Inclusion and diversity in the NHS: let’s be bigger and bolder

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This week marks NHS Employers’ Equality, Diversity and Human Rights Week. In the past year, the NHS has started to make progress in this area, particularly in terms of raising awareness – a crucial first step. However, measuring diversity and setting quotas are not ends in themselves; they are part of the progression towards inclusive, successful organisations and cultures of high-quality care.

There is increasing evidence that a diverse, inclusive workforce can bring economic and strategic advantages. McKinsey’s Diversity matters report makes the case that diversity is business-critical and no longer about piecemeal policies, one-off interventions and well-intentioned recruitment drives. Diverse companies, it says, are ‘better able to win top talent, improve their customer experience, improve employee satisfaction and decision-making, leading to a virtuous cycle on increasing returns'.

The report finds a statistically significant relationship between more diverse leadership and better financial performance – ethnically diverse companies are 35 per cent more likely (and gender-diverse companies 15 per cent more likely) to outperform less diverse companies. It goes on to argue that diversity beyond gender and ethnicity/race (such as diversity in age and sexual orientation) as well as diversity of experience (for instance, cultural or regarding mindsets) are likely to bring competitive advantage for organisations.

McKinsey, together with Google and PwC, has been modelling a new approach to inclusion, shifting the focus to a more sophisticated and compelling debate around the business case for inclusion in an increasingly competitive and global world, and to the potential to drive radical changes in social mobility. PwC, one of the biggest graduate employers in the United Kingdom, for example, is seeking to broaden opportunities in relation to social class, announcing that it is rejecting A-level results as part of its graduate selection process, arguing the qualifications are biased against those from poorer backgrounds. The company has recognised that ‘talent and potential presents itself in different ways and at different stages in people's lives’. It aims to create ‘a fairer system in which students are selected on their own merit, irrespective of their background or where they are from’.

I think it’s fair to say the NHS is lagging behind other sectors – not only in embracing the diversity agenda in its widest sense but also in realising the significant benefits of a more diverse, inclusive workforce.

There is evidence (research by Michael West et al published in 2012) that treatment of black and minority ethnic (BME) staff in the NHS is directly linked to patient outcomes, but this seems not to have made the NHS stand up and listen let alone take action yet.

The NHS is still talking about difference, when other sectors have moved on to focusing on the broader advantages of approaching diversity from a strategic perspective. Diversity is critical to organisational success and not an add-on, an HR policy or a leadership development programme designed for a minority group.

Given the scale of financial challenge currently facing the NHS, it is difficult to understand why the economic case for diversity is not being embraced. The NHS tends to see the end-point as being a percentage of black and minority ethnic staff or the number of women on the board. This is important and deserves a focused effort – however, the journey does not end there. That is in fact the beginning. We need to think bigger and beyond having more women, black people or under 30s on boards as goals in themselves. We need to start recognising the business case and that this is absolutely fundamental to the performance of any organisation.

Piecemeal initiatives aren’t enough – there is no point tinkering around the edges if we want to achieve real impact. Let's make this issue a visible priority all year round – not just for one week.

What we are looking for here is sustainability – cultural and economic. Sustainability requires strategy. As the evidence base for the economic advantage of diversity grows, the NHS ignores it at its peril.



part time midwife,
princess alexandra nhs
Comment date
05 May 2016
would like to receive updates, dates of midwifery study days/ courses organised by the Kings Fund

Susan Saunders

OD Consultant-Coach,
HR SASco Ltd
Comment date
16 May 2015
'Talent and potential presents itself in different ways and at different stages in people's lives’ rings so true! Leaders need to be able to recognise, harness and nurture this by prioritising a culture of cpd and by offering a variety of leadership development opportunities within their organisations. This can be enhanced via visible encouragement, access to coaching/coaching conversations and accessible support within the workplace.

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