1. Encourage accountability 

  • Identify what you are trying to achieve and how you are holding yourself and the organisation to account.
  • You are accountable to the population you serve, and the workforce you lead, so seek assurance from them on whether you’re making meaningful progress.
  • It is one thing to say you’ve got a “zero tolerance” approach but if there are no consequences then there is no point.
  • Embed EDI into an accountability framework.

2. Education on race

  • Make race education a priority to ensure people understand the external and internal context.
  • Encourage people to join the dots on their own (self learning). 
  • Give people the literature and then challenge them.
  • Tell people the session starts with the literature, so they know they must read it. 

3. Foster safe spaces

  • Create space for honest conversations.
  • Ensure conversations are confidential.
  • Find skilled facilitators. Shouldn’t always be the HR director.
  • Consider external coaching, particularly for chairs, to build confidence and capability to lead on race.

4. Focus on personal values and behaviours

  • White leaders taking the lead on this agenda is essential. 
  • Be fully committed to EDI as you cannot drive change without the support of the board.
  • Recognise leadership is fundamentally about prioritisation. 
  • Listen to people's lived experience. Understand what it feels like to be excluded. 
  • Get people to express their vulnerabilities. 
  • Be humble and admit that you don't know everything and hold biases. Recognise and acknowledge where you haven't done well. 
  • Personally believe in it and role model it.
  • Behaviours and actions speak volumes to colleagues from diverse communities. 

5. Challenge discrimination as a priority 

  • Call out and challenge things that are discriminatory.
  • Listen to the experiences of minority communities and the micro-aggressions that aren't called out. 
  • Support staff to stand up to unacceptable behaviour from patients - yellow carding demonstrations that abuse won't be tolerated. 


6. Create a culture of challenging yourselves 

  • Where the board is not cohesive, this is a positive thing - only by understanding the core views of board members can you start to have more challenging conversations. 
  • Draw on external support so you have someone who can look objectively and challenge your thinking. 

7. Close engagement with staff and community networks

  • Staff networks are like a social movement - they can speak truth to power inside the NHS. A crucial way of checking what is going on. 
  • Networks give people a place to share. This is best done in specific groups i.e not all minority ethnic people experience prejudice in the same way.
  • Buddy executive champions with your staff networks to help foster trust between staff and the board. 
  • Co-design programmes with board members and the minority ethnic network. 
  • Reverse mentoring - it can be a powerful with white colleagues. 
  • Don't just talk to staff about their live experience, talk to your communities about how they experience your services. Put them in the driving seat in how to tackle inequity. 
  • Link into community groups through their trusted voices and run community-based workshops.
  • Do more as an anchor institution to offer employment opportunities to the most deprives communities. 

8. Improve HR processes

  • Look at all HR processes, recruitment and retention - embed equality, diversity and inclusion (EDI). 
  • Comply or explain accountability.
  • Be proactive - we introduced an associate NED post on our board as a development post offered only to candidates from ethnic minority background. 
  • Clear policies and position on allyship, intersectionality, promoting psychological safety within the organisation. 
  • Positive action especially in recruitment.
  • Criteria used for recruitment searches are as open as possible to encourage diverse applicants.
  • Ethnic minority representative on all band 7 and above interviews.

9. Better use and understanding of data 

  • It is not about what you say, it is about what is found when research is done on the organisation. 
  • Be an evidence-based organisation which is held to account by hard data. But recognise data alone will not drive change. 
  • Address and make links between data and personal experiences.
  • Implement systems to cut all data by different characteristics.
  • Cut waiting list data by ethnicity and deprivation - do more work to discover why ethnic minorities are waiting longer.
  • Look at the staff survey - recognise that one person's informal performance management conversation is another person's bullying conversation. 

10. Link with health inequalities interventions 

  • Make tackling health inequalities a central part of any organisational strategy - the golden thread. 
  • Put health inequalities into the annual planning cycle. 
  • Provide support for the board on understanding health inequalities across the system - how to prioritise and address. 


Trust leaders describe initiatives that didn't work for them: