"I joined the NHS for a fulfilling career and ended up doing a routine job.” I often hear such striking comments when visiting NHS organisations across the country. But while we are humbled by the task to transform such experiences, we are also firm in the belief that together we can and must, make lasting difference on the staff experience agenda. Why? Because one of the main factors believed to effect patient satisfaction and safety is the experience of staff working in the NHS.
I first came across the evidence showing the links between staff experience and patient satisfaction in 2009 when the seminal report by Jeremy Dawson informed the development of the Equality Delivery System. We asked Jeremy and Professor Michael West to repeat that analysis last year; they found that relationship to be as strong today as it was ten years ago – that’s with even more source data and even more sophisticated data analyses techniques.
But while the researchers were not explicitly looking out for the diversity angle, they found it. They showed that the extent to which an organisation values its black and minority ethnic (BME) staff is a good barometer of how well patients are likely to feel cared for. Indeed, if we are cared for, then we are more likely to care for others.
Research shows that the extent to which an organisation values its black and minority ethnic (BME) staff is a good barometer of how well patients are likely to feel cared forPolicy lead, WRES Implementation Team
We know all too well that the key elements necessary for cultures of inclusion are not just associated with staff happiness and patient outcomes, but also with organisational efficiency. Diversity and inclusion, therefore, need to be viewed as a strategic priority by the NHS – and that is why we have embedded this agenda within the NHS long term plan and the heart of the Interim NHS People Plan.
Although the NHS draws on a remarkably rich diversity of people to provide care and safety to our patients, we often see discrimination against BME staff in particular. Such inequalities need to be addressed, not just by words but by deeds. And that is why the WRES programme and associated interventions – including the report outlining the implementation of the WRES within a Quality Improvement approach, are critical for NHS organisations.
This is a significant problem. Even at the best of times, neglecting an evidence-based, cost-effective means to improve patient outcomes appears foolish. At the time of increasing staff shortages and pay restraint, it comes close to negligent.
Ensuring staff have equal opportunities is critical
Ensuring that staff have equal opportunities to flourish and be supported to rise to leadership positions in organisations is critical. Today, in 2019, we have just eight BME chief executives in over 200 NHS trusts in the country; and while this is a much better picture than before the WRES programme commenced, it is not good enough and, as outlined in the WRES Model Employer strategy, we have more work to do.
So why don’t we have more BME people in senior positions across the workforce pipeline? There are possibly two elements to the answer: (i) the barriers imposed by the way in which our systems and structures are designed, and (ii) the barriers we have in our own minds.
But at the same time, we know that workplace race inequality is not self-correcting. The solution is not to give time to resolve itself. We must face these challenges head on – but unless these challenges are shared, the failure to meet them will impact on everyone. Indeed, action on this agenda is not something that any of us should leave to those who so routinely experience injustice: we all have a role to play to narrow the gap between the promise of our ideals and the reality of our time – to turn the dream into reality.
Our approach to workplace inclusion promotes effective and authentic interventions that do not just place ‘race’ at the centre – they do not erase our unique identities. They centralise compassionate leadership – and when compassionate leadership is fully centralised, every door opens, and experiences are made better for all staff and patients alike.
Dr Habib is the policy lead for the NHS Workforce Race Equality Standard (WRES) at NHS England, and is leading on the national strategy for this programme. Further information about this work can be found here.
Habib will be speaking about happiness at work at the NHS Providers Quality Conference on 4 June.