Recommendation 25

HM Government Not Addressed

In response to your request for a comprehensive definition of the racism and discrimination that we are seeking to eradicate from the NHS, our approach is aligned to the respective definitions in the Race Relations Act 1976 and Equalities Act 2010. (I attach at Annex A the legal definitions of discrimination and racism which we align to from the Equalities Act 2010 and the Race Relations Act 1976 respectively.) Our work to address racism and discrimination is multi-faceted and covers the following areas: The Workforce Race Equality Standard (WRES) The WRES was launched in 2015 provided data and evidence on the disparities in experience between black and minority ethnic staff and their white colleagues. The need to ensure BAME staff are treated fairly and their talents valued and developed is one that all NHS organisations need to meet. The WRES remains the NHS’s primary tool in highlighting disparity of opportunity and experience for ethnic minority staff in the NHS. The WRES draws data to assess the relative experiences of white and BAME staff against nine indicators relating to disparities of opportunity, experience, and representation in the workplace. The WRES has been embedded within the NHS standard contract, CCG assurance framework and within the CQC ‘well-led’ domain inspections of hospitals. We are currently finalising the WRES 2020 report, that will set the context for how we entered the pandemic. We also intend to publish a Medical WRES for the first time, as we look to delve deeper into the issues facing BAME staff in particular professions. The Medical WRES will include consideration of the pay gap, revalidation, complaints and differential attainment. Action on race To tackle some of the specific issues highlighted by the WRES since 2015, in July 2020 NHSE/I set out clear actions that employers should take to address ethnic disparities in their workforce including: • An overhaul of recruitment and promotion practices to make sure that their workforce reflects the diversity of their community, regional and national labour markets. • Publication of progress against the Model Employer goals to ensure that at every level, the workforce is representative of the overall BAME workforce • Closure of the ethnicity gap in entry to formal disciplinary processes. • Reviewing their governance arrangements to ensure that staff networks are able to contribute to and inform decision-making processes. • CQC will place increasing emphasis on whether organisations have made real and measurable progress on equality, diversity and inclusion We Are The NHS: People Plan 2020/21 – Action for us all sets out our priorities and describes the issues we are committed to addressing. We have asked employers to take action against the following areas: • Recruitment and promotion practices • Health and wellbeing conversations • Leadership diversity • Tackling the disciplinary gap • Governance • Accountability • Regulation and oversight • Building confidence to speak up Further detail on each of these actions can be found Annex B. As an example of the work we are undertaking, I enclose the London Workforce Race Strategy (Annex C) which is helping to drive a step change in improving the experiences of our Black, Asian and minority ethnic (BAME) colleagues and make the NHS a more inclusive, fair and equitable place to work. Key recommendations from the strategy are as follows: Recommendation 4: Increase BME representation among Freedom to Speak Up Guardians and champions and ensure support is available across the system, including within primary care Recommendation 7: Work with the Care Quality Commission to develop specific race related key lines of enquiry for inspections Recommendation 13: Identify and close the gap in experience for agency, bank and temporary staff NHS Race and Health Observatory In addition to the above, the NHS Race and Health Observatory, launched this year, supports work in these areas with the following key functions: (i) catalyse and facilitate high-quality and innovative research evidence; (ii) make strategic policy recommendations for change; and (iii) help facilitate practical implementation of those recommendations. Work to improve the experience of BAME staff in the NHS COVID-19 further served to underline the differences in the experience of BAME staff. We acted quickly to launch a comprehensive programme to address the impact of COVID-19 on our BAME workforce with five streams of work: (1) Protection of staff, (2) Rehab and recovery, (3) Communications, (4) Staff networks and (5) Representation in decision making. As part of this response, legal obligation for every NHS organisation was set out, specifying the need to manage the health and safety of their employees. NHSE/I sent a clear instruction to all NHS organisations on 29 April 2020 to risk assess staff at potentially greater risk. This was in advance of the Public Health England (PHE) report commissioned by Department of Health and Socia