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Making the difference

Diversity and inclusion in the NHS


Recent research demonstrates that very little progress has been made in the past 20 years to address discrimination against black and minority ethnic (BME) staff in the NHS.

NHS England commissioned The King’s Fund to produce a report assessing the scale of this problem; the research analysed data from the 2014 NHS Staff Survey and drew on wider work on climates of inclusion to suggest strategies for lasting and pervasive change. The report for NHS England also addresses the question of how to make a difference at individual, team, organisational and national levels.

The King's Fund has produced a summary of the NHS England-commissioned report.

Key findings

  • Overall, levels of reported discrimination vary significantly by type of trust, location, gender, age, ethnicity, sexual orientation, religion and disability status.

  • Reported levels of discrimination are highest in ambulance trusts.

  • Overall, women are less likely to report experiencing discrimination than men (except in the case of ambulance trusts).

  • Older staff are less likely to report experiencing discrimination than younger staff.

  • Reported levels of discrimination are highest for black employees and lowest for white employees; all other non-white groups are far more likely to report experiencing discrimination than white employees.

  • People from all religions report experiencing discrimination on the basis of their faith, but this is by far the highest among Muslims.

  • Disabled staff report very high levels of discrimination; levels of reported discrimination are higher for this category than for any other (gender, age, etc).

Implications for NHS organisations

  • Diversity training for individuals can be helpful, but some strategies are more effective than others in bringing about wider positive changes.

  • Opportunities to bring about change are most likely to be effective at team level, as this is where most discrimination occurs.

  • Teams are more inclusive when they are well-structured and have effective processes that include: clear vision and values; shared team leadership; valuing diversity as a positive element of the team; and a pattern of listening to and valuing all voices within the team.

  • Within organisations, effective diversity management policies, practices and procedures that can shape and reinforce equal employment are vital.

  • Organisations must take a strategic approach to creating a culture of inclusion. The key elements necessary for cultures of inclusion are also associated with high-quality health care.

  • Nationally, there should be clear guidance on how to develop climates for inclusion and the NHS should exercise its power to set national standards around developing cultures of diversity and inclusion.

Summary presentation

Mandip Kaur shares findings from The King's Fund's report and discusses how leaders can create cultures of inclusion within their organisations.

This presentation was recorded at our event, Maximising the impact of the NHS in tackling health inequalities, on 12 May 2016.