Access to good quality employment is central to ensuring good population health. However Office for National Statistics data shows a considerable employment gap of 28.1% across the UK between disabled and non-disabled people, particularly for those living with severe learning disabilities, autism or mental illness. The impact of this inequality is exacerbated by today's difficult economic climate – Torsten Bell of the Resolution Foundation recently highlighted how disabled households are disproportionately struggling financially as a result of the increased cost of living. As the country's largest healthcare provider and employer, the NHS is uniquely positioned to play a central and pioneering role in tackling inequalities both for disabled patients and its disabled staff.
The power of leadership diversity
Access to accurate and granular data is a vital initial step in tackling inequalities. Within the NHS, this is provided both locally and nationally by the Workforce Disability Equality Standard (WDES), introduced and mandated as part of the NHS standard contract in 2019. Some WDES metrics are reported as part of the NHS staff survey results – released this year in March – but last week's third national WDES report gives us a fuller understanding of performance against all ten indicators.
It is encouraging to see a continued increase in the percentage of the NHS workforce disclosing a disability to their employer (3.7%) in the past year and to see an increase in the number of board members who have done the same (also 3.7%). Diverse leadership is, after all, a central pillar in fostering an inclusive culture at work. In this regard, it is positive to see the total number of disabled staff on boards almost double over the past two years.
However, the latest NHS staff survey results also show that over 23% of staff identify as having a disability or long-term illness – much closer to the percentage of the population who report having a disability, which stands at 22% economy-wide according to Department of Work and Pensions. This considerable difference shows there is still much work to be done to ensure NHS staff feel safe and comfortable to identify as disabled within their organisations and, furthermore, that they feel empowered to do so. Trusts with no senior staff who have declared a disability - only 5.5% of organisations - see much higher rates of 'unknown' disability disclosure (43%) compared to a national rate of 21.3%, further demonstrating the importance of diversity in senior leadership.
We are pleased to see this reflected as a priority area in the WDES recommendations with a target of at least 4% disclosure by 2022. There is though, room to be more ambitious in seeking to quickly reach the stated longer-term goal of 20%.
Using data to break down barriers
Accurate and contemporaneous data is only the first step in understanding the gap between the experience of disabled and non-disabled staff, but it is a crucial one – and one that the NHS is committed to through the mandatory introduction of WDES. The government is currently analysing consultation responses on disability workforce reporting for larger private sector employers as part of the National Disability Strategy and the NHS has helpful experience to share in this regard.
But trust leaders including HR directors are clear that there is still much work to be done, a message replicated in responses to the most recent NHS staff survey data and across WDES recommendations.
It is crucial that initiatives to narrow and eradicate disparities in employment and experience are co-produced with disabled staff to fully understand true barriers to equality. It is also important that figures are not viewed in isolation, and that we explore and seek to better understand the impacts of intersectionality. Staff with multiple or specific protected characteristics will experience variation in their day-to-day experience at work and there is not one approach to resolve and tackle these complex and varied barriers. It is particularly welcome to see more granular data included in this year's staff survey results, which should aid trusts in understanding where specific targeted support is required.
The NHS offers a helpful and evolving national example of disability data collection and reporting which also allows systems and provider collaboratives to share good practice and learn from each other. This year’s WDES report shows that mental health trusts perform particularly well on disability declaration, for example. The data shows that steps forward have been made, but it also highlights that an important, and considerable, journey of improvement lies ahead. At NHS Providers, we look forward to supporting our members to share these examples of good practice and learning, as one important means to ensure the NHS is a great place to work for all, now and in the future.
This blog was first published by HSJ.