HIGH WRES DEFINITION AN EVENT REPORT, OCTOBER 2015
In October 2015 brap and Birmingham Cross City Clinical Commissioning Group held a joint event to discuss the Workforce Race Equality Standard (WRES). The event was attended by over 20 healthcare professionals, representing a range of trusts, clinical commissioning groups, and commissioning support units. This is a short summary of what was discussed. Promoting and embedding equality is not a new ideal. Unfortunately, the WRES has to join the queue along with a number of other initiatives which are all trying to promote fairness. But this doesn’t mean the WRES isn’t useful. Hopefully, hearing how other organisations are implementing the standard will give you some ideas about how it can be used in your workplace to deliver better outcomes for staff and patients.
1. IMPLEMENTING THE WRES: WHY, HOW, & WHAT NEXT? The event was opened by Roger Kline, Co-Director of the WRES for NHS England.
Roger reiterated how a lot of existing data shows the need for the WRES. For example: there has been a decrease nationally in Black and minority ethnic (BME) board members and nurse managers in recent years there aren’t any BME exec directors at Monitor, CQC, NHSTDA, NHS England, NHSLA, HEE White staff are 1.74 times more likely to be appointed once shortlisted than Black and minority ethnic (BME) staff Black nurses take 50% longer to be promoted and are less likely to access national training courses
Traditionally, workplace equality has been sought to ensure fairness for staff. As important as this is, there is evidence that inequality also impacts adversely on patient care. For example: inequality prevents patients getting the best out of staff diversity improves innovation and team work bullying and poor treatment of BME whistleblowers affects patient safety
This is important, as not all boards understand the business case is now driven by patient care.
Tackling inequality will require a change in the culture of most organisations. BME staff are too often reluctant to share concerns about their treatment, while NHS employers are reluctant to explore the root causes of the issue.
Roger pointed out that the WRES might be necessary to promote equality, but it is by no means sufficient. The WRES is only the start of a process – it helps identify if and where problems exist. It is not an end in itself.
Roger finished by asking attendees some key questions he hoped NHS organisations could help answer: What challenges did organisations have preparing their first baseline report? What priorities did trusts decide upon? What improvements would you like to the support the WRES team offers? How can we get value added through the local health economy collaborating?
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Participants then discussed some of the issues arising from the presentation, including: recruitment development and progression representative boards bullying and harassment The goal of each discussion was to identify best practice that could be shared with others. In particular, each group tried to answer three key questions: What, if anything, are you doing that is working well? Why is it working? What conditions are required for interventions in this field to work well? If there’s nothing working well, do you have any plans or do you see any opportunities for further work in this field in your organisation?
2. RECRUITMENT
Many organisations are facing issues appointing Black and minority ethnic staff. The issue is not necessarily about attracting applicants from BME communities: most organisations said their data showed the number of applications was proportional in this respect. Instead the issues are: a) proportionally fewer BME people are shortlisted and appointed; and b) BME workers within organisations tend not to apply for internal roles.
It is important to note this is not just an issue affecting BME people: similar issues affect women, young people, and the disabled.
Research looking at academics in America suggests that how you write job titles and job descriptions significantly affects who applies. This is because men tend to overrate their abilities and women tend to underrate them. As such it is important employers ask themselves some key questions: what is the job called? What really are the key competencies? And finally, where and how do we advertise it?
Another issue to consider is how the allocation of jobs is sometimes a stich up. People are all familiar with someone being asked to fill in for a colleague whilst she’s on maternity. Whilst it’s officially only temporary; on many occasions it ends up permanent. Or, to take another example, an individual is asked to act up because someone has left. Again, what’s meant to be temporary ends up permanent. All these informal processes make a big difference to who applies for positions because people can see when processes aren’t applied fairly. In addition, the people who generally aren’t asked to take on other roles start to lose confidence in their abilities and the whole system.
To combat this, we need to look at ‘those things that can be measured’. We need to consciously think about who we are sending on courses, who is being asking to act up and take on projects, and so on. The best trusts ensure they can’t hide because they monitor and publish data relating to everything.
Once things are measured, the next step is to ensure people are held to account. This isn’t about blame. In the best performing trusts, underperforming teams or individuals aren’t punished – but they do receive a visit or call from someone senior who talks through the data
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with them and offers advice on what to do or suggests other teams to talk to, etc. The key is for senior managers to communicate that – while they don’t expect things to change overnight – they do expect them to change.
3. DEVELOPMENT AND PROGRESSION
Ensuring staff have access to mandatory and good, relevant non-mandatory training is key to ensuring BME staff progress within organisations. However, many organisations have faced problems capturing data on this. A few organisations have given people access to their own electronic staff register (ESR) entry so they can keep their training records up to date themselves. Whilst this has tended to be successful, we need to recognize it won’t necessarily work in every organisation. In some places, it’ll be a challenge getting people to update regularly. But if boards and senior leaders show they're using the data, people will take it seriously.
Connected with this, participants felt it was important managers made themselves accessible on these issues. Staff should, for example, feel comfortable asking managers if they can attend 'informal' training (such as networking meetings or training not organized by big companies).
Part of the problem here is that managers often make decisions about this kind of training based on organisational culture – the way things tend to be done. More transparency around training requests would be helpful here.
Perhaps a response is to make the training request process more transparent. It would be really helpful if we could in some way capture the number of times training is refused (rather than just look at the training that is provided).
One trust has held a workshop on this – inviting all staff to come along, share their stories, talk about what the 'blockers' are, finding out what courses people have applied for. It was a conscious decision to make this open, as it provided a picture across the whole trust, which helped understand organisational culture and how some groups fared better or worse than others.
We need leadership from the top on this issue. The WRES is a good start. However, people interested in equality shouldn’t wait to take action in their organisations: bottom-up approaches can be more authentic, grounded, and responsive.
It is important to look at the sustainability of BME leadership. One participant relayed how, in her trust, BME staff were sent on leadership courses, but there was no follow-up afterwards. As such the individuals in question continued to languish. There is a business case to make here as well as a moral one: if trusts are going to invest in training it makes sense to ensure the conditions are there to allow the organisation to capitalise on their investment.
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4. REPRESENTATIVE BOARDS
This is a key area as it is one of the worst performing areas on the WRES.
Some fairly well established practice worth reiterating: commissioners should use contract management meetings to ask questions about equality issues and BME representation.
Commissioners should not shy away from asking about missing data – a common issue. They should also take a lead in following up about uncompleted WRES submissions.
A couple of trusts have recently undertaken development sessions with their boards on the WRES. They found it valuable to look at what their WRES data was telling them and have open conversations about this. One participant recalled his board were shocked by the data. Whilst initially they looked to the board BME champion for answers, they quickly realised inequality was a trust-wide, whole-system issue. In response (rather than undertake work with specific BME groups) the trust are trying to see how race equality fits in with their revamped values. In this respect, three key questions boards should ask themselves are: what is the data telling us? what do we want to look like? how does this fit with our existing values?
Following on from this, participants were clear boards can't just have one person championing equality, which is what happens at the moment. This is often due to a lack of confidence amongst other board members on this issue. They therefore need proper training so they are equipped to deal with these issues confidently. There was a feeling that creating a board equality competency framework would be a good idea.
If boards are going to become more representative, boards themselves will have to prioritise this and show they value it. Conducting an equality impact assessment of the board recruitment process is a good start.
5. BULLYING AND HARASSMENT
The single biggest barrier to people reporting bullying and harassment is that they don’t understand that grievance procedures require them to gather ‘evidence’ about the treatment they’re facing. Once they find this is the case the vast majority of people back off. As such, HR teams should do more to make people aware of how bullying and grievance processes work. Importantly, they should help people wanting to submit a grievance understand what sort of ‘evidence’ is required. People should also receive ongoing moral support while they go about doing this.
Connected with the above, there is a tendency to go straight to the formal processes. More emphasis should be placed on resolving issues informally. This is not only good for team morale, but it also recognises that a lot of what we call bullying can appear relatively minor (constantly talking over someone, for example, or pulling a face when someone makes a training request).
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Bullying often takes place because organisations have a bullying culture. As such, the first step to tackling it is to admit you have a problem. Changing the culture of an organisation takes time, and it is important to recognise this.
As ever, boards have an important role here in holding the organisation to account. They should be requesting data on bullying, broken down by protected characteristic, and asking questions if this data is not robust.
Having said this, it is important to remember data doesn’t tell the whole story. A lot of incidents go unreported and some people are unaware of what constitutes bullying and harassment. As such, organisations might find it useful to hold listening events, where staff get things off their chest and get some indication of whether their experience constitutes bullying.
Organisations need to conduct proper exit interviews: they are a valuable source of information. In many organisations, this does not happen or the data doesn’t go anywhere.
6. ATTENDEES Baljit Bahai, Birmingham CrossCity CCG Barbara Webster, Governing Body Birmingham CrossCity CCG Denise Bolger, Birmingham Community Healthcare Trust Emma Wilkins, Birmingham Community Healthcare Trust Iqofo Adetola, Birmingham Women’s NHS Trust Jaskiern Kaur, South Staffs Mental Health Trust Jay Kumar, Birmingham Community Healthcare Trust Jen Weigham, Birmingham CrossCity CCG Julie Steward, Heart of England NHS Foundation Trust Juliet Herbert, Wolverhampton CSU Naledi Kline, NHS England (Midlands and East) Paul Singh, Dudley and Walsall Mental Health Partnership NHS Trust Ramzan Mohammed, NHS Central Midlands CSU Ranjit Senghera, NHS England Roger Kline, NHS England Saba Rai, South West Birmingham CCG Satnaam Nandra, Birmingham Cross City CCG Simon Redwood, Royal Orthopaedic Hospital NHS Trust Sofia Jabeen, West Midlands Ambulance Service NHS Trust Yasser Mohamed, Black Country Partnership NHS Foundation Trust
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Š brap October 2015 brap is transforming the way we think and do equality. brap offers tailored, progressive and common sense approaches to equality and human rights training, research and community engagement issues.
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