Making the difference: diversity and inclusion in the NHS - summary of King's Fund report

This report for NHS England used data from the 2014 NHS staff survey, including responses from 255,150 individuals across 284 organisations, to assess discrimination in relation to the variables used in the survey: discrimination overall; discrimination from patients, families and the public; discrimination  from managers, team leaders and colleagues; discrimination on the grounds of ethnicity, gender, religion, sexual orientation, disability and age.

Headline findings

• Staff who are demoralised or demotivated influence patients’ experience of care. If staff suffer discrimination because of their disability or ethnic, religious or sexual identity, it is highly likely patients who are members of these groups will have a similar experience.
• Reported levels of discrimination are highest in ambulance trusts, but discrimination on the basis of ethnicity is highest in acute and mental health/learning disability trusts.
• Reported overall discrimination is higher in London than elsewhere, from all sources.
• At the most senior levels of the NHS there are disproportionately fewer women and staff from black and other minority ethnic groups, which due to the high numbers of respondents to the staff survey, is not reflected in the results of this analysis.

Recommendations

• The whole system must take responsibility for solving discrimination. National policies can help tackle overt discrimination, and clear guidance on how to develop a climate of inclusion would be helpful.
• Research suggests that visible management support for positive diversity and inclusion policies and practices is important. These must be consistently reinforced by middle management and frontline supervisors.
• Areas where having effective diversity management policies and practices is vital include: recruitment; promotion; mentoring for under-represented groups; use of quotas; and appraisal and disciplinary procedures.