Tanya Carter, chief people officer at East London NHS Foundation Trust (ELFT), shared both her personal journey and actions being taken by ELFT as part of the race equality agenda. Tanya shared that the trust has one of the most diverse boards in the NHS and their conversations on race equality are impactful due to the questions they ask, the challenge they give, and their ability to apply the lens of race and EDI to everything.

Tanya also emphasised the importance of creating safe spaces to talk about lived experience and that leaders should listen to understand lived experience, not to question it. A key learning included the importance of having uncomfortable conversations with others about race.

Following the murder of George Floyd, ELFT took their time to identify and develop tangible actions for race equality and their anti-racism statement. Actions included:

• Partnering with FLAIR, specialists in EDI analytics to assess race in their workplace, to evaluate the whole organisations biases, behaviour, awareness and barriers to race equality
• The creation of a dashboard to benchmark these behaviours and awareness of race in the organisation
• The use of the continuum from the Institute of Health Improvement to support the work of becoming an anti-racist, multicultural institution. The continuum helps hold the board accountable on where it sits with anti-racism
• Board development work, with a particular focus on microaggressions.

Eniola Oladipo, head of equality and inclusion support and transformation at NHSE, discussed the importance of recognising the impact of racial inequality, and the need to act and provide appropriate support.

Eniola sign posted upcoming work from NHSE that will enable leaders to support, including:

• The NHS EDI improvement plan
• A repository of support offers for board leaders, staff networks, EDI leads, HR/OD professionals and board level sponsors
• A dashboard to underpin accountability for the EDI plan, with actions for leaders to take forward.

Cath Byford, deputy CEO and chief people officer at Norfolk and Suffolk NHS Foundation Trust, reflected on their organisational challenges relating to culture and racism. Cath named the deep-seated issues they needed to tackle and the approach taken by the board thus far in addressing these. 

The actions taken included:

• Exposing the gaps in the actions, informed by the data
• Shining a light on a range of issues, including the acceptance of racial abuse in the organisation and inequality within recruitment processes. The board also started taking ownership of cultural issues by naming the racism faced in the organisation in public board meetings
• Recognising their capabilities as a board whilst also having humility, accepting the lessons that need to be learnt, and where they require support
• Enlisting the support of Roger Kline, research fellow at Middlesex University Business school, to lead board development sessions on the race equality agenda
• Transforming induction programme, with a focus on encouraging accountability and honesty from day one
• Creating a cultural improvement programme as part of which they have recruited two new roles to bring expertise: a director of culture and a director of people 
• Commissioning an external guardian service to create a safe-space for people to speak up.

Cath expressed the need for commitment, conversations and openness about anti-racism to enable change.

Paul Devlin, chair at Nottinghamshire Healthcare NHS Foundation Trust, shared his own journey of being a white ally, what it means to him and why it matters. He discussed how the recent context of race inequalities – such as the murder of George Floyd, the disproportionate impact of the pandemic, the latest WRES report and the Michelle Cox case – make it important to name racism, talk about race and for boards to ask “what does this mean for us?”.

In his approach to being an ally, Paul listed the following:

• Own this work and take responsibility
• Recognise and use power
• Proactively build knowledge
• Work alongside staff networks
• Remember patient focus – patients can experience racism and also be racist to staff/others.

Paul also shared some key questions to ask, to help others take action:

• Why does this matter to me?
• Where is my power and how will I use it?
• What are my knowledge gaps and how will I fill them?
• What do I know (e.g., from data and the staff survey) that I have yet to learn and act on?