The NHS is the fifth largest employer in the world and the largest employer of global majority people in the UK.
Imagine, more than 200,000 health service staff (around a third of doctors and a fifth of nurses and midwives) are from global majority backgrounds and a third of NHS doctors are trained overseas.
Unfortunately, the level of representation at senior levels across all professions in the NHS is not proportionate.
Rethinking EDI in the NHS
The NHS is doing an amazing job but is it at risk of being white-washed?
Could better HR save the NHS?
According to a report by NHS Providers, the proportion of global majority chief executives in NHS trusts is only 4.9%; this should not be given the diversity within the NHS.
The impact of systemic bias is evidenced in the number of staff disciplined, the number of referrals to professional regulatory bodies and the poor clinical outcomes; all are disproportionate for black, Asian and minority ethnic groups.
We cannot simply re-imagine fairer workplaces, but rather take decisive action to address matters of social injustice that are embedded into the fabric of our organisations, policies, procedures and our people.
NHS Employers has recently summarised some of the key challenges we face as a health service, that we need to positively disrupt if fairer workplaces are to become commonplace.
Positive disruptors challenge societal constructs and look for new ways of working, doing business, learning and combatting the status quo.
Positive disruption drives innovation and can eradicate systemic racism.
However, this can only be achieved with the right mindset with decision-makers, who are keen to address and transform outdated practices. Here are some facts;
- Black people make up 6.5% of NHS staff. While the proportion has increased, only 10% of NHS board members are from global majority backgrounds
- White staff are still 1.5 times more likely to be appointed to a job than global majority staff
- 2% of the medical workforce and 6.6% of the non-medical workforce in the NHS are from a black background
- Career progression remains a problem and is highlighted year after year in the annual NHS staff survey
Many organisations talk about wanting psychologically safe inclusive, diverse and equitable workplaces, but can this really happen in an unequal society?
Can employment practices influence and challenge inequitable practices and beliefs in society?
HR has been described as the moral compass of an organisation, and has the opportunity to influence the activities, behaviours and culture of an organisation.
Yet in order to influence, HR needs to use its voice at the table and recognise the various forms of inequality and speak truth to power in various forums.
HR departments can collectively disrupt existing patterns of inequality contributing to fairer workplaces.
Becoming positive disruptors enables difference to be acknowledged and valued, which leads to better outcomes for all, including marginalised groups.
Recently the CIPD has recognised the responsibility and impact that HR can have on the wider community, in terms of corporate and social responsibility.
The difference we can make to society through fairer work practices that disrupt long-standing patterns of inequality and disproportionate outcomes is massive if time is taken to invest and develop HR as a profession.
The #InclusiveHR social movement for change launched in the NHS recognises those patterns of inequality and accepts they are replicated in our organisations and within our profession.
Only 17% of HR professionals in the NHS nationally are from a global majority, and the majority sit at recruitment officer level. We have to ask ourselves why that is.
We have an opportunity to lead with credibility by addressing these inequalities, by being more intentional and purposeful about positively disrupting these patterns by undertaking a deeper level of learning that fundamentally changes our practitioners and leaders from the inside out.
#InclusiveHR understands the inequity within the HR profession and realises that there are a series of interventions needed to shift the dial. The pace of change is slow and often relies on goodwill.
Despite the evidence, there are still no business incentives or performance metrics with consequences that place a level of importance of eliminating race discrimination.
As long as it is not mandatory, and become an essential part of business, marginalised groups will continue to suffer.
HR professionals need to have the courage of their convictions to speak up and openly, utilising their privileged positions for good as true equity and inclusion is underpinned by psychological safety.
In the instance of racial inequality, it is clear the global majority will continue to suffer and be at the forefront of poorer outcomes, which plays out in society in terms of health, education, housing and wealth.
HR can play a key role in communicating issues of social injustice, using this to influence decisions taken in their organisations that can help shape the type of organisations that are led by their values.
However, this can only be achieved if the issues are properly understood, taking personal intentional and collective action.
Cheryl Samuels is people director, Evelina London Women’s & Children’s Clinical Group
