The NHS is the UK’s largest employer, employing 1.3m people across the health service. So when it comes to addressing issues such as racism and company culture, there are few places where more can be learned than from within our health service.
Countless reports have shown that problematic cultures within the NHS are reinforced by intrinsically hierarchical systems, statistical evidence of gender imbalance, and inappropriate behaviour against multiple marginalised communities across the service.
To create a more inclusive culture, the NHS, much like all organisations, need to take a multi-pronged approach to supporting their employees. As we’ve previously discussed, short term interventions are not the solution to creating long term change.
This is something that the NHS Improvement team have captured well in their 10-point guidance on addressing racism.
However, for these to be effective the NHS needs to truly understand the issues faced by their Black employees, as well as ensure consistent feedback and consultation among Black employees.
The key to this is trust. Here are a couple of considerations for managers within the NHS to consider when trying to build trust amongst their employees to encourage a speak up culture around Racism, and effectively execute the 10-steps already prescribed.
Don’t buy your training off the shelf
Training is important because it’s a way to educate your employees on important topics, and also show them what is and what is not acceptable behaviour. Anti-racism training can help to achieve this, however to gain maximum impact and to demonstrate to your Black employees that it is not just a tick box exercise, the training needs to be specific.
A standard training programme is a good step forward, however it may miss the nuances and misunderstand specific manifestations of racism within the NHS.
It is important that your Black employees are consulted in advance, to ensure that the training is true to their experiences, and tackles the actual issues faced by Black employees within the NHS. This can demonstrate that the intention is to create real change, and not just appease the cries for equality seen throughout the NHS.
It is important to gauge whether this should be carried out by an internal or external team. If a lack of trust is an issue, then employees may feel more comfortable sharing their experiences with an external agency.
If you have members of your team internally who have shared experiences and are correctly trained to discuss Race with victims of racism, then you can carry this work out yourself. The key is understanding what will make your employees feel comfortable, so that you can get honest and impactful feedback.
Anonymity here is also important. The size of your research group needs to be large enough that the information shared is not identifiable to one person or group. This can be hospital wide, Trust wide or bigger, depending on the number of Black employees within those groups.
You can gather this information through interviews, questionnaires, or over time using an anonymous reporting tool that gathers and aggregates data on specific incidences across your institution.
Remove localised challenges by offering consistency
Once you’re aware of the issues at hand, and you have developed an effective training and education programme, you need to take meaningful action.
Of course, if an issue can be managed at a local level, that is ideal. In the best case, you will be able to train your senior leaders to handle issues of racism effectively and fairly, where all parties feel the situation has been remediated.
However building that level of trust throughout every team is challenging, and there are a lot of factors outside of your control. Is the leadership team sympathetic towards victims of racism? Is your leadership literate in coping with minority stress? Is the individual confident enough to speak up directly to those in charge?
Some areas of the NHS will have a bigger problem with racism than others. Some teams may find it harder to speak up about racism and other harassment issues than others.
Creating a consistent process of speaking up can help to remove these individual barriers, but only if that process is clear, simple, and reliable.
Your case management system needs to be easy to access, it needs to avoid unnecessary bureaucracy and have a swift and clearly communicated resolution timeline.
Alongside the existing plan to ensure that employees can have ‘difficult conversations about racism without fear of repercussions’ this can help victims of racism know that they are able to speak up about racism and have their concerns logged and action taken swiftly.
The key is effective 2-way communication
For people to speak up about Racism within their hospital, ward or Trust, they need to feel confident that something will be done to address the issue, and that this will be done without having an impact on their career or safety at work.
To achieve this the voices of Black employees need to be centred at every stage of strategic planning and execution. You need to offer avenues for employees to communicate with you. Whether that be through internal or externally facilitated routes, or anonymously or named.
How you encourage and motivate feedback needs consideration and variety to tailor to the broad range of employees within your community.
Equally, how you communicate back to employees is important. Showing the impact of their input is key to encouraging ongoing engagement. Showing the value of employee contributions can build a level of appreciation, and therefore trust.
Ultimately, your employees need to be shown that changes that are being made have been done so with their needs, their feelings, and their best interests in mind. Ensuring that top down changes are supported at a local level, and maintained by local authoritative figures is fundamental. If there is any part of the process or plan that isn’t working, the means to speak up about that needs to be available too.
If you believe that your team could benefit from an anonymous platform to speak up about their experience of racism, we’d love to talk. Our product might offer you the tool you need to give your employees a trusted place to share their stories, so you can take meaningful action.