I was recently asked to chair a round-table event for the Health Service Journal on ethnic diversity and equality in health care leadership.
Out of interest I researched the origin of the term ‘round-table’ and discovered that it came from a speech made by HRH Prince Edward, Prince of Wales, to the British Industries Fair in 1927. He urged ‘young business and professional men… to get together round the table and adopt methods that have proved sound in the past, adapt them to changing needs and wherever possible, improve them’. Setting aside the gender focus of the original use, I would like to reflect on issues that were discussed at this particular round-table event in 2016 – namely what leaders in the NHS can adopt, adapt and improve to enable black and minority ethnic (BME) staff to achieve their potential as leaders.
Participants began by sharing their personal emotional response to the topic, an important recognition of the often painful experiences of being treated differently based on ethnicity. An exploration of the existing barriers to progression for black and minority ethnic staff touched on both unconscious bias and conscious bias; there was a recognition that failure to tackle this was in itself a barrier and that talking about the conscious bias that exists in the system is a significant step towards addressing inequality.
One of the known, visible aspects of conscious bias is in the processes and practices used to recruit, develop and retain talent. Recruitment in particular has been spoken about widely by Roger Kline, who most recently pointed out the lack of ethnic minority specialists operating in the executive search agencies who work with the NHS.
There is a lot to learn from the huge progress made at the United Nations on tackling gender inequality. Through setting cultural expectations and mandating the use of a system-wide action plan, the UN were able to bring about a change to global culture. Male shortlists are a thing of the past, and Secretary-General Ban Ki-Moon’s personal commitment to gender equality led to the appointment of 150 women to Assistant Secretary-General or Under-Secretary-General roles over nine years – and to nearly a quarter of UN missions being headed by women, compared to none when he took office.
We explored the issue of intersectionality – the theory of how different types of discrimination interact – raising a discussion about how practical action could be taken to increase BME representation at senior levels of the system. One simple and effective example was given from an acute health provider where the leadership team has invested in development workshops and masterclasses designed by BME leaders; decisions about what should be offered were made in a series of conversations held over a period of one month, often over lunch. Opportunities were offered in a number of areas such as interview practice, help with communication skills and coaching conversations. The short events were attended by staff from all parts of the organisation and at all levels. Repeated over a three-month cycle, these interventions combined to create a culture in which BME leaders had improved confidence and felt valued; an impact assessment is currently under way but anecdotally the organisation reports a threefold increase in applicants for internal vacancies at supervisory and middle management level. Increasing the talent pool in this way will potentially lead to this group being developed and supported to apply for roles at the higher levels. The crucial ingredient was senior leaders acting to promote the development and talent of BME staff in their workforce.
Black and minority ethnic staff make up a disproportionately large part of both the workforce and the patient population of today’s NHS, compared with their proportion in senior leadership roles. We accept a number of factors in modern motivation theory as being critical to the wellbeing and confidence of all people yet five of these factors (possibility of growth, opportunity to do something meaningful, a high level of responsibility, sense of importance to the organisation, recognition for achievements) are consistently being ignored in relation to our BME workforce. Achieving the recent requirements set out in the NHS Workforce Race Equality Standard may force compliance, but as the round-table conversation demonstrated, much more is possible with proactive change.
We can no longer accept the status quo. Within any power system there is always a moment when the act of people uniting to disrupt things that are simply wrong provides the resistance that moves towards righting that wrong. I’d like to think that participating in the round-table event was a small part of such an act.
It is my perception is that Organsiations are run like political parties. The senior management is interested in having yes men and women who will rally support for them within the wider Organisation. This will keep their working lives easier and they will survive without improving performance. This leads to a culture of closing ranks and secrecy. There is a glass ceiling within which you dont see it will knock against you!
Best wishes for any body who wants to change culture.
Thanks for reading blog and leaving comment . Our lived experiences are powerful influences on our perception and I have to believe,as a developer of leadership potential, that we can create new ways of being . If the next generation of BME talent are to realise their potential then we need to help clear the path. This needs all our efforts.
Thank you for continuing to raise the issue. It will require a number of initiatives to address the problems many BMEs face. We need a multifaceted approach and a complete rethink with regard to senior leadership role recruitment, period of office and talent management approach. We need to break-up the cultural clicks and remind every organisation that they are not a law to themselves but public servants appointed to carry out a specific role for the benefit of the patients. We cannot deliver for patients without inclusive leadership at every level, we are not delivering for patients today, but are processing patients in a system we have created. What we need to s national task force to address this problem through system re-design. I have some great ideas if those in power are willing to listen this humble BME member of staff.
Ram Jassi, views are my own.
No idea too small or humble these often have huge impact. Please do offer your ideas , through 100s 'being the change' we can make a ripple that creates a wave.
Thank you Ram .
The most important thing for NHS is to appoint values based leaders. Values based leaders are individuals with very high core values and beliefs who are kind, caring, compassionate but also courageous. These are individuals who are good role models and staff trust and respect them and feel inspired. Value based leaders are very self-disciplined and aware of impact of their own behaviour on others. They are good human beings and good team players. They respect fellow human beings irrespective of race, gender, ethnicity and sexual orientation. They treat everyone fairly and equally.
Sadly NHS culture and system of appointing senior leaders and managers is what stops NHS from appointing good value based leaders. NHS Board has 80% of members who are non-clinical leaders. Many are appointed for technical skills than for values and not trained in leadership. Most of these leaders genuinely try their best to do a good job but sadly finance and targets dominate. In such a culture patients and staff suffer.
NHS must appoint values based leaders, remove culture of naming, shaming, blaming, disciplining, bullying and must promote 'fair and open' culture and supportive and learning culture. There must be robust governance and accountability for leaders and managers for their own values, behaviours and leadership skills. There must be robust governance for staff. There must be robust staff and patient engagement.
NHS leaders must always promote patient safety and quality of care as the top priority and staff happiness as the most important thing. NHS leaders and managers job is to make staff job easy. Happy staff - happy patients.
In a value based organisation diversity and inclusion thrives and both staff and patients are safe and happy.
Umesh ,
All that you say is true and we know that values based leadership has still managed to breech on equitable treatment of the potential talent that resides in the BME community of leaders. For the next generation we need to do better . Thank you for reading and leaving your comment .
How can we help black and minority ethnic (BME) staff to achieve their potential as leaders? Is a question in my observation remained unanswered for decades if not centuries! Why don't BME staff get to their goals as frequently as their non-BME colleagues? The answer is very simple but the problem is a very Wicked One. Institutional Racism is rife even in the 21 century! shame on us, the members of the so called civilized societies. The system i.e. society is delivering perfectly what it is made to do. Sadly vast number of incidences of inequalities are frequently faced by the BME staff. In the eyes of the social anthropologists these will be examples of Structural Violence!
When we judge the world with our 5 senses; when our heart is disengaged; we make fundamental mistakes in our lives. As a medical professional I can promise you that we all have the same colour blood in our veins and under the skin we look all the same. It is such a pity the myopia has most aggressively hijacked the heads of many decision makers and multiple levels of many organisations (including the NHS) who find it impossible to accept the talents and potentials of a BME staff.
We are all equals but some still remains more equal than the others. This observation is pretty old. If we cannot change this aphorism can we really call ourselves civilised??!!
The situation is even worse when we see appointments of Non Executives or Lay Persons on NHS Boards. Members from BAME groups need to prove they have the right connections and happy to emulate rather than values and the diverse thinking and insights they bring. Some people who are good role models are Lord Victor Adebowale.
I am really sorry to disagree with you. In any organisation where there are truly values based leaders, inclusion and diversity thrives and right people are appointed to do the right job by leaders and organisational culture is such that they value each and every staff irrespective of race, gender, ethnicity, disability or sexual orientation.
Sad reality is in most Institutions and even in NHS leaders get confused between their own individual values with NHS values!
Institutional values are simply mission statement and talking the talk but value based leaders are those who walk the talk.
This is what has transformed Wrightington, Wigan and Leigh FT and we are not perfect and still long-way to go. But results speak for itself.
Sam thank you for reading blog and for leaving comment . We are as you say more alike than different , building on areas where we have successes in advancing BME / BAME talent on merit is the job to be done . Looking at the work you are contributing to in patient safety & quality improvement reinforces the invitation to the system to do more , to do the right thing.
Thank you Varsha . Your observations on the lack of representation at NED/ Board level was discussed at the Roundtable . Many recalled the success of the once established appointments commission in this area. Being able to contribute diverse points of view and not going with 'the club' is the very reason we need more diversity at senior leadership levels in the NHS and across all sectors.
I congratulate you and other colleagues for continuing to create awareness and encourage dialogue so that this vital issue remains alive and at the forefront of people's minds.
Judy Kane's 2009 book 'Being White in the helping professions' makes an interesting and fundamental point. "The white, western culture tend to see themselves as 'culturally neutral", she writes. The consequence of this is that non-western cultures are defined in reaction to western 'normality'.
For the NHS to be truly transcultural, it requires a 'paradigm shift' to work beyond difference and to operate within the frame of reference of others who are not like me.
Thank you Donna , being able to accept that this is a live issue and one in which we all contribute is fundamental step . We can then create a fairer more inclusive future for current and future black , Asian and all visible ethnic minority individuals aspiring to lead in and out of the NHS.
Thankyou for your timely article which I found very interesting. Firstly your reference to progress in terms of gender equality poses an interesting question of leadership and progress and the challenge of mirroring similar progress when it comes to BME senior leadership. What can we learn from the Gender experience? Why haven't we been able to do the same for the BME experience. Secondly placing BME Staff at the centre of designing interventions has to be welcomed instead of 'fixing the BMEs' from the outset. Thirdly as a keen advocate of coaching I welcome the importance you place on coaching. What I find missing often from this debate is the lack of reference to (a) talent management (b) workforce planning (c) role of the line manager. The Workforce race Equality standard needs to link strongly with these areas if we are to move forward. In addition through the leadership academy and the senior leadership courses they offer provide ample opportunities for existing and future leaders of the NHS to come on board with the agenda. These are the key agents of change who in turn will cause ripples in the system and in doing so help create a NHS leadership more reflective of the workforce. It was therefore welcoming recently to hear recently a senior NHS Leader talking about his responsbilty and commitment to talent management and the importance of diversity at the centre of his thinking. We need more of these leaders they are out there and they would be ideal for any future round tables you chair - keep up the good work and hope to see you soon.
Dear Donna Willis, thank you for making a contribution to this very pertinent article. I would like to add reference to your comment that simply operating from a framework that is not like yourself is not the answer. I qualify my view in that you cannot answer or deliver the needs of another by simply recognising what is different. You have to go beyond that difference in understanding the "WHY". We often think we have got it right but in reality if we asked what could I have done different you might get some interesting insights. This applies to all in every aspect of our engagement on a daily basis. I do not believe we have a reference point to call "normal" regardless of western or other cultures.
Ram Jassi, views are my own
Hi Mo,
Thanks for comments , I know how much you and colleagues do to take action in this area. When times are tough and money is short this agenda slips off the agenda . Harnessing the talent of our BME/ BAME community has never been more important . Hope to catch up soon .
We need to hear from aspiring BME themselves. I have observed BME nursing staff who have no aspirations at all to be in middle or senior level management. The ones I know have extended families back home to care for and support financially. These nurses would rather work bank/ agency shifts to supplement their income than have their wages at band 8 (AfC). Furthermore the level of hard work and commitment required to operate at that level is prohibitive when one has a family especially children to take care of.
Interesting comment from Mo about NHS Leadership development. I am just finishing off the Mary Seacole Program with NHS Leadership Academy and I am looking forward to making a difference. Hopefully, i will come back some day with a positive story to share.
Thank you Fadzai for taking the time to write a comment .You raise an important point . Enabling individuals to achieve their potential and aspirations is the focus. Removing the barriers to progression conscious and unconscious is only part of the job to be done. Valuing all the roles we hold and our caring responsibilities is also valuing individual aspirations. I hope you achieve all your aspirations .
Vijaya, there is so much truth in this. This issue is even more acute in Northern Ireland. We have a significant minority of BME nurses and doctors but the executive level leadership in the Trusts, commissioners and DH is still all white. I probably know of one BME NED in one trust in NI. In my observation, there arent any/many asst.director level BME staff too. On many occassions I have reflected after a meeting/event that I was the only BME staff there, not that it bothers me but its something im acutely aware of.
Vijaya thank you for this blog and generating such a lively debate! It demonstrates how important this issue is and I am heartened to see it being given the focus if deserves by The King's Fund and the HSJ.
I have read the comments with interest and intrigue particularly from Fadzai and would add that we must be careful of making generalisations of any kind at risk of replacing one type of discrimination with another. The issues you talk to may be true for some BME people and not so for others. This issue of how employers enable and support those with childcare commitments is a universal one.
How do we enable a wider debate where we can all speak to our difference whatever kind that may be and begin to build a culture where we all feel valued? Perhaps the HSJ would consider a further round of discussions with some of those who have commented here to build on this and begin to develop some actions.
Thank you Deepak . All four countries of the United Kingdom benefit from diverse staff and patient populations and so this is a question to be asked and answered at a local level . Where there are willing individuals , who want to step into leadership roles sharing- what works may be a good starting point .
Thank you Mandip . Excellent suggestion for taking this forward and alongside the work that you and colleagues at The Fund have lead -an opportunity for us to continue to contribute with others in the system to new possibilities .
Spot on! I endorse this article 100% I'm in! Let's collaborate to disrupt the status quo. We need strong, courageous leaders like you as role models. #BMELeadership
Nichole thank you for leaving his comment . You are yourself a rolemodel and change leader. I know that in taking this work forward your contribution will be much needed and appreciated .
Awesome! So can we agree a date/time and venue and invite all those system leaders trying so hard to advance this agenda together so a proper well thought out discussion can take place. I am hearing so much but very little joined up thinking from a lot of well intentioned people on this agenda, but I do not see any joined up approach! If we are truly going to make a change then only a united and multifaceted approach will work.
Ram Jassi, views are my own
Thank you sincerely for raising this important topic again and keeping it at the forefront of people’s minds.
Might the first step be for NHS system leaders from across the whole system to acknowledge that barriers to opportunities by BAME staff actually exists across the whole system?
And, that these barriers deny our NHS organisations the full depth and breadth of the skills and knowledge that it could have (and needs) in order to effectively address the well documented challenges it faces;
Also, it is denies some patients the ‘quality of care’ the NHS promises to deliver - Kline’s research, along with others, points out that “there is an established link between the treatment of BME staff and the patient’s experience of care….the experience of BME NHS staff is a good barometer of the climate of respect and care for all within the NHS. Put simply, if BME staff feel engaged, motivated, valued and part of a team with a sense of belonging, patients were more likely to be satisfied with the service they received.” West, M et al, (2012) quoted in Kline (2015:39);
(further, it may also deny some BAME staff of the life chances afforded to others, in the pursuit of leading what we may consider to be successful, meaningful and productive lives).
Dealing with a problem first requires us to accept that the problem exists, this may cause us to reflect on our own words and actions which have/or are still contributing to the problem, or perhaps how we stand by and watch it happen without questioning it – it can be difficult to accept, it’s easier to ignore or deny that the problem even exists. I think denial may be the common reaction.
Bad decisions are made, bad words are said and bad behaviours are enacted, because we stand by and consciously or unconsciously allow it to happen.
Its a complex problem, but I think it begins with system leaders stepping forward and accepting the issue exists, and for us to join them in changing it. I think it also requires us to (amongst other things) re-address organisational strategy, change and culture management strategies, along with organisational systems, policies and processes so that they facilitate the change towards a more diverse and inclusive workforce. The following link provides an interesting read on how we may support or penalise those who support diversity, it’s from another sector, but perhaps it can be insightful https://hbr.org/2016/03/women-and-minorities-are-penalized-for-promoting-diversity
“I’m In Too” I whole heartedly support you, in what ways I can, from where I am.
Ram following on from your comments and those of other colleagues- concerted effort at a system level is one approach . And I would also advocate any individual , local action to be promoted . Thank you for your energy and commitment to taking action .
Leon, thank you for taking the time to leave such an insightful contribution.
In pockets the system acknowledges that these barriers exist . As you and other colleagues writing on this blog and elsewhere indicate - now is the time to draw a line under rhetoric and take action. Those participating in the Roundtable strongly support your views. Together we can make progress our patient and staff populations deserve this .
Dear Vijaya,
Thanks for an excellent and very timely article on BME leaders in the NHS. The responses on this topics highlights this crucial issue in the modern NHS. NHS is going through the worst phase since its creation, only thing which might save the NHS is going to be brave leaders across the whole healthcare system.
Instead of blaming the well known "institutional racism" card, let us come forward as BME doctors, nurses, managers as true leaders. This is a country of opportunity, this is a time of crisis, let us be brave leaders for our patients.
best wishes
Vijay
Vijay, thank you . In your role as Divisional Director HENHSFT you will be intimately aware of why the call to action requires collaboration and understanding. The Diversity of thought available in our workforce has never been more needed . Perhaps you and other leaders making a difference can share examples and the ways in which we in the NHS can recognise our own resourcefulness .
Some really great comments and thoughts. As someone who has worked in other organisations and most recently the NHS, there are similar themes when it comes to career progression and development of BME staff coming up against the glass or concrete ceiling. As an outsider I always viewed the NHS as a trailblazer of inclusion and equality, however having worked in the NHS my perception is,
there is a lot of talking the talk, there is a ton of cutting edge research, however the progress seems a lot slower than say Civil Service (forgive me if it's not the best comparison). I haven't quite put my finger on why this is . I think it's something about the structure of NHS and which Director General or other senior leader holds accountability for championing the BME agenda. Im not sure if there is one? Plus like it or not in other public sector organisations there are some metrics in place to increase BME leadership and it's very much ingrained in the psyche of recruitment , leadership and talent management agenda. Within NHS organisations it's very patchy. For instance some Trusts would ensure that they have a diverse recruitment panel, within other Trusts it's not even considered. So there is a mishmash of processes taking place and it's the luck of the draw on whether BME is on that organisations radar at that time.
Thanks for a thought provoking debate
Interesting blog... an issue that continues to intrigue me. I hear a lot about focusing on 'Women' and 'Blacks' but very little about 'Asians' or any other ethnic minorities... it's almost as if we are forgotten altogether, and yet whilst I don't have the figures, my experience and perception is that Asians form a fair size of the workforce in the NHS. I can tell you this however, no matter how bad it feels in the UK, the issue of equality is even worse in other parts of the world!
Sadly, any intervention will come too late to make a difference for many asians, blacks or other ethnic minorities currently working in this environment ... so i guess for now the reality is 'if you can't beat them, join em' and try and work from within.
Thank you Audrey for reading and leaving a comment. I know the WRES was established as a metric for enabling leaders to take stock and action re BME / BAME leadership . We have much more to do . It sounds like you have experience from other sectors that would be helpful. Going forward we need individuals with experience in how we succeed in this area to share what works.
Sohaib ,Thank you for leaving this comment. Your experience and those of others is the very reason that we need to do better in acknowledging the talent from BME / BAME and all ethnic minority communities.
If we feel excluded on the grounds of racial difference , whatever the label attached BME/ BAME -other visible ethnic minorities it is painful . As someone who believes that education is a great leveller then I encourage all to continue to have conversations , and to believe in the human ability to change .
Any change is possible if we get truly values based leaders who value each and every human being irrespective of race, gender, ethnicity, sexual orientation and so on. Leaders simple job is to appoint right people to do the right job and to support and empower them to be leaders. Leaders only job in NHS is to make everyone a great leader and patient safety champions.
NHS needs good leaders and that too good clinical leaders and sad reality is NHS has never trained, encouraged, nurtured or supported good doctors or nurses to be good leaders and never held leaders to account.
Until we get these basics right BME, BAME, Women and BME women will continue to be under-represented and there will be more and more such articles even after few more years in our NHS.
BME or BAME issues are complex as there is not only BME versus White discrimination but sadly inter-ethnic discrimination! I recently heard that someone very senior BME women leader who is Black saying 'I hate Asian men! What an irony!
Leaders must lead from the front and lead by example. Unless there is a culture of holding leaders to account for their own values and behaviours nothing will change.
NHS is a great institution, it has amazing highly values based staff who would do anything for their patients. It simply needs good leaders with good values who are self disciplined and role models for their staff. Who inspire and motivate their staff and who are kind, caring compassionate towards staff and create a culture of staff happiness. All staff matter and that includes BME or BAME.
Umesh, I agree with you latest comments. We talk about racism quite a lot what about casteism?
There is a great deal of discrimination going on between Asians and furthermore BME to BME.
With regard to changing behaviours, well when you have leaders whose values do not accord to the Nolan principles what can you do? Until you have a national “command and control” over leadership accountability "well led" at every level you are not going to address localised problems and break-up the cosy club culture. Without a united approach we will just carry on fighting localised issues and quite frankly some of us are becoming so battle scared that you can do a sequel to the movie Gladiator.
Ram Jassi, view are my own.
Thanks Vijaya for raising this important issue which has started to receive increasing attention. I perceive two issues; the first one is lack of aspiration due to past experience in the BME community. This can be addressed by better training and possibly mentoring and coaching. The second issue is the cultural stereotype directed at members of the BME community when they try to go for senior leadership positions. I feel aspiring BME leaders need to shadow and get support and inspiration from BME existing leaders who can act as role models.
Thank you for leaving these comments both points well made and both will benefit from remedies as identified by you and others writing on this blog .
One suggestion that I & colleagues at The Fund are looking into is inviting those of you who left comments indicating interest in working on these issues to a discussion - where we collectively (and with colleagues who participated in the the roundtable) look at what further options for action may be available .
Thanks again as through the comments left by you and other colleagues more is possible .
I agree with all of the points highlighted and in the original blog post. I also have concerns relating to equality in leadership but in the area of disability. More and more staff within health and social care are hiding disabilities for fear of experiencing stigma and discrimination; I have experienced both as a result of being open about my disabilities. As a disabled woman, I feel I've still got some mountains to climb ...
Deborah ,
Thank you for reading the blog and leaving this comment . Doing better in all aspects of inclusion is vital to society and our NHS & Care sectors .We have much more to do , I do hope that you receive support in scaling those mountains . We will continue to raise these issues as imperatives to be addressed.
The recent publication of the workforce race equality standard (WRES) has just confirmed what we have been saying. What is striking is the disparity of BME to Non BME experiences. We have actually gone backwards in addressing equality of opportunity. I recite this requires joined up action and therefore a call to action. #BrokenSpirits
Ram Jassi, views are my own
Hi I just wanted to introduce my self ..i am in a leadership position over at Bolton CCG..i have just bern appointed as chair of the EDHR committee, am enjoying the NED role and am passionate about equalities . .please get in touch thanks Zed
Comments
Best wishes for any body who wants to change culture.
Ram Jassi, views are my own.
Thank you Ram .
The most important thing for NHS is to appoint values based leaders. Values based leaders are individuals with very high core values and beliefs who are kind, caring, compassionate but also courageous. These are individuals who are good role models and staff trust and respect them and feel inspired. Value based leaders are very self-disciplined and aware of impact of their own behaviour on others. They are good human beings and good team players. They respect fellow human beings irrespective of race, gender, ethnicity and sexual orientation. They treat everyone fairly and equally.
Sadly NHS culture and system of appointing senior leaders and managers is what stops NHS from appointing good value based leaders. NHS Board has 80% of members who are non-clinical leaders. Many are appointed for technical skills than for values and not trained in leadership. Most of these leaders genuinely try their best to do a good job but sadly finance and targets dominate. In such a culture patients and staff suffer.
NHS must appoint values based leaders, remove culture of naming, shaming, blaming, disciplining, bullying and must promote 'fair and open' culture and supportive and learning culture. There must be robust governance and accountability for leaders and managers for their own values, behaviours and leadership skills. There must be robust governance for staff. There must be robust staff and patient engagement.
NHS leaders must always promote patient safety and quality of care as the top priority and staff happiness as the most important thing. NHS leaders and managers job is to make staff job easy. Happy staff - happy patients.
In a value based organisation diversity and inclusion thrives and both staff and patients are safe and happy.
All that you say is true and we know that values based leadership has still managed to breech on equitable treatment of the potential talent that resides in the BME community of leaders. For the next generation we need to do better . Thank you for reading and leaving your comment .
When we judge the world with our 5 senses; when our heart is disengaged; we make fundamental mistakes in our lives. As a medical professional I can promise you that we all have the same colour blood in our veins and under the skin we look all the same. It is such a pity the myopia has most aggressively hijacked the heads of many decision makers and multiple levels of many organisations (including the NHS) who find it impossible to accept the talents and potentials of a BME staff.
We are all equals but some still remains more equal than the others. This observation is pretty old. If we cannot change this aphorism can we really call ourselves civilised??!!
I am really sorry to disagree with you. In any organisation where there are truly values based leaders, inclusion and diversity thrives and right people are appointed to do the right job by leaders and organisational culture is such that they value each and every staff irrespective of race, gender, ethnicity, disability or sexual orientation.
Sad reality is in most Institutions and even in NHS leaders get confused between their own individual values with NHS values!
Institutional values are simply mission statement and talking the talk but value based leaders are those who walk the talk.
This is what has transformed Wrightington, Wigan and Leigh FT and we are not perfect and still long-way to go. But results speak for itself.
I congratulate you and other colleagues for continuing to create awareness and encourage dialogue so that this vital issue remains alive and at the forefront of people's minds.
Judy Kane's 2009 book 'Being White in the helping professions' makes an interesting and fundamental point. "The white, western culture tend to see themselves as 'culturally neutral", she writes. The consequence of this is that non-western cultures are defined in reaction to western 'normality'.
For the NHS to be truly transcultural, it requires a 'paradigm shift' to work beyond difference and to operate within the frame of reference of others who are not like me.
It starts with me and others like me.
Kind regards
Donna
Ram Jassi, views are my own
Thanks for comments , I know how much you and colleagues do to take action in this area. When times are tough and money is short this agenda slips off the agenda . Harnessing the talent of our BME/ BAME community has never been more important . Hope to catch up soon .
Interesting comment from Mo about NHS Leadership development. I am just finishing off the Mary Seacole Program with NHS Leadership Academy and I am looking forward to making a difference. Hopefully, i will come back some day with a positive story to share.
I have read the comments with interest and intrigue particularly from Fadzai and would add that we must be careful of making generalisations of any kind at risk of replacing one type of discrimination with another. The issues you talk to may be true for some BME people and not so for others. This issue of how employers enable and support those with childcare commitments is a universal one.
How do we enable a wider debate where we can all speak to our difference whatever kind that may be and begin to build a culture where we all feel valued? Perhaps the HSJ would consider a further round of discussions with some of those who have commented here to build on this and begin to develop some actions.
Thanks,
Mandip
Ram Jassi, views are my own
Thank you sincerely for raising this important topic again and keeping it at the forefront of people’s minds.
Might the first step be for NHS system leaders from across the whole system to acknowledge that barriers to opportunities by BAME staff actually exists across the whole system?
And, that these barriers deny our NHS organisations the full depth and breadth of the skills and knowledge that it could have (and needs) in order to effectively address the well documented challenges it faces;
Also, it is denies some patients the ‘quality of care’ the NHS promises to deliver - Kline’s research, along with others, points out that “there is an established link between the treatment of BME staff and the patient’s experience of care….the experience of BME NHS staff is a good barometer of the climate of respect and care for all within the NHS. Put simply, if BME staff feel engaged, motivated, valued and part of a team with a sense of belonging, patients were more likely to be satisfied with the service they received.” West, M et al, (2012) quoted in Kline (2015:39);
(further, it may also deny some BAME staff of the life chances afforded to others, in the pursuit of leading what we may consider to be successful, meaningful and productive lives).
Dealing with a problem first requires us to accept that the problem exists, this may cause us to reflect on our own words and actions which have/or are still contributing to the problem, or perhaps how we stand by and watch it happen without questioning it – it can be difficult to accept, it’s easier to ignore or deny that the problem even exists. I think denial may be the common reaction.
Bad decisions are made, bad words are said and bad behaviours are enacted, because we stand by and consciously or unconsciously allow it to happen.
Its a complex problem, but I think it begins with system leaders stepping forward and accepting the issue exists, and for us to join them in changing it. I think it also requires us to (amongst other things) re-address organisational strategy, change and culture management strategies, along with organisational systems, policies and processes so that they facilitate the change towards a more diverse and inclusive workforce. The following link provides an interesting read on how we may support or penalise those who support diversity, it’s from another sector, but perhaps it can be insightful https://hbr.org/2016/03/women-and-minorities-are-penalized-for-promoting-diversity
“I’m In Too” I whole heartedly support you, in what ways I can, from where I am.
Thank you for reading.
In pockets the system acknowledges that these barriers exist . As you and other colleagues writing on this blog and elsewhere indicate - now is the time to draw a line under rhetoric and take action. Those participating in the Roundtable strongly support your views. Together we can make progress our patient and staff populations deserve this .
Thanks for an excellent and very timely article on BME leaders in the NHS. The responses on this topics highlights this crucial issue in the modern NHS. NHS is going through the worst phase since its creation, only thing which might save the NHS is going to be brave leaders across the whole healthcare system.
Instead of blaming the well known "institutional racism" card, let us come forward as BME doctors, nurses, managers as true leaders. This is a country of opportunity, this is a time of crisis, let us be brave leaders for our patients.
best wishes
Vijay
there is a lot of talking the talk, there is a ton of cutting edge research, however the progress seems a lot slower than say Civil Service (forgive me if it's not the best comparison). I haven't quite put my finger on why this is . I think it's something about the structure of NHS and which Director General or other senior leader holds accountability for championing the BME agenda. Im not sure if there is one? Plus like it or not in other public sector organisations there are some metrics in place to increase BME leadership and it's very much ingrained in the psyche of recruitment , leadership and talent management agenda. Within NHS organisations it's very patchy. For instance some Trusts would ensure that they have a diverse recruitment panel, within other Trusts it's not even considered. So there is a mishmash of processes taking place and it's the luck of the draw on whether BME is on that organisations radar at that time.
Thanks for a thought provoking debate
Sadly, any intervention will come too late to make a difference for many asians, blacks or other ethnic minorities currently working in this environment ... so i guess for now the reality is 'if you can't beat them, join em' and try and work from within.
Good luck
If we feel excluded on the grounds of racial difference , whatever the label attached BME/ BAME -other visible ethnic minorities it is painful . As someone who believes that education is a great leveller then I encourage all to continue to have conversations , and to believe in the human ability to change .
NHS needs good leaders and that too good clinical leaders and sad reality is NHS has never trained, encouraged, nurtured or supported good doctors or nurses to be good leaders and never held leaders to account.
Until we get these basics right BME, BAME, Women and BME women will continue to be under-represented and there will be more and more such articles even after few more years in our NHS.
BME or BAME issues are complex as there is not only BME versus White discrimination but sadly inter-ethnic discrimination! I recently heard that someone very senior BME women leader who is Black saying 'I hate Asian men! What an irony!
Leaders must lead from the front and lead by example. Unless there is a culture of holding leaders to account for their own values and behaviours nothing will change.
NHS is a great institution, it has amazing highly values based staff who would do anything for their patients. It simply needs good leaders with good values who are self disciplined and role models for their staff. Who inspire and motivate their staff and who are kind, caring compassionate towards staff and create a culture of staff happiness. All staff matter and that includes BME or BAME.
There is a great deal of discrimination going on between Asians and furthermore BME to BME.
With regard to changing behaviours, well when you have leaders whose values do not accord to the Nolan principles what can you do? Until you have a national “command and control” over leadership accountability "well led" at every level you are not going to address localised problems and break-up the cosy club culture. Without a united approach we will just carry on fighting localised issues and quite frankly some of us are becoming so battle scared that you can do a sequel to the movie Gladiator.
Ram Jassi, view are my own.
One suggestion that I & colleagues at The Fund are looking into is inviting those of you who left comments indicating interest in working on these issues to a discussion - where we collectively (and with colleagues who participated in the the roundtable) look at what further options for action may be available .
Thanks again as through the comments left by you and other colleagues more is possible .
Thank you for reading the blog and leaving this comment . Doing better in all aspects of inclusion is vital to society and our NHS & Care sectors .We have much more to do , I do hope that you receive support in scaling those mountains . We will continue to raise these issues as imperatives to be addressed.
Ram Jassi, views are my own
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