University Hospitals Birmingham NHS Foundation Trust

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Report on the NHS Workforce Race Equality Standard (2017)

1. Purpose of report

The report sets out University Hospitals Birmingham NHS Foundation Trust’s performance information against the nine mandatory NHS Workforce Race Equality Standard (WRES) metrics. The metrics cover the workforce profile, staff survey, and board composition by ethnicity. The report also details the calculations and analyses the results against each metric, with recommendations for improvements where appropriate. The report is due to be published in August 2017, in line with the NHS England mandate.

2. Background

The 2016/17 NHS Standard Contract included a new Workforce Race Equality Standard which requires large health care providers and CCGs to demonstrate progress against nine workforce race equality metrics, including a specific indicator which looks at the ethnic composition of boards.

2.1 The nine metrics

NHS England has produced technical guidance for the NHS Workforce Race Equality Standard, detailing the requirements and how organisations should report their information against the metrics.

Baseline data has been produced for each metric together with an analysis of the results. The data for metrics 5–8 is based on the results of the 2016 NHS Staff Survey.

3. Matters for consideration

3.1 Summary of UHB's results against each metric

Workforce indicators

For each of these four workforce indicators, the standard compares the metrics for white and BME staff.

1. Percentage of staff in each of the Agenda for Change (AoC) bands 1–9 and VS (including executive board members) compared with the percentage of staff in the overall workforce

29.23% BME staff in workforce overall.

Non-clinical staff
 Reporting year
WhiteBME
Below Band 1 0
Band 1 349 177
Band 2 321 101
Band 3 322 90
Band 4 419 100
Band 5 178 47
Band 6 119 33
Band 7 111 40
Band 8a 47 12
Band 8b 47 2
Band 8c 27 3
Band 8d 15 0
Band 9 0 0
 
 Previous year
WhiteBME
Below Band 1 0
Band 1 355 185
Band 2 327 83
Band 3 306 89
Band 4 408 78
Band 5 165 41
Band 6 102 31
Band 7 111 43
Band 8a 48 14
Band 8b 43 2
Band 8c 23 2
Band 8d 5 0
Band 9 0 0

 
Clinical staff
 Reporting year
WhiteBME
Band 1 0
Band 2 694 318
Band 3 244 82
Band 4 64 20
Band 5 1074 617
Band 6 820 281
Band 7 605 102
Band 8a 150 35
Band 8b 60 10
Band 8c 20
Band 8d 9
Band 9 2 0

 

 Previous year
WhiteBME
Band 1 0
Band 2 672 277
Band 3 312 107
Band 4 63 14
Band 5 1060 620
Band 6 806 281
Band 7 591 94
Band 8a 133 22
Band 8b 62 10
Band 8c 20 0
Band 8d 11 0
Band 9 2 0

 

 Reporting yearPrevious year
VSM 12 0 12 0
Workforce 6296 2677 6295 2515

The total percentage of BME staff in the workforce has increased this year from 27.9% to 29.23%.

However, we note a difference in the percentage of BME and white staff at different banding levels. BME staff are more represented in the lower bands.

However, at clinical bands 5–7 there is a higher representation of BME staff. We will endeavour to create career pathways to aid clinical staff to move into higher banded management posts in future years.

It should be noted that the Trust has a very stable management structure at senior level which leads to few opportunities becoming available for staff to progress to higher grades.

The Trust has developed a middle management leadership programme at 8a and b which will be extended to levels 6 and 7 to ensure that all staff at these grades are given the opportunity to progress to the higher level 8 grades over time.

2. Relative likelihood of BME staff being appointed from shortlisting compared to that of white staff being appointed from shortlisting, across all posts
Data for reporting yearData for previous year
1.76 1.90

The data used is from April 2016 – March 2017.

Data for the previous year was recorded differently and we must exercise caution in comparison. Next year’s WRES will give us comparative data in order to make clear comparisons.

We have cautioned against a direct comparison. Improvement may be attributable to inclusion training, and in particular unconscious bias training, but it is too early to claim a direct correlation.

Action

We will make unconscious bias training mandatory for all managers involved in interviewing with the target in year one of at least one member of the panel being trained and able to challenge unconscious bias where applicable.

3. Relative likelihood of BME staff entering the formal disciplinary process, compared to that of white staff, as measured by entry into a formal disciplinary investigation

Note: this indicator is based on data from a two year rolling average of the current year and the previous year.

Data for reporting yearData for previous year
1.52 1.76

This year has seen a decrease to 1.52 times more likely. This decrease follows a further decrease from 1.96 in 2014/2015.

This improvement may be due to the inclusion of unconscious bias training in all of our inclusion training, and a specific three hour long session for senior managers on unconscious bias. The focus of the training specifically challenges managers to reflect on their unconscious bias with regard to initiating formal process for their staff and in their recruitment.

Action

Continue to roll out inclusion and unconscious bias training for managers, and consider making this training mandatory for investigating managers.

Add bespoke targeted HR training where ‘hotspots’ are noticed across all workforce metrics.

4. Relative likelihood of BME staff accessing non-mandatory training and CPD, as compared to white staff
Data for reporting yearData for previous year
0.98 0.97

The relative likelihood of BME staff accessing non-mandatory training compared to white staff is 0.98, indicating the likelihood is very similar for both groups. The likelihood has also remained static over the past year.

All staff have access to non-mandatory training, which is promoted via the internal intranet site and through management communication channels. In particular, annual appraisals identify training needs resulting in training uptake through an agreed personal development plan. Additionally, staff can access, independently of their manager, training via the me@QEHB portal.

Our staff survey result of 4.11 (out of 5.0) indicates the quality of our non-mandatory training is highly rated by staff.

Mandatory and non-mandatory training is seen as key to staff performance and ability to do their job. As such there is significant emphasis on training and development across all staff groups.

National NHS staff survey findings

For each of these four staff survey indicators, the standard compares the metrics for the responses for white and BME staff for each survey question.

5. (Q15a) Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or the public in the last 12 months
 Data for reporting yearData for previous year
White 23.20% 23.13%
BME 22.02% 17.44

This year we have noted a 5% increase in BME staff reporting that they have experienced harassment, bullying or abuse from patients, relatives or the public in the last 12 months. Last year’s WRES also showed a 5% increase

The percentage of white staff reporting has stayed static, although is at a higher level than that of BME staff.

We have seen an increase in patients presenting with mental health issues and those with no right recourse to public funds. With both groups we have seen an increase in violent and aggression.

We have noticed an increase in reporting of verbal abuse asking staff “when are you going home?”. This typically comes from an older generation. The Trust has robustly supported staff with clear messages from the CEO, and a reiteration of our intolerance of the bullying and harassment of our staff.

The 2016 NHS staff survey reported the average for acute Trust staff experiencing bullying, harassment and abuse is 27%. Despite being lower than the national average, this increase in abuse of BME staff indicates an area for concern.

The Trust has recently introduced flexible visiting and published a Visitor Charter. This charter makes explicit reference to violence and aggression and what our expectations are of visitors. Importantly, the charter also makes clear what visitors can expect from staff.

The Trust’s online Datix reporting system is a ‘live’ system that enables immediate reporting. Daily summaries of violence, aggression and harassment reported by staff, whether from colleagues or patients/visitors, is circulated to a key group (including the Head of Inclusion Engagement and Wellbeing) at 08:00 every morning enabling immediate responses/intervention to issues raised.

Action

Conflict resolution training will, in future, contain increased content, definition and description of what constitutes bullying and harassment and will encourage reporting.

6. (KF 26) Percentage of staff experiencing harassment, bullying or abuse from staff in the last 12 months
 Data for reporting yearData for previous year
White 21.29% 25%
BME 27.88% 23.26%

This year we have seen a 4% decrease in the percentage of white staff experiencing harassment, bullying and abuse from other staff, compared to a 5% increase in the percentage of BME staff. This means the difference between white and BME staff experiencing harassment and abuse from other staff has increased.

When at work, staff should be free from abuse, harassment, bullying and violence from any source. At UHB, we encourage staff to report immediately any behaviour that falls into these categories (see Datix entry above and conflict resolution training).

We also have a Freedom to Speak Up Guardian (FTSUG), who is there to support staff who wish to raise a concern or report any inappropriate behaviour if necessary. This role is shared with the Head of Inclusion and Engagement and Wellbeing, and the Lead Nurse for Quality and Clinical Standards, to ensure organisational awareness of issues raised.

Action
7. (KF 21) Percentage believing that the Trust provides equal opportunities for career progression or promotion
 Data for reporting yearData for previous year
White 89.10% 91.40%
BME 75.62% 79.66%

The percentage of both BME and White staff believing the trust provides equal opportunities has reduced slightly for both groups, with the percentage of white staff agreeing decreasing by 2%, compared to a 4% decrease among BME staff.

The 2016 staff survey Trust average was 86%, compared to a national average of 87%. This indicates we are at the average for acute trusts.

The Trust ensures strong support for Black History Month, with the CEO launching the month. This year, we focused on the experiences and achievement of our own staff with screensavers and poster exhibitions of their lives, both in the NHS and outside, in their own words. We were keen to make the connection to people who others could meet and speak to, rather than historical or national figures where there would inevitably be a degree of detachment.

8. (Q17b) Percentage of staff reporting having personally experienced discrimination at work from a manager, team leader or other colleagues
 Data for reporting yearData for previous year
White 6.06% 6.35%
BME 14.49% 12.50%

The percentage of white staff experiencing discrimination from managers and colleagues has remained stationary this year, while the percentage of BME increased slightly by 2%.

The percentage of BME staff experiencing discrimination from managers and colleagues is 2.5 times greater than that of white staff.

Action

In addition to the establishment of a BME network we will arrange a number of confidential ‘listening events’ for staff, to hear directly what issues staff are experiencing. We will robustly follow up issues raised so that staff can be confident in raising their concerns.

Boards

Whether the board meet the requirements on board membership, as per indicator 9.

9. Percentage difference between the Trust’s board voting membership and its overall workforce
Reporting year
 EthnicityTotalPercentage
Total White 16 94.1%
BME 1 5.9%
Voting White 7 100%
BME 0 0%
Non-exec White 6 85.7%
BME 1 14.3%
Overall workforce White 6296 68.7%
BME 2677 29.2%
Previous year
 EthnicityTotalPercentage
Total White 16 94.1%
BME 1 5.9%
Voting White 7 100%
BME 0 0%
Non-exec White 6 85.7%
BME 1 14.3%
Overall workforce White 6295 71.5%
BME 2515 28.5%

Our board has remained stable over the past five years, with our percentage of white membership staying at 94.1% compared to 5.9% BME.

One new appointment to the board has been made in the past five years. We are aware that the current board is not representative of the ethnicity of the local population we serve. However, a stable board has been noted as a positive factor for supporting neighbouring trusts in the local health economy.

It is worth noting that managers immediately below board level are a more diverse group of people, providing representation and sitting in the pipeline as future board members.

3.2 Recommendations identified to support the Trust's performance against the metrics, where gaps have been identified between white and BME staff

Recommendation 1: Extension of middle management leadership programme to bands 6 and 7
Recommendation 2: Continue to address unconscious bias, making unconscious bias training mandatory for all recruiting managers
Recommendation 3: Address bullying and harassment within the Trust
Recommendation 4: Establish a BME staff network

4. Implications (including financial, consultation, equalities, HR and legal)

The WRES has implications under the Equality Act 2010, and supports the Trust to undertake its obligations under the public sector equality duty. The WRES is a mandatory requirement under the NHS standard contract.

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