The Ward Round: National bodies must walk the walk on race

Staffing is the issue keeping NHS leaders awake at night — and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter ensures you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. This week’s edition is by workforce correspondent Nick Kituno

If the NHS is to continue eliminating the workplace discrimination its ethnic minority staff experience, then national bodies should continue to lead from the front.

While local trusts have made strides according to the NHS workforce race equality standard, which monitors progress against several metrics published annually, less is known about national bodies’ commitments in recent years.

The third edition of the WRES was published for 11 arm’s-length bodies in September 2020, released at a time when the country was still deep in the throes of covid-19.

It provided a useful snapshot into the state of play at NHS England and other national authorities, but its findings illustrated a slow rate of progress.

“For the majority, there has been very little significant improvement on the WRES indicators from the previous year,” the report said. Only three ALBs had any very senior managers from an ethnic minority background.

Public Health England, which was dissolved last year, was the only organisation to increase its executive board members from ethnic minority backgrounds.

A little over half a dozen had none, with PHE and NHS Blood and Transplant being the only exceptions.

This is all-important context for two reasons.

First, there has not been another WRES report for two years. The Ward Round has heard the next edition is “due soon,” but “soon” could mean anything and that therefore leaves the 2020 report as the last one.

Some would point to the context of a global pandemic.

The immediate counter is this has not stopped the WRES – and the workforce disability equality standard, which monitors the workplace experiences of disabled NHS staff – being published at trust level during this time.

Also keep in mind that national organisations were not obliged to submit their data for the WRES, which deserves its own conversation.

It also questions how committed these organisations are to this agenda. The whole point of the WRES is to hold leaders accountable for improving the experiences of their ethnic minority workforces – and the key to this is transparency.

If it is not necessary, are white applicants still 1.6 times more likely to be appointed from a shortlist than those from ethnic minority backgrounds, a metric that has barely shifted in the last few years?

Trusts are told they must do better, but ALBs have not always held themselves to the same standard. Why not?

According to the last report, most did not submit their staff survey data, which was required to measure against some of the WRES indicators.

For those that did, the proportion of staff that believed they had equal opportunities was “low and significantly worse than the NHS trust average”.

No wonder trust leaders become frustrated when they are told to submit their WRES data each year, but those above them are not compelled to do the same.

This is what risks holding progress back, as those who are committed to improvement may become disillusioned, while others who were less so might feel vindicated.

Unless you were savvy enough to wade through pages upon pages of board papers, know where to look, and what for, you could easily take what these bodies say about what they are doing at face value.

That can be dangerous and mean the public is oblivious to the actual experiences of ethnic minority staff.

As the 2020 WRES report said: “Local NHS organisations are being supported to set improvement targets. ALBs should consider doing the same.”

Winter is coming

Leaders are bracing themselves as Unison, one of the country’s largest unions, has asked its members to vote for strike action over pay this winter.

The government is taking a hard line for now, while shadow health and social care secretary, Wes Streeting, isn’t sounding overly sympathetic either.

At a New Statesman event this morning, he was asked whether industrial action was the “right call”.

He said: “It’s certainly not in the interests of patients or the NHS, which is going through the biggest crisis in its history.”

Mr Streeting said he would not condemn staff for choosing to, but rather focused on why they were considering strike action, adding many likely felt like their “backs are against the wall”.