Those in the most senior positions across health care, are generally not from historically marginalised groups, meaning they are unlikely to have to navigate persistent inequity in the workplace themselves, and might also not notice subtler and more pervasive forms of discrimination, including where their own practices are falling short.
However, we cannot ‘force’ leaders to be inclusive. History tells us that such draconian approaches end up with minimal levels of compliance that change nothing. It is by choice that leaders step into inclusive practice. However, this does not mean that inclusion should be relegated to an optional extra. Discrimination is harmful and these forms of ‘institutionalised harm’ cannot ethically simply continue without consequences. The NHS is a people business, and all people should therefore matter equally.
Time and again the data paints a picture that disparities are the norm, which means that discriminatory practices and therefore harm persists. We hear these stories constantly from participants on our programmes at the NHS Leadership Academy, where they feel safe enough to share their distressing accounts. Currently, however, these incidents occur with little proper acknowledgement from leadership teams, no apologies and little or no organisational learning, and with the individual managers involved receiving guidance from HR professionals. It is still all too common for those who complain to then be dislodged from their workplaces for speaking up or become so ‘weathered’ by their experiences that they simply have to leave. This is in stark contrast to those in positions of power, who may have abused that power, as they seem to fall upwards. Deep work is needed to address these inclusion fault lines, which are often compounded by entrenched and uncontested negative stereotypes about those audacious enough to complain.
A further obstacle to progress is the tacit acceptance that leaders are delivering on inclusion simply because they are now talking about it – learning a few more inclusive terms sadly looks as if it is enough evidence for some. But if inclusion is about fundamentally changing the nature of the relationships people have in the workplace across similarities and differences, and progressively eliminating discrimination in all of its forms, this effusive game of words is just not good enough.
So how should leaders be different? A start would be to create safe spaces for people to openly speak about discrimination and exclusion, producing the knowledge that would provide a critical foundation for leaders to begin to ‘know’ what to do. If this single activity is not present in our organisations and teams, we are simply deluding ourselves by concurrently making claims that inclusive progress is being made – progress according to whose knowledge and lived experience? There is much to learn from this solitary paradigm-shifting activity, as those who face discrimination cannot simply choose not to.
Organisations need to be clearer about leadership accountability, with the ‘lived experiences’ of their own staff being the most important indicator of inclusion at organisation, department and team levels. Great quality, evidence-based, life-long inclusive leadership development and support for leaders should also be a given and, most importantly, those who understand and experience exclusion, should be leading initiatives to bring about change across HR, organisational development and all other functions. Focusing change strategies around the knowledge created by lived experience is the only approach that can ensure that inclusion initiatives are relevant, effective and sustainable.
HR has the potential to be a change enabler for inclusion. The role of HR professionals across systems that have consistent disparities (for example, between BAME and white staff) should therefore be examined. HR approaches and practices urgently need to be updated in light of what we currently know about the lack of inclusion across the system, with the goal of having no policies or practices that do not support systemically just and equitable outcomes.
Once safe spaces and organisational processes have been established, leaders can then apply themselves to life-long learning, continually asking themselves how to listen to the experiences of those impacted by discrimination and exclusion.
- How can I hear without making negative judgements about those who are courageous enough to speak their truths?
- How can I hear without denying the messages that are being communicated?
- How can I hear without placing covert pressure on people to only tell good news stories?
- How can I hear, while asking myself ‘what does this story tell me about the culture here, and how can I lead in ways that will transform the lived experiences of my staff’?
- How can I hear without assuming there is nothing new that I need to learn?
Listening with humility and humanity is the first and most important attitude shift that must therefore take place.
Speaking truth to power is only one part of a very important equation, the other part is the examination of how power responds to truth. We need to embrace innovation on inclusion, this is what the NHS Leadership Academy’s Building Leadership for Inclusion strategy is all about, transformation through leadership development. How ready are we now to learn?
I concur with all this article particularly the toll that exclusion leadership has on individuals and cultures and on patient care
I wholeheartedly agree with this article, particularly the comments on accountability and on staff being allowed to voice their experience without judgement. Our Executive Directors have equality objectives and we've also begun to introduce more inclusive HR practices, its still early days but I think we are heading in the right direction. I'm happy to keep you in the loop on our progress Tracie.
Leaders are called leaders because they lead a team, organisation or country successfully or mate successful.
Leaders must be honest, sincere, with great integrity and college. Leader must be ethical. It is called compassionate courage or value based leadership or servant leadership.
For them fairness, inclusion, truth, justice and fairness means a lot.
Good leader is a role model. They respect everyone and value everyone. They treat everyone with respect. They do not discriminate.
Here in Leeds we've many rivers to cross but we'll find our way over.
I will share your thoughts