The NHS would not be able to deliver its services without the ethnic minority staff who work within it. The advantages of a diverse workforce are well evidenced with inclusive and diverse organisations being eight times more likely to achieve better business outcomes. Workforce diversity is essential for the delivery of high-quality care to all patients, many of whom are also from diverse backgrounds.

The 'disciplinary gap' is highlighted in the NHS Workforce Race Equality Standard (WRES) data. This is the relative likelihood of ethnic minority staff entering the formal disciplinary process compared with white staff (WRES metric three).

Despite annual measurement and reporting on this metric since 2015, the disciplinary gap in the NHS persists, with ethnic minority staff being disproportionately likely to enter formal disciplinary processes compared to their white counterparts. In 2022, ethnic minority staff were reported to be 1.14 times more likely, (where 1.0 is equally as likely, and anything above 1 shows inequality) to enter the formal disciplinary process compared to white staff, unchanged from 2021. This inequity, although it has narrowed since 2015, remains a critical concern. Multiple factors contribute to the disciplinary gap, including bias, lack of cultural awareness among managers, disparities in the application of HR processes, wider challenges around organisational culture and systemic patterns of discrimination.

The disciplinary gap has significant implications, including negative effects on staff wellbeing, loss of talented staff, and the potential negative impact on patient care and satisfaction, alongside the legal and financial consequences and damage to the NHS's reputation.

Reducing the racial disciplinary gap is an essential part of developing an anti-racist and inclusive NHS which supports all staff to thrive and provide the best possible patient care.

This guide aims to support board members to have an increased awareness and understanding of the existing disparity and provides practical advice and examples of how the gap can be reduced. It outlines:

  • The data on disciplinaries and the impact of the current inequity in the treatment of white and ethnic minority staff.
  • The legal framework and learning from recent cases.
  • The practical implementation of strategies outlined in A fair experience for all for minimising and closing the gap based on case studies from four trusts.
  • The role of leadership in addressing the issues.

While the Equality Act 2010 provides protections against race-based discrimination, imposing a duty on public sector organisations including NHS trusts to eliminate discrimination and advance equality, board leadership is pivotal in addressing the disciplinary gap.

The case studies within the guide share practical interventions implemented by trust leaders that have narrowed the gap and improved the workplace experience for staff. Each case study also contains top tips from trust leaders for action and impact. Though there are a range of strategies that have proved effective, there are a number of common themes which have enabled improvement:

  • Strong board and leadership commitment to race equality is crucial in driving change.
  • Developing a restorative, just and learning culture that views mistakes as opportunities for growth, minimises the negative impacts and empowers staff to learn from them is foundational.
  • Providing anti-racism training, cultural awareness programmes, and leadership development is essential to changing attitudes and behaviours.
  • Regularly monitoring and analysing data, especially by ethnicity, helps identify disparities and measure progress.
  • Seeking sources of external support and learning, including from trusts that have made progress in this area, can provide practical advice on what drives greatest impact.
  • Transparent communication about race equality, even when conversations are 'uncomfortable', is key to progress.

Achieving equity in the NHS workforce's disciplinary processes requires a comprehensive and sustained effort involving leadership commitment, training, data analysis, and fostering an inclusive culture. Implementing strategies which support organisations on their journey towards closing the disciplinary gap not only improves the experience of ethnic minority staff but improves both workplace experience and the likelihood of entering the formal disciplinary process for all staff.

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