How to tackle equality and diversity in the health service

Equality and diversity is important within healthcare for two basic reasons. One is about providing better services for patients and the second is about making the NHS a better place to work. “While we concentrate on the workforce issue, what is increasingly important is the link between the issues around equality and diversity in service provision and as an employer, that you can’t neatly separate them entirely into separate boxes,” says Alastair Henderson, deputy director of NHS Employers.

Yeovil District Hospital foundation trust has recognised the link between what it does as an organisation providing services to the public and what it does as an employer for staff.

The trust’s iCARE programme has become central to how the organisation operates.

The i stands for the individual, which is a reminder that it must treat people as people, and also the fact that every member of staff has a fundamental role to play. CARE refers to good, clear Communication, a positive Attitude, Respect and a clean, safe and welcoming physical Environment which is both a good place to be a patient and a good place to work.

“It’s recognising that how we treat our patients and how we treat our staff are two sides of the same coin,” says trust chief executive Gavin Boyle. “And if you don’t look after your staff then you’re not in a position to look after your patients.”

Service improvements

iCARE was not designed exclusively around the equality and diversity drive but it does help with that. It originated after two patients’ families raised concerns about their experiences in hospital.

One of the trust’s matrons tried to understand what the failures had been, with the aim of improving the service, and in the process it became apparent that if they could fix the four basic issues that now make up iCARE, it would be a better place to be a patient and a better place to work.

Now the trust runs training programmes for staff on the four principles of iCARE, and has built those principles into mainstream processes such as recruitment, appraisal and induction. Impact is measured through the annual staff survey and the patient survey, plus a Your CARE questionnaire given to patients just before they leave hospital.

Yeovil is just one of NHS Employers’ 20 equality and diversity partners for 2009-10. Trusts submitted evidence and were chosen after a rigorous judging process.

Over the next year, the partners will share their good practice with other trusts in their area, and NHS Employers will promote their work nationally on its website and through events.

A central part of the selection was around leadership from chief executives and boards, says Mr Henderson. “In places where it seems that it [equality and diversity] is happening well there is that level of engagement from senior parts of the organisation, the chief executive and the board. We know for lots of things that is really important and where you see them involved, that agenda is likely to be much more successful.”

Trusts that have yet to get high level engagement on equality and diversity should emphasise the business benefits. Mr Henderson says: “What I would do at the moment, particularly now, where we know trusts are going to be facing financially harder times, is make the links between this agenda and the productivity and the quality agenda.”

There are four business benefits of equality and diversity. First, it contributes to organisational reputation because how organisations treat their staff is regarded as important by consumers. Second, valuing diversity enables employers to recruit and retain the best people.

Productivity also improves because if service users feel that they are being treated by people who understand them and their needs, there will be a better delivery of services.

Finally, it helps trusts ensure that they meet their legal obligations on diversity and avoid the cost of falling foul of the legislation.

Mr Henderson concludes: “This is not about a luxury add-on, this is about something that supports and helps you with the delivery of your services and your productivity. I think that’s one of the major changes, of recognising that tackling this right is something that supports your business, not impedes it.”