As set out in the NHS standard contract (NHS England, 2018), implementing the Workforce Race Equality Standard (WRES) is a requirement for all NHS healthcare providers. The WRES was first introduced in 2015, with the aim of identifying and helping to close the workplace inequality gap between black and minority ethnic (BME) and white staff working in the NHS. The WRES was seen as key to supporting the improvements required for developing better practice environments, and creating workplaces where staff feel valued and enabled to deliver high-quality care. There are many opportunities for nurse leaders to deliver the necessary improvements.
A package of measures in the NHS Long Term Plan (NHS England and NHS Improvement, 2018) to improve race equality in the health service includes a £1 million annual investment until at least 2025, along with a team of 42 experts from within the existing NHS England workforce. The latest WRES data report highlights the experiences of BME staff in the NHS.
An analysis of the data against nine indicators (NHS Equality and Diversity Council, 2019) shows that, although there has been a year-on-year improvement in BME representation in the most senior NHS roles (including at board level), and an increase in recruitment from BME backgrounds, the health service needs progress in a number of areas. One of these is against indicator three, which looks at the relative likelihood of BME staff entering the formal disciplinary process compared with white staff. The key findings in the data report were that:
Over-represented
Bennett et al (2016) highlighted research across the UK showing that NHS staff from BME backgrounds often experience inequality, discrimination and prejudice in the workplace. Indeed, they are over-represented in the national data outlining the number of grievances, investigations and disciplinary hearings that involve NHS staff.
At a local level in my previous role, I became aware that RCN West Midlands had identified just such an over-representation of BME staff. Focus groups conducted by RCN West Midlands in response to these concerns showed that BME staff believed that they were not adequately supported during formal processes. In response, RCN West Midlands developed the cultural ambassadors programme.
This scheme trains BME staff volunteers (band 7 or above) to observe the formal disciplinary process and highlight any concerns around unconscious bias or potential cultural differences. The hope is that this approach will increase trust in the process, help ensure that BME staff have a fairer experience of the disciplinary process and increase understanding across the organisation. This should contribute to a reduction in the relative likelihood of BME staff entering the disciplinary process.
Potential
Bennett et al (2016: 58) presented a detailed evaluation of the cultural ambassador programme, which concluded that, although there were areas for improvement, it ‘has the potential to have a lasting and beneficial impact on the cultural competence of the participating organisations’.
Four trusts were involved in the pilot programmes and one of the four projects (based in a mental health trust) was nominated in a national award. Paul Vaughan, the then director of the RCN in the West Midlands, commented:
‘As a result of the project, the trust has reported a reduction in the number of disciplinary investigations against BME staff, with fewer sanctions imposed.
‘Avoiding unnecessary and sometimes protracted disciplinary proceedings also saves money which can be spent on patient care instead.
‘The trust also reported an increase in requests from trade unions and staff for a cultural ambassador to be assigned to disciplinary panels, indicating that BME staff members have more confidence in the process when a cultural ambassador is present.’
The success of these roles, and the learning from the pilots, offers a valuable opportunity to consider the potential of the cultural ambassador role. It is possible that frontline cultural ambassadors could offer support beyond employee relations cases, potentially in a number of workforce activities, such as recruitment and retention.