Published: 24/02/2005, Volume II5, No. 5944 Page 19 21

Breaking Through is helping black and minority ethnic managers step up to board-level positions. Rebecca Coombes examines the secrets of its success

In a little more than a year the Breaking Through programme has helped fast-track the ambitions of 320 aspiring directors from black and minority ethnic backgrounds.

It is the first national leadership programme for BME staff in the NHS and was developed in 2003 as a response to the continued dominance of white faces in senior management roles.

John Batchelor, the programme's national lead, says the intention from the outset was to do something fresh and cutting edge. For example, in the spirit of democracy they asked candidates to self-nominate, providing they had the support of a senior person in their organisation.

Focus groups were conducted to find out what help BME staff really felt they needed to reach the dizzy heights of a board director. Staff were also involved in the initial tendering process.

Mr Batchelor says: 'We didn't want an off-the-shelf training programme, but one tailored to the needs of BME staff. So Breaking Through is actually delivered by 10 different providers.' Some obvious names are represented among the final 10, such as PricewaterhouseCoopers, Hay Group and Henley Management College.

However, not all the successful candidates were big hitters, says Mr Batchelor. 'We decided to ask companies to make a presentation to a group of about 20 BME staff. Some of the big brand names didn't get the job because they didn't come over well. We wanted organisations that were different and cutting edge, but also had a grasp of the NHS, ' he says.

The lesser-known providers include Beacon Organisational Development Ltd, which delivers the programme's action planning module, and Berkshire Consultancy Ltd, responsible for the empowerment module.

Programme participant and Bolton primary care trust primary care development manager Doriann Bailey was one of those asked to evaluate the shortlisted companies.

'It is a good idea as we are aware of the culture and needs of people from BME groups. I felt that some of the companies were just saying what they wanted us to hear, ' she says.

The programme was given a big bang launch by health minister John Hutton at a major conference in Birmingham in October 2003.

The first cohort kicked off in January 2004, made up of 160 participants out of 200 applicants. Every participant has to take part in the two-day development centre module, but thereafter people take a selection of modules that best meets their individual need.

A leadership revolution At the development centre, groups are observed as they go through a series of activities, such as simulated exercises and discussions. Most importantly they get the leadership qualities framework 360-degree assessment - a diagnostic tool compiled by a participant's senior managers.

Two days later, a personal development plan has been drawn up, detailing which modules a participant will take.

The most senior and gruelling module is the aspiring director programme, delivered by Hay Group. Programme director Alison Wilcox says: 'It is for people for whom the next career step is logically to a board-level role.'

She explains that the NHS Leadership Centre, which runs the programme, was very specific about what tone to strike.

'There is no argument that a lot of people work against additional obstacles in terms of institutional racism and discrimination. But rather than thinking about how unjust that is we want to work on how you navigate the system and work it to your advantage.

'Some elements of the programme deal with universal truths about good leadership and board-level positions. The NHS has the same principles about what sort of character makes a good leader as, for example, Unilever. But we also needed to be very specific.

'One of our measures, for example, is how many of our participants are making it into board-level positions after six months. We made a choice to be heavily oriented to practical development. What we focus on is what they are like as an individual and what help they need.

The additional spin is the fact that these are people who perceive that, in some ways, they have a harder job than their white counterparts.' The module discourages reliance on programme leaders and instead tries to create strong bonds between participants through coaching groups.

'It is something that should endure beyond the final module. You want a group small enough to create an intimate environment and then people can talk freely, ' says Ms Wilcox.

The module strongly relies on input from senior NHS ranks - for example, chief executives run mock interview panels or mentor individual participants.

She adds: 'It hasn't been at all difficult to get chief executives involved because a lot are aware of the issues and want to help. And partly because [NHS chief executive] Sir Nigel Crisp has made it clear it is an initiative he is sponsoring.' Ms Wilcox says the changes in participants do not take place for about six months.

'It takes a long time for people to settle in and internalise some of things we talk about. At first we are dealing with who you are and your psychological drivers. Second, we look at how effective you are currently as a leader, including feedback. It takes a long time to assimilate.' The third part of the aspiring directors module forces participants to imagine what being a board director is like.

Ms Wilcox says: 'A lot of people in the NHS who have taken that step say they feel knocked off their feet. The depth of water or the strength of the current is not visible below board level.' 'We try to be very clear, for example through lectures given by board directors. Simulations give them a visceral experience of what that might feel like. At that stage a lot of things gel for people. Some begin to think, 'I have wanted this for years but is it for me?'' she adds.

Career progression

Those who are not selected for the aspiring directors module may be encouraged to try again a few years later after completing other modules and gaining some more senior experience. One of the modules designed to get participants on the fast track is on career progression, run by PricewaterhouseCoopers.

Programme leader Lee Newbold says the aim is to get people to take some risks. 'A lot of people think all you have to do is apply for the job. We talk about using networks, doing your groundwork before sending in your form. It is tips and tricks to get ahead.' Before designing the course, Mr Newbold spoke to human resources managers and potential participants. 'We found people were conservative.

They would apply for jobs only if they could tick off nine out of 10 of things on the job description. In career terms it would not mean a rapid ascent to chief executive level. And what did it mean in terms of personal development if they could already do 90 per cent of the job?

'We talk about taking more time on job descriptions where you have 50 per cent of the qualities. If you have transferable skills it is possible to convince employers you can do the other half of the job. You need to be more confident but it means you can take bigger steps, ' he says.

For those BME staff who feel they have been knocked back because of their race, Mr Newbold says the approach is more positive.

'We try to put some of that behind them.

Everyone has different experiences. Some people have got on with their careers with no real issue about their ethnicity. Others may have had a bad experience and we acknowledge this. The people who succeed are those who get beyond the issues and succeed despite the challenges, ' he says.

John Batchelor says Henley Management College is continually evaluating the programme and there is a plan to follow up more case studies.

He believes the success of the programme is in its core philosophy: 'The fundamental premise of all modules is to help participants see they live in the real world and that discrimination is a reality.

The only way to get on is to have resilience to compete and get on, ' he says.


Courtney Smith (pictured) is head of capital investment at South East London strategic health authority. He has already been through the development centre module and will start the aspiring directors programme in March.

But before entering the Breaking Through programme he had 'opted out of the system'.

'I had put myself forward for promotion so many times over the years and had constant setbacks. I felt the interview panels had already made up their minds and were just going through the motions. I was always told: 'You are a good, credible candidate although someone else had the slight edge.'' After leaving Jamaica in the 1980s, Dr Smith worked as a civil service economist, latterly at the Department of Health, a job he is on secondment from to the SHA.

Mr Smith, who has two degrees, a master's and a PhD, says BME staff need more qualifications to get ahead in the NHS.

'They make themselves over-qualified so employers can't use that as an excuse.' He enjoyed the first two days at the development centre: 'The 360-degree feedback is a good diagnostic tool as it highlights what your strengths are. It also found that I have a tendency to opt out if I feel I am banging my head against a brick wall. I discovered I needed to develop better emotional resilience.

'You do need the support of your manager - mine is 100 per cent behind me. It is the first time I've had that - if I had had that from the beginning I would be a director by now!

Find out more

The Modernisation Agency has details of the Breaking Through programme www. modern. nhs. uk

The aspiring directors programme www. haygroup. co. uk

Key points

Ten different providers deliver Breaking Through, including PricewaterhouseCoopers, Hay Management Group and Beacon Organisational Development.

The first cohort started in January 2004 with 160 participants.

All participants take a development centre module first but then take modules that best meet their needs.