How to make equality and diversity a central part of your organisation

Making equality and diversity part of the fundamental operating principles of an organisation requires leadership from the top.

Lisa Rodrigues, chief executive of Sussex Partnership Foundation Trust, Fiona Edwards, chief executive of Surrey and Borders Partnership Foundation Trust, and Will Hancock, chief executive of South Central Ambulance Service Foundation Trust, chair their equality and diversity boards and committees and speak out publicly on equality, diversity and human rights issues. They are clear that creating the right culture and behaviours in their organisations relies on visible commitment to the issues.

“People listen to what you say but more than that, they look at what you do,” says Ms Rodrigues. “The chairs of all the networks know that all my team take it seriously. They have events, they report to the board and they know they have our support.

“The fact that it’s me chairing the equality and human rights group and me sitting there, biting my knuckles about where we would come in the Stonewall index – I think that does make a difference.”

Will Hancock’s personal contribution is to spend time supporting the people in his organisation who are responsible for equality and diversity, chairing the steering group and ensuring his management team understands that it is part of core business.

“You’ve got to resource the function and training. I’ve got a dedicated [equality and diversity] specialist and we’ve carved out budgets and resources for training our managers,” he says.

According to Ms Edwards, making equality part of the trust’s quality programme has been her personal mission as a leader. “You have to be a bit ‘campaigning’ about it,” she says. “You have to be really concerned to help staff and communities around you and to see patients as human beings first, with the same rights as you and I – and because they are very vulnerable people these rights are more likely to be compromised. My staff know this is really important to me as a leader.”

In all cases, admitting to the organisation’s challenges and recognising a need to improve were the first part of leading the changes these chief executives wanted to see.

Progress at Sussex Partnership was the result of its response to the Healthcare Commission’s race equality review of the trust. Surrey and Borders Partnership Trust achieved registration with the Care Quality Commission with two conditions against it, around care planning and assessment and consent to treatment. At South Central it was the realisation that while patient satisfaction with emergency services was high overall, it wasn’t getting qualitative feedback from the range of communities it served.

The hard work then was getting the systems and processes in place to measure how they were doing and respond to problems.

Sussex: everybody’s business

Sussex Partnership first brought in an interim specialist in equality and diversity to work with Ms Rodrigues on its systems and processes and it made a decision to appoint a new team to focus on equality and diversity in the trust.

Now a team of three, it coordinates activity and sets the stall out, but works across the organisation to make equality, diversity and human rights everybody’s business. The board and all staff underwent training about why it was important within the trust. Three staff networks were also created for LGBT, disabled and BME staff.

Ms Rodrigues is passionate that equality, diversity and human rights are not only at the heart of everything the trust does, but that it has the evidence to show it.

This has paid off. The trust was listed as fourth on the Stonewall workplace equality index last year, making it the highest ranked NHS organisation ever.

“Our approach to equality includes our services and the way we support those who use them, so this ranking is also an important recognition of the quality of our services,” she says.

“Above us were Ernst and Young, the Home Office and Barclays Bank – money making ventures and huge employers compared with us. If they take it seriously so should we.”

Surrey and Borders: human rights in action

At Surrey and Borders the issue of consent to treatment went on to the board’s key indicators so members could keep an eye on it. The medical director treated it as a performance issue for every consultant and the nurse director took responsibility for making sure the system was in place for reporting and action.

Supervision for all clinical professions was a big priority and the regularity and quality of this was tested through the staff survey. The chief executive and board instituted a weekly walk-around of the services, using directed conversation to find out:

• Is supervision and appraisal happening?
• Do staff know how to blow the whistle?
• Are they confident they can talk to us if there is a problem?

They also look at the climate of the service.

“The test is: is this how we’d like to see a relative being treated? We offer positive reinforcement when we see good practice and when we have a worry we increase walk-arounds,” says Ms Edwards.

She sees her trust’s turnaround regarding consent to treatment as a practical example of human rights in action. “Part of the message about [equality and diversity] and doing it right is that you have to own up to your problems.”

She continues: “People who come to us and are assessed under the Mental Health Act are very ill, chaotic and at risk of harming themselves and others. With consent to treatment you have to demonstrate that you’ve discussed and had their consent within a reasonable time of them arriving at the trust. You have to know how many people you have detained under the act at any one time and know where they are in their treatment plan.”

The organisation set itself high standards of compliance, beyond the Care Quality Commission’s standards, and has seen significant improvements in the past two years.

South Central: listening to feedback

South Central Ambulance Service Foundation Trust set up processes to help it get the feedback it needed. This included working with three gateway organisations – Reading Council for Racial Equality, Milton Keynes Equality Council and Hampshire Independent Forum – that allowed the trust to tap into feedback from a wide range of diverse groups.

Internally, it is beginning to address the challenge the organisation still faces in recruiting and retaining staff from diverse backgrounds through setting up staff
support arrangements within the trust to try to create the right culture for staff to feel comfortable. It is also increasing their presence and profile at events recognising and celebrating diversity.

For Mr Hancock, tackling equality issues internally and externally is part of a broader drive to create personalised services for all of the service’s patients. “We’re trying to improve the service through personalising it and the way we do that is to get feedback about what is the best and most appropriate response for our callers,” he says.

“What many people don’t know is that ambulance services now are mobile healthcare providers. For about 40 per cent of patients, we don’t need to take them anywhere – we have the skills to care for them on the spot. Getting the right response to patients at the right time and in the right place is crucial in reducing the amount of patients who go to hospital unnecessarily.”

South Central is the only ambulance trust to have NHS Employers equality and diversity partnership status and its work on equality and diversity internally and externally is beginning to see results.

Find out more:

NHS Equality, Diversity and Human Rights Week