Hunter Healthcare were proud to attend the Acute and General Medicine Conference this year at London’s ExCeL Centre. The Acute and General Medicine Conference is regarded as the ‘largest annual conference and exhibition involved in emergency, acute and advanced internal medicine’. Isobel Harrop (Medical) and I (Jackson Wilson, Governance, Quality and Nursing) were there, representing Hunter. We had a great time speaking with doctors and nurses from different specialties across the country about their experiences and the issues that are affecting them at the moment.
We were also fortunate to be in sight of Theatre E and so, in between conversations, we managed to catch some of the fascinating lectures that had been going on throughout the conference. Two of the lectures that we found particularly powerful were “Women Empowering Women in Medicine” presented by Dr. Sarb Clare, Deputy Medical Director of Sandwell and West Birmingham, and “Unconscious Bias, Bullying & Behaviour Change” by Scarlett McNally, a Consultant Orthopaedic Surgeon at East Sussex.
While they were on separate topics they both spoke of issues that we hear about every day, and (based on the packed crowds they drew) issues that doctors and nurses know all too well. What was particularly impactful was how both lectures highlighted that these are systemic issues, with no one individual to blame, while also emphasising the individual cost of discrimination and what we, as individuals, can do about it. Dr. Clare gave pragmatic advice on how women can support the women they work with, while Ms. McNally asked us to question our own preconceptions and biases, even those we may not be aware we have.
At Hunter, we speak with individuals across the NHS, so we know the difficulties that people often face and it was incredibly moving to see these issues being talked about so openly. We also know how difficult it can be to implement lasting behavioural and cultural change. It takes the right people being in the right place at the right time. We understand this and we are proud of the work we have done to support this. Most recently we sponsored Colourful Healthcare and the Seacole Group’s Hidden Gem awards, celebrating NHS staff from diverse racial backgrounds, and we supported Lancashire Teaching Hospitals with the placement of the NHS’s first ever Filipino Chief Nurse.
In the current climate, now more than ever it is important to remember how much value diversity of thought and background can bring especially within the healthcare sector. Dr. Clare and Ms. McNally’s impactful lectures emphasized the collective responsibility to combat discrimination, providing valuable insights into fostering a more inclusive healthcare environment. As we continue our commitment to supporting positive change, we are reminded of the vital role diversity plays in enhancing the healthcare sector, and we remain dedicated to championing inclusivity and supporting organisations to address the challenges within the sector.
If you or your organisation would like to have a conversation about how we might be able to support you, please don’t hesitate to get in touch.
Following a recommendation from Yvonne Coghill, The University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) came to us with a dilemma: they had a significant amount of diversity within their Nursing workforce in particular, and no Black or Minority Ethnic representation on their Executive Board. The NHS set a target to increase the representation of Black Minority Ethnic staff in senior leadership roles to 20% by 2021.
The population of Morecambe Bay is considerably less ethnically diverse than the population of England. Black and Minority Ethnic groups account for only 5% of the resident population (including white non-British). Nevertheless, recent WRES data shows that at UHMBT, 40% of nurses up to Band 5 and 12% up to band 7, are Black or Minority Ethnic. However, there were only two BME senior nurses who had reached band 8a. Upon speaking with the Head of Inclusion and Engagement at UHMBT, it was also clear that some staff were experiencing racism from their colleagues. Therefore, alongside campaigns such as UHMBT’s Anti Racist Nursing Leadership Programme, it was important to the Trust that their next Executive Chief Nurse (ECN) would not only champion diversity, but tackle racism and commit to their Equality, Diversity and Inclusion (EDI) programmes.
To increase diversity at Board level, we recognise that the support must be in place for Nursing leaders to take the leap, into territory where they may feel underrepresented. We undertook the following steps to encourage an inclusive recruitment process, which would be attractive not just to current ECN’s, but also experienced deputies:
- Mentoring: we spoke with Nursing leaders at ICB level to agree a two-year wrap around mentoring programme for the joining ECN, to encourage those with less experience to apply.
- Intentional and proactive in our efforts: Hunter’s collaborative research with The Seacole Group, ‘The Way Forward’, indicated that only 14% of respondents found out about their role through traditional advertisement. We engaged with Nursing leaders through diversity networks, following recommendations, and those we knew had not been appointed at other recent shortlisting events, which can discourage individuals from applying for similar opportunities.
- Inclusive language: recruitment materials made specific reference to tackling inequalities in the Trust and the community. This made it clear that UHMBT recognises that having representation of the workforce at the top allows for a wider range of perspectives, more creative and innovative solutions to challenges, improves employee morale and reduces turnover.
- Feedback: If candidates were not interested in the opportunity, we asked them what would need to be different to encourage them to apply. If we could see a reasonable pathway to accommodate these changes, we challenged UHMBT to do so.
- Knowledge building: candidates valued the opportunity to speak to their potential future Board colleagues informally, whilst Hunter gave them insight on how their skills and perspective might enable them to add value to UHMBT and the Board.
- Support and assistance: candidates need to be able to draw on the advice, guidance, and support on the recruitment team during what can be a difficult and unfamiliar process. This included interview preparation and writing advice, particularly if English was a second language or they had not undergone a formal interview process for some time.
- EDI focused stakeholder session: to ensure the appointed candidate would be an accountable champion for the Nursing workforce, the candidates chaired their own stakeholder sessions, including one with a panel consisting of the Inclusion and Engagement leaders at UHMBT.
Following a competitive shortlisting process, UHMBT has welcomed Tabetha Darmon as their next ECN, who was the Interim Executive Director of Nursing at Nottinghamshire Healthcare NHS Foundation Trust. Tabetha is part of the NHS BAME Leadership network and has a commitment to being both the patient and clinician ‘voice’. She is a graduate from the Nye Bevan Leadership Programme and has over 15 years of experience in Nursing leadership.
Market conditions have changed and certain areas of how we conduct business that we previously had confidence in have been exposed, such as the ongoing strength of certain client relationships and our own live market knowledge.
One issue that continually comes up is the time it takes to be an effective NED in the NHS. Our clients rightly ask us to find the best possible candidates for their NED roles and on their behalf we speak to everyone we think could add value to an NHS board. We are always delighted to hear how enthusiastic people are about the opportunity to contribute their talents to the NHS. However, when we mention the time commitment required, conversations are reluctantly cut short as potential candidates struggle to see how they can fit this into their already busy lives, which might include working full time and/or caring responsibilities.
So, we decided to explore this issue further; not only because it was in our interests as a search company, but also to support the NHS as a client and valued public service. Our objectives were simple. We wanted to:
- Understand what the NHS is asking its NEDs to do and why it takes longer to be a NED in the NHS than it does in any other area of life.
- Make sure that those who determine the time commitment for NEDs appreciate the impact of asking for more and more of their time.
- Share the great work some chairs are already doing to reduce the time commitment of their NEDs and focus their energies where they add most value
We think this report achieves our objectives. It sets out what we learned from conversations with more than 50 chairs of NHS trusts and foundation trusts, as well as 30 responses to our online questionnaire. It highlights the problem and challenges the NHS to do something about it. Perhaps more importantly, it provides practical support and advice to chairs to enable them to make changes for their boards, both now and in the future.
As we prepare to go to print, the NHS Confederation has just released its report Chairs and non-executives in the NHS: The need for diverse leadership. It highlights the need for the NHS to take steps to improve the diversity of its leadership of and makes a number of recommendations. This report will, we hope, support this process.
We want to express our thanks to all of the chairs who gave their time to this project. Some of them have generously agreed to be quoted and their remarks can be found throughout this report.
Hunter Healthcare is not a campaigning organisation. Having done this work we leave it to others to drive forward change, but if we can provide any support to you or your healthcare organisation please do get in touch with our team.