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Diversity and inclusion needs to be embedded in all NHS leaders, according to a major review as another report finds endemic racism in the health service.
More action is needed to embed inclusive leadership practice in all NHS leaders rather than being solely the province of diversity and inclusion experts and existing measures to improve equal opportunities and fairness need to be better enforced, according to a major review.
The review into health and social care leadership by General Sir Gordon Messenger and Dame Linda Pollard found evidence of poor behaviours and attitudes such as discrimination, bullying and blame cultures in certain parts of the health and social care system and identified a lack of equal opportunity for managers to access training and colleagues to progress in their careers, with those who have existing networks or contacts more likely to access these opportunities.
In addition to action on embedding diversity and inclusion in all leaders, it also called for the role of the Care Quality Commission’s role to be enhanced to boost diversity and inclusion outcomes.
The news comes as another report from the Royal College of Nursing [RCN] found racism is endemic in health and care with White nurses twice as likely to get promoted as Black and Asian staff.
The RCN UK-wide survey of almost 10,000 nursing staff found that White respondents and those of mixed ethnic background across all age groups were more likely than Black and Asian colleagues to have received at least one promotion since starting their nursing career.
It says the difference appears most stark among those aged 35 to 44. While 66% of White and 64% of respondents from mixed ethnic backgrounds in this age group said they had been promoted, this dropped to just 38% of Asian and 35% of Black respondents.
The report also found that Black respondents working in both hospital (39%) and community (32%) settings are more likely to report having experienced physical abuse than respondents of other ethnic backgrounds.
The RCN wants to see health and care organisations, regulatory bodies and inspectorates being required to tackle racism, including in the workplace. It says this could include a legal requirement to eliminate disparities in recruitment, retention, and career progression or a greater responsibility for employers to protect minority ethnic groups from racism in all its forms.
It also wants the Covid-19 inquiry to get to the bottom of why a high number of ethnic minority nurses died during pandemic, including any structural reasons.
The Messenger Pollar review covers several other areas of NHS leadership. For example, it calls for new career and talent management function for managers, including the creation of a new function at regional level to address a lack of clarity and structure in NHS management careers, providing clear routes to progression and promotion and ensuring a strong pipeline of future talent.
There are five other recommendations, including a call for targeted interventions on collaborative leadership and a unified set of values across health and social care, including a new, national entry-level induction for all who join health and social care and a new, national mid-career programme for managers across health and social care. Other recommendations covered training for more consistent management standards, a more simplified appraisal system, more effective recruitment and development of non-executive directors and more support and incentives to attract people into areas of the NHS with high vacancy levels.
Leeds Teaching Hospitals Trust Chair Dame Linda Pollard said: “Today’s report is about empowering you to be the best version of yourselves – to work to the best of your abilities, have the tools to develop your careers and support each other and to create an equal opportunities workplace of which we can all be proud.”
Matthew Taylor, Chief Executive of the NHS Confederation, said: “The report acknowledges that we have much more to do to create a more diverse leadership in the NHS. We can’t hide from the fact that all too often staff from ethnic minority backgrounds are still not being provided with the support they need to progress to leadership roles. We need to move beyond admiring the problem and make concrete progress in addressing it.”
Publication of the report, described as the most far-reaching review of health and social care leadership in 40 years, will be followed by a delivery plan with clear timelines on implementing agreed recommendations.