, we will learn, and we will take action so that we improve. We are committed to doing better and are ready to be held to account for our progress.

Why are we doing this?

We believe NHS Providers must actively tackle racism. This is important for our team, for our member trusts and because of the impact we can have on wider society.

For our team: we must create an environment where every member of staff feels safe and valued, and can thrive. It is the right thing to do. We benefit as an organisation because welcoming everyone's contributions, perspectives and experiences will give us richer understanding and insight. Becoming an organisation which everyone feels fully part of helps colleagues give their best and makes us more effective and happier in our work.

For trusts: we see the impact racism has on patients and trust staff. We recognise that trusts need to do more to tackle racism, just as we do. As their membership organisation, we should reflect the issues they are dealing with, and lead by example where we can. We encourage our members to make progress on race equality. 

For wider society: our organisation exists to support the NHS, a huge and diverse employer which has contact with everyone in our society. We represent the NHS in the media and in our engagement with government and other partners. We know that there are wide disparities in health outcomes and life expectancy between different ethnic groups, and there is strong evidence of their differential access to and experience of services. We therefore have a responsibility to use our profile and influence to make a difference to the world we live in.

Our anti-racism statement

This is what we mean when we say we are an anti-racist organisation. This sits alongside our organisational values and action plan for improvement on race equality. It is not static. This is our statement to members, staff, and the wider community of our commitment to becoming actively anti-racist. Each and every member of staff shares this commitment and takes personal responsibility for it.

Our five commitments

1. We recognise that structural racism exists and is harmful

Race inequality is a blight on our society. The effects of racism can be seen across society, in the NHS and also at NHS Providers.

At the moment, NHS Providers reflects the inequalities seen across the NHS workforce, trusts, and wider society in too many ways. Our senior leadership team does not reflect the diversity within either our organisation or wider society. It is incumbent upon white people in leadership positions at NHS Providers to be effective allies: to understand how they have benefited from structural racism, to own the problem and to use the advantages, opportunities and resources they hold to tackle it.

As we seek to improve the experience of our staff, we recognise some will suffer discrimination on several fronts, including race, socioeconomic status, and other characteristics protected under the Equality Act. In our work we acknowledge the relationship between race and our wider commitment to equality and inclusion across the full range of factors that shape people's life chances and lived experience.

2. We acknowledge the impact of racism and support ethnic minority staff

Every member of staff at NHS Providers is committed to supporting ethnic minority staff to ensure the burden of tackling racism does not fall on those who already experience its injustices.

We know from staff feedback that people have not always spoken up because they did not feel supported. This has compounded the hurt and distress felt by our colleagues who have experienced racism.

Guided by our staff and our race equality and cultural inclusion group (RECI), we nurture a culture that gives people the time and space to speak up about their experiences confident that they will be listened to and supported. We seek to ensure people feel safe in talking openly about racism and race inequality. All colleagues at NHS Providers, whatever their ethnicity stand shoulder to shoulder on this: improving our culture is the responsibility of everyone in NHS Providers.

3. We act to redress racism and call out discrimination

We seek out, identify, and redress racism and strive for equality, and justice, and embed this thinking in all our processes, policies, outputs, and interactions.

This means actively drawing attention to and calling out discrimination where we find it within NHS Providers and tackling it, and explaining why remarks or actions are harmful. It means listening with commitment to learning and change when someone speaks up about their experience of racism. Where someone shares their experience we focus on their needs, and recognise where we hold power and can act to bring improvements. And, it means examining our recruitment processes and our approach to progression within the organisation and involves making sure our events and publications live up to the standards of diversity we are aiming for.

Our race equality and cultural inclusion group (RECI) has an important role in highlighting issues to the organisation as a whole, and advising and challenging our leadership. Equally, our leaders have a responsibility to listen and act on issues when they are raised.

We do this from a position of humility and in the spirit of supporting one another, understanding that as an organisation and as individuals none of us are perfect, we all want to get this right, and we all have much to learn.

4. We are transparent and accountable, and we measure our progress

We are open and honest about our progress on race equality, and we set measurable goals against which our progress can be judged.

Our goals are based on staff and board feedback and include qualitative and quantitative measures. Our action plan sets out in detail how we will deliver on our commitment.

Our board of trustees is responsible for ensuring NHS Providers is an anti-racist organisation. It holds the executive management team to account for delivery on the action plan and commits to embedding anti-racism into its own structures, processes and decision-making.

The director team also works to embed race equality into its decision-making, processes and structures and holds the organisation to account for implementation of the action plan. We continue to measure and monitor progress via our annual staff survey, which began collecting anonymised data on race equality in 2021, along with regular consultations and conversations carried out through the year, including via RECI.

We welcome scrutiny, feedback and challenge from staff and from our members.

We keep this statement under review alongside quarterly reviews of our action plan, for the remainder of our four-year strategy period.

5. We use our unique position to influence the NHS and the wider community

NHS Providers has an opportunity and a responsibility to make a positive difference on race equality in the NHS and beyond.

As the membership organisation for NHS trusts and foundation trusts, we are uniquely placed to support NHS leaders to make progress on race equality. Through our race equality programme and our action plan, we help boards take action against structural racism within their own organisations and address gaps and challenges in their working cultures that impact on staff, patients and the communities they serve. We embed race equality throughout all our networks and events, induction programmes and member communications, and aspire to lead by example.

We can and do advocate for race equality through our influencing work, which puts us in regular contact with the most senior leaders in government and in the wider health and care sector. We use our position to influence national health policy from an anti-racist standpoint – this includes offering constructive challenges when necessary. And, through our public communications, we highlight race inequality and challenge racism where we see it.

*as per the Gov.uk style guide we use 'ethnic minority' to refer to all ethnic groups except the white British group

Anti-racism action plan

Introduction

In 2022 NHS Providers made a public commitment to become an actively anti-racist organisation. We are striving to create an organisational culture where all our people feel safe, valued and can achieve their potential. We are also seeking to lead by example to support our members to make progress on race equality, and to use our profile and influence to make a difference in wider society.

Our anti-racism statement explains why we have embarked on this journey. It sets out the detail behind our five specific commitments to:

• Recognise that structural and systemic racism exists and is harmful, in particular to staff and patient outcomes.
• Acknowledge and understand the impact of racism and support ethnic minority staff who experience it.
• Act to redress racism and call out discrimination.
• Be transparent and accountable, and measure our progress and the impact we are having.
• Use our unique position to influence the NHS and the wider community at every opportunity.

Our anti-racism statement is underpinned by a cross-organisational race equality action plan, setting out the specific actions we are taking to translate our commitments into reality for each of our four strategic objectives – influence, voice, support and excellent organisation. All of this, together with our organisational values which include a commitment to inclusion, seeks to ensure that race equality is fully embedded in everything we do.

Holding ourselves to account

With feedback and challenge from staff, including our internal Racial Equality and Cultural Inclusion Group (RECI), the senior management team carry out a six-monthly review of our action plan commitments. We triangulate our review against information from our annual staff survey and ask specific questions in the annual member and stakeholder surveys on our progress towards becoming an anti-racist organisation. We report to a dedicated board sub-committee on race equality for detailed oversight and to the full board for discussion and approval.

Our latest report sets out our overall progress and a number of successes we have achieved against our initial 2023/24 race action plan priorities, as well as our challenges and learning.

Influence – We have incorporated a race equality focus into our influencing work across a range of policy areas including health inequalities, workforce, manager regulation and the Covid-19 inquiry. We want to do this in a more coordinated and impactful way in the year ahead.

Voice – We have made progress in taking a more proactive approach to ensure our outputs and media messaging reflect our anti-racist ambitions. The NHS Communicate conference and awards and the State of NHS Communications report focused on the theme of diversity with the report offering a benchmark of diversity in the profession and a clear set of recommendations which we are now taking forward.

Support – Alongside the launch and development of our dedicated member support programme on race equality, we have strengthened how we embed diversity as a thread through our wider support offer. We are starting to collect richer data and feedback from speakers and delegates to help us identify opportunities to bring a race lens to our existing programme content. Our data suggests we have diverse speakers and panelists at our conferences, larger events and webinars.

Excellent organisation – We have made progress in some key areas, including the roll out of inclusive leadership training to all line managers, work on our HR system to improve our data and the continued flourishing of our internal staff network, RECI.

Whilst we are keen to celebrate our successes, we want to acknowledge the challenges we have encountered, and areas where progress has been slow. Our first action plan was ambitious with a significant number of actions. On reflection, it has been important for us to streamline our priorities for 2024/25 so we can make more focused progress with the organisational resources we have. Across key areas, particularly our influencing work, measuring and understanding the impact of our actions has been harder to evidence.

Across all our strategic aims, we recognise the need to build in more capacity and headroom to ensure we maintain momentum. The report acknowledges that we need more accountability within teams for progressing actions.

We also need to keep under review the way teams and the organisation discuss and report on progress against our race action plan commitments, particularly how we create safer spaces and minimise the potential double burden on staff with lived experience.

Our race action plan for 2024/25 was drawn up with input from staff from across the organisation, including RECI, and reflects these learnings from our first year of work.

Our priorities for 2024/25

Influence

Voice

Support

Excellent organisation