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Commitment and collaboration

Organisations that are explicit, clear and engaged with their EDI strategy have a greater chance of succeeding and have a better reputation among service users. Commitment also brings a sense of accountability, which is critical to the overall success of any strategy. This section outlines practical steps you can take to represent and execute your commitment to EDI. Whether your organisation is only a few people, or a larger entity, declaring the organisation’s intention to consider EDI in all it does can be powerful.

Embed EDI as a strategic priority

An EDI policy is a written agreement for your organisation which addresses how you will promote equity and create a safe and inclusive atmosphere for your employees and service users. Equal Measures has created an adaptable EDI policy template you can use. You can also take a look at this example from the Health and Care Professions Council.

To create your EDI policy:

  1. Before embarking on creating an EDI policy it is crucial to first set a specific vision on what your EDI policy is and its impact on your company and its customers. 
  2. Review existing resources, such as this one from High Speed Training, which includes guidance and a free template.
  3. Outline the behaviours expected from the workforce and ensure they align with the organisational and EDI values.
  4. Clearly state that any form of discrimination, victimisation, harassment or bullying is unacceptable, in the form of a zero tolerance approach and statement. Set out procedures for dealing with complaints and reporting. Take a look at this resource from Acas.
  5. Be clear about how to access support within your organisation as well as any helpful external resources. Also be clear about how to go about reporting discrimination within your organisation specifically.

GPs in particular are always squeezed for time and wear many hats in the organisations they work in. Setting aside time regularly to consider EDI will help to create a regular habit. Even 30 minutes a fortnight or a month will help you to become more intentional about how you build EDI into your work.

Where you can, allocate a specific pot of money for EDI. This pot of money could be used to:

  • Upskill people in your team on EDI. For example, staff  training on  inclusive and safer recruitment practices for anyone who makes hiring decisions in your organisation;
  • Attend networking conferences led by diverse health organisations. If you are too busy, send a representative of your practice as part of a mentoring programme;
  • Update your website to include your EDI vision statement, strategy or commitment.

General Practices are often pushed for time. The practice manager has responsibility for many different parts of the organisation. While setting EDI expectations may not seem like an efficient use of already constrained time, once these expectations are set they become much easier to manage. With the basics in place, adjustments can be made quickly when needed.

Setting clear expectations for EDI can encourage growth within the organisation, and define best practice within the sector. These may already be defined within the terms of your insurance or contracts, so may not need to be written, but simply shared internally and externally. Sharing builds trust within the organisation, and opens up a dialogue relating to EDI, cultural awareness, and wellbeing.

A good example of an EDI strategy was released by Portsmouth Hospital University. This strategy is both comprehensive and goes beyond regulatory compliance toward thoroughly embedding EDI. It includes measurable goals and specific roles and responsibilities, which is essential to accountable and sustainable EDI practice.

Joint EDI Strategy -  In 2022, Barnet, Enfield, and Haringey Mental Health NHS Trust and Camden and Islington NHS Foundation Trust launched a joint EDI strategy. The aim was to create a just, fair and inclusive culture.

The five focus areas were: improve service user access and experience; better health outcomes; representative and supported workforce; inclusive leadership; and culture change by mainstreaming EDI.

Further actions include encouraging a healthy work-life balance, developing collective leadership at all levels, and realising individual development opportunities through collaboration.

A flexible work schedule is a great way to make your organisation more attractive to potential candidates, particularly if they have caring responsibilities. Reasonable adjustments ensure your organisation is inclusive to all, by meeting their specific needs. They typically will involve adapting working methods, procedures, or the physical work environment to mitigate against any potential disadvantage.

Flexible working can improve employee well-being and morale, reduce sick leave, protect against burnout and ill-health, and increase productivity and career longevity. It is also a crucial way to support parents and carers, and help retain neurodiverse and disabled employees. Employers may wish to consider offering flexibility across the workforce more broadly where appropriate.

It is helpful to note that employers have a legal duty to deal with requests for flexible working in a reasonable, unbiased, and transparent manner, and offer an appeal process should the request not be met with approval.

Senior leadership support for your organisation’s EDI ambitions is critical as they have influence over organisational priorities and can ensure the EDI vision is effectively communicated. Equally important are middle leaders and managers who are crucial to the promotion and embedding of EDI actions and principles.  Spending time ensuring they understand the organisation’s vision, values and expectations on EDI is central to how the strategy is received and implemented.

A maturity matrix is a useful tool to assess your organisation on EDI, review progress, and consider next steps. This can then be shared internally and externally; inviting feedback from both internal and external stakeholders can provide further opportunities for honest reflection and building on key successes.  You can see an example of a maturity matrix.

Regular internal communication on your organisation’s commitment to EDI is essential to keeping employees engaged with your strategy. Making your EDI commitment public ensures accountability of senior leadership, encouraging stakeholder buy-in. Communication around your EDI strategy should also invite views and feedback from both internal and external stakeholders. Where feedback isn’t positive, it is important to be honest about any challenges, admit mistakes, and understand EDI as an ongoing process of improvement.

Many organisations communicate their commitment to EDI by signing a pledge. This can be helpful in raising industry standards and encouraging open dialogue across organisations.

Below are some best practice examples of organisations sharing their EDI Strategies on their website:

Build upon your knowledge of EDI, and how it applies to healthcare

EDI best practice, legislation and advice evolves quickly. Continual learning about EDI and how it applies within your sector will help your organisation to be an EDI leader with a positive culture and working environment. Consult and share your emerging findings with your organisation’s board members and any Employee Resource Groups (ERGs) as well as collaborating with them in relation to updates and expertise. You can learn more about EDI in the Health sector in London.

There are specific reports available which will help give you a solid grounding in the concerns facing your particular sub-sector at present. See what resources are available.

Continue to collect a wide range of data on the diversity of your workforce

Data is fundamental to any successful EDI initiative, as it helps to identify where particular interventions will successfully improve EDI outcomes. By having a deeper understanding of the diversity and lived experiences of your workforce, you can begin to identify any existing biases, gaps or challenges and plan to improve them.

Although data collection is mandatory for many NHS organisations, you can go above and beyond mandated data collection by looking at your data through an intersectional lens.

Research compiled by Nuffield Trust has shown, for example, that only 68% of disabled ethnic minority staff reported that adequate adjustments had been made for them, compared with 75% of disabled white staff. On the other hand, BMJ research found that minority ethnic groups are sometimes categorised together in data collection efforts, which can mask challenges faced by particular ethnic groups. Understanding your current data, and establishing the gaps within it, will allow you to collect the data required to support more nuanced and targeted actions.

Analysing data from grievance and disciplinary, salary band, progression, recruitment, sickness and leavers data, can reveal trends within particular departments, teams or locations. This makes it easier to identify challenges, barriers and opportunities to support underrepresented groups.

ONS have released guidance on how best to group ethnicity data at a high level. Using these groupings is one way to structure data to aid comparisons and benchmarking, whether to other NHS organisations, trusts, ICBs, or to show year-on-year progression to your own historic data.

The importance of reliable and triangulated data, that includes lived experience, is emphasised throughout the high-impact actions that form NHS England’s first EDI improvement plan. It has committed to the same high impact actions that have been directed at trusts and ICBs.  The plan emphasises that the actions have been chosen to address “the widely-known intersectional impacts of discrimination and bias”.  Find out more on information and resources.

When we spoke with sector employers, data-sharing was cited as an issue in most trusts, and accessing information regarding EDI or recruitment is still a work in progress. Collecting data about who is in your workforce and their pay is fundamental to embedding EDI in your organisation, particularly in order to identify any disparities that can be remedied. Do not limit salary analyses to gender; search for pay discrepancies by ethnicity, disability and other characteristics, or within departments and teams. You can go further again by looking at pay gap data intersectionality. For example, cross referencing information on gender pay gaps with information on ethnicity and disability pay gaps. The intersection of gender and age with regard to NHS pay gaps, for example, is also an area that is only just beginning to be researched.

INvolve ethnicity pay reporting shows commitment to transparency, and why it is important to have  conversations about race in the workplace.

Mend the Gap is a comprehensive, independent review into gender pay gaps in medicine in England.

Engage with other healthcare organisations and trade unions

For Priority Group individuals not currently working in the sector, seeing a whole industry committed to positive change may help alter perceptions that the industry is not for them. Engaging with other healthcare organisations can help organisations access advice and support, whilst also sharing lessons learnt and best practice. It provides an opportunity for the industry to evolve into a sector committed to inclusion.

Trade unions are also a helpful source of guidance on equality issues in the workplace. If your employees are members of a union, their representatives will be important stakeholders in consulting on and developing your EDI strategy. Whether your employees are members or not, the TUC, the BMA and many others have a range of helpful resources on EDI issues.

Here are some of the ways that your organisation can start to think about engaging and collaborating:

  1. Encourage and support employees to speak on external industry panels and publicise these events explicitly via all appropriate channels;
  2. Attend networking events for Priority Groups within the industry and highlight role models , encouraging leaders and managers to attend events;
  3. Share health sector EDI best practice with other organisations, as well as obtaining guidance on how best to facilitate a robust EDI strategy and culture. Share collaborations publicly to bolster accountability
  4. Consider cross sector mentoring and reverse mentoring; 
  5. Take part in research within the sector to improve data disclosure, data gathering, and data analysis in relation to EDI.