Posted on: 9 February 2024
Dear Colleagues
West Yorkshire Health and Care Partnership prides itself on the diversity of our workforce and richness of all communities that form our area.
We value the unique perspective of everyone and how diversity in its widest sense continues to support our aspiration that West Yorkshire is a place where everyone can fulfil their potential and thrive. To make this a reality we cannot lose sight of the impact of racial trauma within our communities.
A timely reminder of this is the latest report, ‘Too hot to handle’ from BRAP published this week (5 February 2024) which explores the impact of racism within the NHS.
The report findings
This report brings together learning from various significant tribunal cases and responses from 1,327 people who answered the BRAP survey.
All relaying their experiences of raising allegations of racism within their respective organisations across the NHS.
The report highlighted the following.
- UK trained staff are much more likely than internationally trained staff to raise concerns. 71.0% of UK trained staff have highlighted race discrimination as an issue, compared with 53.1% of internationally trained staff.
- Survey respondents said the most common reason for not raising a concern of race discrimination was not believing anything would change (75.7%). In addition, 63.5% of people who did not raise their concerns were worried about being seen as a troublemaker.
- The survey found, of those staff who did raise concerns, only around 1 in 20 ( 5.4%) said they were taken seriously and that their concern was dealt satisfactorily.
- The most common outcome to a race discrimination concern was nothing happening (the outcome in 42.7% of cases).
- In around one in five instances (19.1%), claims of race discrimination were treated the same as any other workplace dispute and referred to mediation.
- One in 20 (5.0%) cases led to the person raising the concern themselves being disciplined.
- 41.8% of respondents left their jobs because of their treatment.
Survey findings also show that ethnically diverse staff face common responses when raising concerns about race equality.
These include:
- Denial: in many of the cases outlined above, staff were subjected to ‘poor behaviours’ and neither managers nor subsequent investigations felt they could name the race discrimination that lay behind these behaviours.
- Reluctance or refusal to acknowledge race as an issue: connected with the above, employers tend to resist acknowledging poor treatment as race discrimination often, it seems, because of the stigma attached.
- Minimising of harm: organisations go to great lengths to downplay the impact of racist behaviours.
- A lack of empathy: racially minoritised staff do not always receive compassion and understanding when raising concerns. Indeed, it is more common they are met with frustration, defensiveness, and exasperation.
This report is a helpful reflection of what is happening in the wider NHS. We applaud the courage of everyone who shared their experiences and as a Partnership we welcome the recommendations within the report.
Report recommendations
The report recommendations support some of the existing transformation taking place across our Partnership, led alongside the West Yorkshire Strategic Race Equality Network.
We are pleased that so many elements of the work taking place in West Yorkshire aligns with the report’s recommendations. We must also challenge ourselves about whether we are doing sufficient work in West Yorkshire to tackle racism. Just as we challenged ourselves during the early part of the Covid-19 pandemic around the sufficiency of actions – which led to even more work being done to address inequity – we should do so now.
Increased representation of ethnically diverse colleagues
West Yorkshire Health and Care Partnership and NHS West Yorkshire Integrated Care Board (ICB) are proud to have a principle of representation of the West Yorkshire Strategic Race Equality Network in all its decision-making forums. This is reflected in our constitution and terms of reference. We reaffirm our commitment that this will continue.
We will also ensure this takes place as our arrangements change with the new ICB Operating Model implementation from 1 April 2024.
The progress of ethnically diverse colleagues
We are very proud of our Fellowship Programme and the Fellows making progress in West Yorkshire and beyond. This is a HSJ award winning intervention, built from proposals of colleagues themselves, and changing with each cycle. The Fellowship is now currently on its third and fourth cohorts.
This is good work, and we recognise that the data regarding the diversity of our leadership tells us that there is still more we need to do. We remain steadfast in our commitment to identifying the actions that will deliver further improvements through our forthcoming West Yorkshire Equality, Diversity, and Inclusion Strategy.
Celebratory events and public recognition
Across West Yorkshire we celebrate diversity and our strengths in this area and local place events regularly take place in addition to our previous work on Connected on Inclusion.
We commit to working with the Partnership’s Strategic Race Equality Network to develop further positive pieces of work that recognise the improvements made and the challenges still to overcome.
Colleagues' experience within the workplace
Our approach is to use qualitative and quantitative sources to continuously understand people’s experience in the workplace. These include our staff surveys, the NHS Workforce Race Equality Standard (WRES) findings as well as our leadership engaging directly with our staff networks. In addition to this and in recognition of the traumatic impact of racism we have developed a focused workstream on this chaired by our West Yorkshire Inclusivity Champion, Fatima Khan Shah.
Our aspiration is this work will support people to have less ‘fear’ and improved confidence on how we can talk about race. This includes line managers and senior leaders.
We are committed to creating a culture, systems and processes that enable people to feel comfortable to highlight concerns in a variety of ways. In addition to the Freedom to Speak Up Guardians across the Partnership, we would like to create a number of Freedom To Speak Up roles from trusted colleagues across West Yorkshire. This includes through our staff networks and champions to create a team of diverse colleagues from a range of backgrounds and professions developing a culture of psychological safety.
Colleagues who find that their experience of racism at work adversely impacts their mental health and / or emotional wellbeing can self-refer for support into the Staff Mental Health and Wellbeing Hub. This support is confidential - no report will be made back to your organisation or manager - it is free of charge and open to anyone who works in health and care in West Yorkshire, including volunteers and those who work in the voluntary sector.
Rooting out systemic racism and creating sustainable change
Following our review in 2020 into the impact of COVID-19 on health inequalities and the disproportionate effect on ethnic minority communities and staff, we launched ‘Root Out Racism’ a movement with our partners, West Yorkshire Violence Reduction Partnership. The movement is part of an ongoing commitment to tackling structural and institutionalised racism.
Root out racism
Through educational resources, real-life images and personal stories, our ‘Root Out Racism’ movement encourages people to better develop their skills and knowledge and inform themselves on anti-racist behaviours and practices.
In the planning of this movement, over 100 ethnic minority colleagues from across the Partnership come forward to share their experiences of racism and help their colleagues and other organisations to act.
We are currently co-producing the next phase of action, supported by the movement’s ethos to reaffirm our commitment to be an anti-racist system. This will include exploring how we can further support line managers to support and advocate on the race equality agenda.
Tacking Inequalities impacting our communities and colleagues
In West Yorkshire we believe everyone deserves the same opportunities to lead a healthy life, no matter where they live or who they are. Yet, evidence shows that people from ethnically diverse communities continue to face discrimination in the workplace and health inequalities.
The pandemic showed that some of the largest communities impacted by health inequalities are people most disadvantaged and disproportionately those from ethnic minority communities.
Our race review aimed to understand this impact on ethnic minority communities and colleagues. The aim was to review existing work, to explore if this work was sufficient to address this impact and to identify recommendations for action to reduce this impact.
There are excellent examples of good practice across West Yorkshire – such as the recently launched Bradford Mental Health, Neurodiversity and Substance Misuse Strategy, coproduced with local communities; the work of the Partnership’s Health Equity Fellows; the work on Core20Plus5 supporting Gypsy, Roma and Traveller communities; and the current campaigns on building confidence in vaccinations.
We need to ensure that this work is embedded in all places and commit to a review, including an event hosted by the Partnership Strategic Race Equality Network to review our progress on this agenda and to identify what further we can do to address inequality.
Disciplinary processes
One recommendation from our Partnership’s race review was for all health and care organisations in West Yorkshire (and Harrogate) to develop independent discrimination panels with BAME representation to review all cases of racial discrimination in disciplinary and complaints cases, prior to progressing through to formal stages. This has been progressed in some parts of the system, but we commit to ensuring that this continues at pace.
Listening
It is timely that we reflect on the theme of this year’s UK Race Equality Week. This year's theme underscores the significance of listening - truly listening - to the challenges and inequalities faced by ethnically groups within our partnership.
Listening is the first step towards empathy and understanding. It involves acknowledging that racial disparities exist and recognising the impact they have on our colleagues and the communities we serve. By creating a space where voices and stories can be shared without fear, we encourage openness and foster a culture of inclusivity.
As a West Yorkshire Strategic Race Equality Network, and as the leaders, we commit to hosting a face-to-face listening event to explore these issues with support from our leadership.
Listening is only the beginning. The essence of #ListenActChange lies in the transformative power of action. We are compelled not just to hear, but to use what we learn to implement meaningful and lasting change. This means re-evaluating our policies, practices, and behaviours to ensure they uphold the principles of equity and justice. It involves actively dismantling barriers and creating opportunities for advancement and growth for everyone.
In West Yorkshire we are ambitious for our colleagues and the people and communities we serve. We see diversity as a strength, share power and risk and have empathy for all.
Together we will hold a mirror of this report up and ask ourselves again – what more can we do? And how soon can we start?
In solidarity we reaffirm our commitment to be an anti-racist system.
Thank you for reading.
Yours sincerely,
Rob Webster, CEO-Lead, West Yorkshire Health and Care Partnership and CEO for NHS West Yorkshire Integrated Care Board
Fatima Khan Shah, West Yorkshire Inclusion Champion, Chair of West Yorkshire Health and Care Partnership Strategic Race Equality Network
Ali Jan Haider, Chair of NHS West Yorkshire Integrated Care Board Race Equality Network