NHS leaders ‘making fewer excuses’ for poor diversity says national workforce chief

Over the summer, in the aftermath of the Black Lives Matter movement, Navina Evans said there was an increased “pressure on white leaders” to act on racism and discrimination in the service.

Speaking to HSJ, she said she has since noticed “more people willing to talk about [diversity] and making fewer excuses… I see more people sitting with the discomfort of it.”

As a leader with an Asian background herself, Dr Evans said it was her “duty and her job” to work on diversity within the organisation and “lift as you climb”.

But she added: “I think it’s really powerful when white leaders speak up, and when male leaders speak up for women.”

In her first major interview since taking the role, Dr Evans said the NHS must challenge its recruitment methods to improve diversity, and revealed she would not have applied for the post without first being approached.

Dr Evans, who previously led East London Foundation Trust since 2016, said: “When the recruitment people contacted me, I thought, I don’t fit the ‘arm’s-length body look’… I would never have applied.”

She emphasised the importance of using social media as well as the NHS jobs website to recruit, and stressed the importance of simply talking to people.

“We absolutely want to tackle [leadership diversity at HEE] at board level and we have a sub-board committee [on this issue],” Dr Evans said. “It’s an organisation that doesn’t have a lot of turnover at senior level but when it does, we make every effort.”

She gave the example of four senior nurses recently recruited by HEE, “of whom three are women from BME backgrounds”.

“Any organisation’s approach to race equality sets the bar for everything else,” Dr Evans said.

She said HEE’s track record showed it to be “not the most diverse” but that the leadership had taken a “long, hard look at what is going on”.

‘Huge’ impact on workforce

Dr Evans also addressed the “huge” impact the coronavirus pandemic has had on the NHS workforce, but stressed “life will not be the same going forward”.

“I think it’s brought out the best in us, in systems and organisations, and we’ve broke down barriers,” she said.

Although there has been an impact on education and training, Dr Evans said she was confident in the domestic pipeline of nurses — a crucial part of achieving the government’s 50,000 more nurses target.

“We have seen an increasing number of people applying for nursing and allied health professions. We are making the case we have to grow university places and universities are keen to support this.”

She added HEE was “really quite confident around the 50k target and GP numbers” (increasing the GP workforce is another government target).

Although she said the nursing target was realistic, she stressed: “We have to look at what happens as we recover and think about redesign and reform of services. We will constantly have to review whether we have got it right.”

International recruitment was set to be a big contributor, but Dr Evans said the NHS was “shifting away from a reliance on international recruitment to service the NHS”.

Since the pandemic began, the number of international healthcare workers who have come to work in the UK has decreased significantly, with workforce leaders concerned targets would have to instead be backfilled.

Less than two years ago, it was expected HEE would lose some of its independence in becoming accountable to NHS Improvement, but Dr Evans said changing mandates and legislation would be “a complete distraction”.

“HEE has multiple relationships with different parts of the system. That convener role is unique,” Dr Evans said. “At the moment [HEE’s] function is what I’m focused on. Making sure we play our part and step up.”