Written by Penny Dash, Chair of NHS North West London and Rob Hurd, Chief Executive.
North West London is a diverse and vibrant community: it is only right that our health and care organisations strive to set an example in tackling the long-standing challenges, and missed opportunities faced by our staff from ethnically diverse communities. Our message to our staff and the residents we serve is clear: we will work with you to make things better.
There are over 66,000 staff working across the NHS in north west London and of these, just over 54% come from a global majority background. However, this is not represented at senior leadership levels.
While 72% of our staff at Band 2 are from a global majority, this has fallen to 46% by Band 7 and just 18% for very senior managers (see table below). Our aspiration is to get to 50% of all staff above Band 7 from a global majority background by the end of March 2025. It is currently 43.5%. In April 2022, it was below 39%.
We recognise that diversity in our senior staff will strengthen the breadth of thinking and approaches across organisations, enhance our ability to effectively engage with all of our communities and be a further catalyst in accelerating our work to reduce health inequalities.
These issues face all organisations in the north west London health and care system. Within the ICB, we have put in place a range of measures to improve equality, diversity and inclusion and de-bias its recruitment processes.
- Every interview panel at every level of the ICB now includes a trained inclusion partner drawn from our staff, with a specific remit to challenge and raise awareness of any potential bias – and inclusion partners have fed back that this has been a positive experience.
- We have put in place an organisation-wide Equality, Diversity and Inclusion strategy, to drive and monitor progress towards an organisation where everyone is not just treated fairly, but feels they are treated fairly.
- We have developed a Black Women’s empowerment programme to support career progression for this group of staff who have been under-represented in senior positions.
- We have increased global majority representation of residents among our non-executive directors.
- An Equality Impact Assessment of our recent ICB staff re-organisation found that the representation of global majority staff at senior level had increased.
We are continuing to work system wide with a number of approaches agreed across our partners and co-produced with our staff following our North West London Equality, Diversity and Inclusion summit that we held in June last year: These include:
- More comprehensive assurance that best practice de--biased recruitment and progression processes are comprehensively and consistently in place across all organisations in the local NHS.
- A more comprehensive and consistent collective cultural competence framework with anti-racism principles and outcomes supported by a cultural competency skills delivery programme in place across all local NHS NW London organisations
- A senior leader programme for potential heads of department and directors, to accelerate career progression for mid-level global majority staff to senior positions.
A variety of initiatives have been put in place by individual NHS Trusts – these can be found on their websites – links to the pages are below.
Across the wider system, our eight local authorities, who employ over 29,000 staff, recognise they face similar challenges and opportunities.
Our NHS and local authority partners are working with us as part of a joint Race Equality Steering Group and a jointly chaired Health Equity Board, which looks at tackling health inequalities across North West London. We hope that by working together we can balance scaling what works with the need for local ownership of initiatives to have impact.
Our Health and Social Care Skills Academy has been set up to raise awareness of NHS and social care roles, create job opportunities with employer partners and design training and skills programmes with education partners. We are also investing national funding towards targeted work with people from our more excluded communities, to help them apply for entry-level jobs and prepare for interviews – or to gain experience as volunteers in health and care settings.
The Barriers to Leadership study supports our wider work undertaken over the last two years. The study sought to understand better the lived experience of ethnically diverse staff to help us progress further and faster as we continuously learn and improve the impact of the actions that we are taking. This work was commissioned by NHS North West London and carried out by Turning Tables, a not-for-profit organisation. There were three phases to the report: a quantitative study of the workforce data across the ICS, qualitative analysis through listening circles and one-to-one interviews and written responses looking into individual lived experience behind the data. Participants included 250 staff, 195 from NHS bodies across NW London and 95 from the 8 local authorities in the sector. 110 attended listening circles (60 NHS, 50 local authority), 40 senior leaders were interviewed (28 NHS, 12 local authority) and a request for written feedback, aimed at ethnically diverse staff across health and care who did not want to attend listening circles, received 100 responses.
The report highlights concerns about opportunities for training and development, mentoring and feedback from interviews. Participants shared experience of perceived bias and favouritism as well as fears of being of racially stereotyped. You can read the report here and watch the accompanying video here.
We want to sincerely thank all staff who took part in the study: we salute your courage in raising these issues and sharing your experiences. While we know that the challenges set out in the report are not unique to our organisations or indeed the health and care sector, they underline the importance of the work we are doing in North West London to improve and de-bias our recruitment and selection processes and create a just and inclusive staffing culture.
An action plan to address this report collectively is being developed and will be published shortly. This will supplement the work already underway across all NHS organisations and local councils across North West London.