Full Public Statement

Name and title of Board Lead for WRES:  Shelagh Meldrum- Chief Nurse, Director of People & Deputy Chief Executive

Name and contact details of lead manager compiling this report

  • Emma Symonds, EDI Lead
  • Debbie Matthewson, Associate Director of Education and Development
  • Elaine Cox, Careers & Work Experience Co-ordinator
  • Bernadette Ford, Performance & Reporting Manager
  • Benjamin Hazell – Information Analyst
  • Lydia Karamura, Staff Minorities Network Chair
  • Tracy Jones, Deputy Director HR and OD
  • Patricia Spruce, Associate Director of UK & International Recruitment

Names of commissioners this report has been sent to: Lee Reed, Equality & Quality Officer Somerset Clinical Commissioning Group

Unique URL link on which this report and associated Action Plan will be found: https://yeovilhospital.co.uk/about-us/equality-and-diversity/

This report has been noted/ ratified by the:

  • Mark Appleby, Director of HR and Organisational Development
  • Shelagh Meldrum, Chief Nurse, Director of People & Deputy Chief Executive

Our Commitment

Yeovil District Hospital is committed to ensuring that all our staff are free from discrimination, feel equally supported in achieving their career aspirations and express a high level of job satisfaction.

Our objectives for attracting, developing and retaining a diverse workforce is to promote an inclusive environment where individuals are able to be their authentic selves. We believe this is achieved by nurturing positive culture changes throughout the organisation.

We strive to be an outstanding care provider and recognise the clear links between the satisfaction levels of our people and the quality of care they provide.

The Equality Act and Protected Characteristics

  1. Age
  2. Sex
  3. Sexual Orientation
  4. Gender reassignment
  5. Ethnicity
  6. Religion and belief
  7. Pregnancy and Maternity
  8. Marriage and civil partnership
  9. Disability

Additional Trust groups

  • Military Groups
  • Project Search

What is the Workforce Equality Standard?

The Workforce Race Equality Standard (WRES) programme has now been collecting data on race inequality for five years, holding up a mirror to healthcare providers and revealing the disparities that exist for black and minority ethnic staff compared to their white colleagues. The report is important as it shows how a motivated, and value workforce helps deliver high quality patients care and increase patients safety.

NHS Healthcare providers and NHS Commissioners are held accountable for the measures they put in place to support their ethnic minority staff member’s .YDH takes this responsibility seriously and aims to push beyond what is expected. Holding ourselves accountable to ensure our ethnic minority staff feel valued for who they are and for, the skills they have whilst supporting them to achieve their career aspirations with equity. We invite you to read about our actions and future plans below in response to the 9 indicators set by the National WRES Team.

WRES Indicators

Indicator 1: Staff in NHS trusts and CCGs by ethnicity: 2016 – 2020 In 2020

Yeovil Hospital has a total workforce of 2270, excluding Simply Serve LTD (SSL) a wholly subsidiary company of the Trust. A total of 2181 staff self-reported their ethnicity, which equates to 96.07% of our work force. We are able to use this data to define our BME staff as 21.32% of the workforce compared to 74.7% of our white work force, with 3.9% registering as unknown. These unknown numbers will be due to staff wishing to decline to share their ethnicity on the Trust’s self-serve Employee system ( Electronic Staff Report- ESR).We have seen an increase on last year’s ethnicity data due to staff self-reporting, by way of the introduction of an electronic new starter’s form which has become part of our recruitment process.

ESR equips us with a range of tools that facilitate effective workforce management and planning which enables us to improve on quality, efficiency and improve patient safety. By making ethnicity a mandatory field, the data is automatically transferred to ESR from as early on as new appointees. This allows us to critically review supportive, wellbeing and EDI training and awareness packages that are in place and how they are reflective of the current workforce.

We actively encourage staff to discuss their ethnicity and other personal characteristics when meeting managers and supervisors at regular support events such as probation, appraisals and through the promotion of its benefits at staff engagement event’s, which include oversea staff transition sessions, Trust Induction Market place, Statutory training and additional Equality, Diversity and Inclusion training sessions.

We are incredibly proud of our culturally diverse workforce, which is made up of over 64 different nationalities, whilst being mindful that we do not disproportionately represent, but rather ensure that we have the correct skill-mix, coupled with a diverse range of staff, in each area. We continue to increase the diversity of our workforce through ongoing international recruitment for not only medical nursing staff but also Allied healthcare professional’s (AHP), Radiographers and mental health nurses. We are also preparing to recruit midwifes from overseas.

It is important that we not only acknowledge the diversity at YDH and the opportunities that brings but that we hold ourselves accountable for the challenges that our BME staff may face. We do this by supporting the development of Staff led Networks who are supported by the EDI Lead and Freedom to Speak up Guardians. The staff networks are the voice of the staff, acting for and with staff from the particular characteristic, whilst offering connections and pastoral support. Each network is able to engage with the board via the Staff Network executive steering Committee, the EDI Executive lead and the EDI lead at The Workforce Committee.

Indicator 2 - Relative likelihood of white applicants being appointed from shortlisting across all posts compared to BME applicants

Leadership and Development is a key focus at YDH. We acknowledge that we do not have the representation that we would like across the more senior levels, however we are committed to ensuring that our BME staff have the opportunities and experiences needed for them to succeed in their chosen careers.  We recognise that for an applicant to showcase their full potential, they may have to navigate an unknown environment and this may leave them unprepared. With this in mind, the Academy is working on the production of a “Map” of staff who have potential at all levels (Bands). This will support the development of ethnic minority staff who have a potential for or interest in becoming a leader.

We have introduced a system of constructive and critical challenge to ensure fairness through the recruitment process for internal and external candidates. This includes implementation of a diverse interview panel at both shortlisting and interviews. Alongside this programme we offer tools and resources for staff pre and post interview to support their knowledge and preparation.

We recognise that bias can play a role in promotion and progression, as indeed at any stage of recruitment for internal and external applicants, so we ensure to undertake a fair and equitable recruitment process, including anonymised shortlisting on the Trusts internal recruitment platform, TRAK. By removing identifying characteristics we are ensuring the question of bias is removed.

The EDI Lead and ethnic minority network have taken a lead in developing a trust wide inclusive recruitment strategy, acting as EDI representatives on shortlisting and interview panels. Within this role and in collaborating with HR & Recruitment, we are able to identify areas of development and excellence for both applicant and recruiting manager. With the additional input from the EDI representatives, we feel confident that we are offering an inclusive approach. We also ensure that the Hiring Managers have EDI awareness training and they never have access to the Equal Opportunities information on the application form prior to selection.

For staff who wish to develop their career or follow a different pathway we have appointed specialised educators in the areas of AHP, Theatres and HCA as well as a Leadership and Development specialist who will support the educational and personal development of staff with a focus on ethnic minorities and underrepresented groups. To encourage staff and potential external applicant to apply we have embraced an Inclusion commitment statement which is promoted via several forms of communication, including email signatures, training confirmation, job adverts and the hospital website.

Indicator 3 - Relative likelihood of BME staff entering the formal disciplinary process compared to white staff by trust type: 2016 – 2020

The Trust has made proactive changes to the Human Resources processes and policies, adopting a Just and fair culture throughout the revised HR policy. The disciplinary policy has been renamed Supporting relationships at work and now includes a risk assessment which challenges any decision making and ensures processes are appropriate. This system of evaluation ensures that a neutral party is involved to ensure that any allegation made against an individual is fair and equitable before any change to their duties are enforced. Human Resources has developed a strategy to ensure that Supervisors/team leaders or staff with management responsibilities have an over sight of Just culture and the impact it has on the team

Our data shows that the likelihood of BME staff in comparison to white staff entering the disciplinary process to be nominal, however we are conscious that there remains a disparity so continue to closely scrutinise the data. We are confident that by adopting and embracing a Just and Fair culture throughout the organisation, both within in policies, process and cultural intelligence, we will abridge this gap.

Responding to alleged incidents, with Just and Fair culture in mind is a positive step forward in challenging bias, however we believe that engendering Just Culture and cultural intelligence throughout the organisation is essential is addressing potential bias. We have addressed this by delivering emotive, responsive and thought provoking training, webinars and listening events that encourage staff to critically consider their own bias and encourages them to feel confident to ask questions or to respond confidently to an inappropriate situation. These packages include, Respect, Belonging and Civility training sessions, an interactive Package which will be delivered to senior leaders by an organisation called Performing Medicine and a planned Reverse/Resipricol mentorship programme.

Implicit Bias & Stereotyping training for midwifes delivered in August 2021. This training was developed in response to a winning academic project by two White midwives. They questioned the apparent lack of recognition and use of BME Resus dolls used within Midwifery training. The concern with that lack of previous exposure, midwifes would not be able to genuinely “treat what they cannot see”. The project has developed and now includes a BME Mother and Baby Resus doll as well as implicit bias training, which we plan to embed into the core element of midwifery training at YDH. From this training we have secured BME representative Venepuncture mannequin arms for staff to practice on throughout their training. We have plans to develop an unconscious bias programme which will be delivered across the trust, at different levels and include micro aggression and institution racism awareness. The aim of this training is to bolster statutory training, support cultural intelligence and empathy and support the objectives of the ethnic minority network and EDI long term goals.

Indicator 4 - Relative likelihood of white staff accessing non–mandatory training and CPD compared to BME staff by region: 2019 – 2020

Providing access to Leadership & Development opportunities in addition to Statutory training requirements is essential when supporting out workforce. We have employed key personal who have a specific focus on areas where we know have a higher concentration of BME staff, particularly International staff. In the last 12 months we have employed an AHP Clinical Educator, Theatre Clinical Educator and HCA Associate Clinical Facilitator as well as a Leadership & Development specialist who will offer support for Band 5-7 staff through their professional development.

In addition to these educators, we ensure that staff are aware of CPD money that is available for learning and career development, national bursaries and national scholarship programmes which can be accessed , such as The Stepping up programme, which is aimed at B5-7  BME staff , Emergent voices programme, Edward Jenner programme etc.

The academy and EDI lead collaborate to promote functional skills for international staff who may not work in clinically, which can be used to access apprentices to access nursing pathways. Both The Academy and the EDI Lead also keep staff and managers updated of additional opportunities via internal electronic newsletters, social media and targeted emails.

Indicator 5 - Percentage of BME staff experiencing harassment, bullying or abuse from patients, relatives or the public in the last 12 months by region: 2017 – 2020

Indicator 6 - Percentage of BME staff experiencing harassment, bullying or abuse from staff in the last 12 months: 2017 – 2019

The majority of incidents reported by staff, as a result of harassment, bullying or abuse from patients, relatives or the public, occur in clinical settings where there is a higher percentage of BME staff. Ethnicity is not requested on the Ulysses reporting system so, unless explicitly stated within incident text, it is difficult for us to determine whether an incident relates to ethnicity. However, the trust encourages all staff to use the Ulysses system to report all incidents and enter any information they feel may be important or relevant, no matter how big or small, so that they can be reviewed and responded to accordingly by key individuals, such as Line Mangers, Security, EDI lead and where appropriate Staff Network Committee members.

Incident reports which specifically mention EDI (e.g. due to race/ ethnicity) are shared with the EDI Lead who in turn liaise with the Ethnic Minorities Network and Diversity Network to identify if/ where potential themes may be developing and discuss/ implement resolutions as appropriate. 

We recognise that there is a disparity in the percentage of BME staff experiencing harassment, abuse and bullying from patient, visitors and /or members of the public so it is essential that we equip our staff on how to respond to these incidents and who they can seek support or advice from. Each member of staff attends induction and EDI statutory training where they are educated on the process of incident forms. Within the EDI training, they are given the opportunity to discuss any incidents that may happen and how they may respond as well as being equipped with tools to help them navigate unknown language or terminology.

Although the staff survey is an invaluable resources when evaluating staff feedback and needs, its anonymity can present challenges when deciphering the data. However, we are confident that staff are aware of other avenues to report concerns or issues. We promote the benefits and use of the Freedom of Speak up Guardians for all staff. The YDH Freedom to speak up Guardian platform is currently being revamped, ensuring it’s easily accessible and user friendly. We have added the option for staff to highlight any potential cultural elements to the concern, which would enable us to respond appropriately.

The Trust is working tirelessly to establish additional robust frameworks which support career progression and promotion across the bands. We know that a good applicant experience is vital, whether the individual be an external applicant or an established member of staff aiming to climb the ladder. So with that in mind we have reviewed our recruitment and leadership development strategy starting with an Inclusion statement of commitment which informs all applicant of our commitment to equitable opportunities regardless of a protected characteristic.

All internal vacancies are advertised on our Trust vacancy pages and on our staff bulletin.  In addition we have a “transfer window” for nurses to give them an opportunity to move into different specialities without a lengthy recruitment process.  This enables staff to gain more experience in other specialities to broaden their skills and knowledge, ready to apply for any promotion opportunities. Alongside these opportunities the trust has developed a robust support package for Allied Healthcare Professionals AHP (UK & International) to support career development and encourage staff to continue their career journey at YDH.

As previously mentioned, we have implemented an inclusive recruitments interview strategy, where we involve the EDI Lead, Ethnic minority network members/HR & recruitment in the shortlisting and interview panels with recruiting managers. These EDI representatives are able to offer constructive challenges and/or advice in terms of Bias. Staff are also able to access an YDH Interview support pack which was designed by the EDI lead, as a resource to prepare for an interview.

In consideration of model employer and our long term goals for BME representation across the bands. The academy is developing a “map” of staff with potential at all levels. This is an ongoing project with Faculty of Extended and Advanced Practitioners (FEAP), Trainee Nursing Associates (TNA), Registered Nurse Degree Apprentices (RNDA) and Continued Professional Development mapping (CPD) mapping. We have already commenced development of individuals learning platforms with a plan to launch “my Career” document, when we are able to deliver at wider focused events.

Understanding and empathy from senior leads is a crucial element in acknowledging how and why BME staff would benefit from additional resources when climbing the career ladder, so the EDI lead is currently developing a Reverse & Reciprocal mentorship programme which will match BME staff with a senior White lead with an aim that each individual will be able to enhance the other, both professionally and personally.

Indicator 8- Percentage of BME staff that personally experienced discrimination at work from a manager, team leader or other colleagues by region: 2017 – 2019:

Yeovil Hospital Is an incredibly diverse environment, with 21.3% of our staff being BME. We acknowledge that over the last 12 months our workforce has experienced challenging and difficult times and this may lead to unusual behaviours or responses between colleagues. We are also aware that staff are often reluctant to report incidents of discrimination from managers, team leads or colleagues, so over the last 12 months we have actively encouraged staff to use the various reporting platforms, such as Ulysses, Freedom to speak up Guardians, EDI lead, staff networks and HR.  The Ulysses incident reporting system extracts only an individual’s name, date of birth and job title from ESR.  It does not have a category for discrimination so those reviewing such reports have to rely on the content provided.  This prevents us from actively comparing our formal incident reporting data with that provided through the anonymous staff survey.

We have ensured that our in-house training is responsive to incidents of discrimination towards staff from colleagues, peers and Leaders. Training has continued through the Pandemic but sympathetic to clinical needs. We have adapted the program to accommodate a virtual learning platform, and where possible small teams were able to receive have been trained face 2 face. Additional resources are available for all attendees

Indicator 9a- Percentage of board members by ethnicity compared to BME workforce within NHS trusts by region (2020)

Indicator 9b- Percentage (number) of BME board members across NHS trusts: 2016 – 2020

When recruiting to the Board, the Trust considers the representation of its members compared to the workforce and locality diversity. 94.6% of Somerset’s population are ‘White British’. This proportion is typical of that seen in Somerset’s neighbouring local authorities but much higher than the England

BME Board representation is discussed at Workforce Committee and at the Directors Huddles, where plans are moving forward to shape communications that would support a more diverse board.

Click here to view the Model Employer Statistics - Appendix A - 2020/2021

Click here to view the WRES action plan - 2020/2021

Date: 27/09/21