The recent 2021 Workforce Race Equality Standard (WRES) painted a complex picture of racial discrimation in the NHS. While there has been progress in representation, it is clear that urgent action needs to be taken at a cultural level to tackle inequities and build inclusive workplaces. 

The last two years have been the most difficult in NHS history. Amid reports of rising waitlists and labour shortages, post-pandemic recovery is a top priority amongst healthcare leaders. Creating a stronger healthcare system is dependent on placing inclusion and diversity at the heart of the organisation to tackle staff shortages and improve employee wellbeing. 

Not only will this help to overcome the critical challenges faced in recruitment, retention and planning, it is also essential to improving clinical outcomes and patient care. 

But driving real progress requires a change of approach. Racial equity cannot be solely treated as an emotional issue, but one that is addressed and reported on like other organisational issues, backed with data and hard numbers. 

The WRES report is an important first piece of the puzzle, but now more needs to be done to map the culture of NHS organisations. Data must be utilised to dive deeper and understand the racial awareness, racist behaviours and inclusion barriers amongst its workforce.

So, what are the tangible steps leaders can take to build racially equitable cultures and how can they ensure they are driving positive results? 

Steps for creating racially equitable cultures in healthcare

The cumulative impact of racial discrimation over time can be debilitating, eroding confidence and creating lasting self doubt within individuals. It can lead to staff under-performing, and can mean people leave the organisation forever, which has a knock on effect on patient care. Fortunately, across all organisations in the UK there is a growing realisation of the importance of racial equity - 79% of business leaders say it is a top priority for their business. 

In healthcare, implementing actions to create inclusive cultures is fundamental for both attracting and retaining talent. As a first step, a simple and transparent reporting process needs to be put in place. According to the WRES report, 16.7% of BME staff had experienced discrimination from a manager, team leader or other colleagues - the highest level since 2015 (14%). Without a clear system in place to report these incidents, employees will feel less empowered to flag issues when they arise. Equally, management will be unaware of what the issues are and how to overcome them. 

Secondly, building a support system for staff who have experienced racism is key. It is important to remember that many racist incidents will go unreported, so creating a safe space for ethnically marginalised groups within the workforce is crucial. Trusts need to establish appropriate counselling services, set up channels on workplace platforms that are safe spaces to talk about race, and consider ways the whole organisation can play an active role. Educating staff should be a top priority. The responsibility for handling racist behaviour should not fall on the shoulders of those being subjected to it. 

Thirdly, getting policies right is imperative when defining and delivering a more inclusive culture. Good policies offer clear direction and guidelines for everyone in the organisation and will help to set realistic and consistent standards to advance racial equity. 

Drive results in healthcare with data-backed action 

Interventions are only as successful as the data underpinning them. In other words, we cannot make the right decisions if we do not understand the root cause of the problem or effectively measure the solutions put in place to solve them.

The WRES report is a great starting point. But individual trusts need to delve deeper to get a clear picture of what their culture looks like from a racial equity standpoint. Importantly, data needs to look beyond representation figures. Racial diversity is just one piece of the puzzle; to retain staff and improve their productivity and wellbeing, more focus must be placed on improving the lived experiences of the employees working for the NHS to drive meaningful change.

This is all dependent on deploying the right tools and metrics. Many trusts are starting to utilise technology available to hone in on the lived experiences of their employees. For instance, trusts such as Pennine Care NHS Foundation Trust and The Tavistock and Portman NHS Foundation Trust are already measuring more advanced analytics, such as racist behaviours, levels of racial awareness and inclusion barriers.

With these in place, they can implement targeted solutions to create racially equitable cultures, while at the same time effectively report on the progress of their live interventions. 

Where strong words have failed, hard numbers will succeed

NHS staff have been our lifeline throughout the pandemic and we know their heroic efforts have really taken their toll, particularly on ethnically marginalised staff.

Data-backed action rather than warm words are the only way to prevent the racial discrimination highlighted by the WRES report remaining static or worse still decline. As a result, it is BME staff who will continue to bear the brunt of inaction.

It is evident that strong words have not moved the dial enough to create long-lasting, systemic change. We need a different approach, one driven by hard numbers to improve accountability and transparency to pave the way forward for racial equity. 

Byline written by Nii Cleland, CEO and Co-Founder of FLAIR