Building an inclusive culture
This section of the toolkit offers strategies that create and support inclusive working environments in the health sector. When people feel they belong at work, they experience greater meaning, satisfaction, and stability; and as a result, the performance and service they provide is positively impacted.
Recent research from Belonging Space and 3Gem Research suggests that a third of the UK working population has felt isolated or lonely in the workplace at some point. Your organisation can build a more inclusive culture by building strong employee relationships, creating positive employee experiences and encouraging frequent employee recognition.
Ensure your employees have access to (internal or external) HR
A trusted and independent HR function, clearly identified to employees, gives staff confidence that issues they raise will be handled fairly and confidentially. They also provide better analytics and reporting, and improve regulatory compliance.
Before creating a discrimination and harassment policy, ensure you have the knowledge and understanding of what these terms mean and also how you as an employer are best placed to respond. In the context of the health sector, it is crucial to consider how this may play out directly within your organisation, as well as from outside the team in terms of patient experience.
It is particularly important to understand the legal responsibility you have to address issues of discrimination and harassment - this is called ‘vicarious liability’. The following are the kinds of discrimination you need to protect against:
- Direct discrimination, where a person is treated less favourably than another on the basis of a ground which is unlawful.
- Indirect discrimination, where a provision, criterion or practice would create a significant disadvantage for a substantial number of one group of persons, who share a protected characteristic, compared with other persons who do not, unless that provision, criterion, or practice is a proportionate means of achieving a legitimate aim.
- Victimisation, where someone is treated less favourably than others because he or she or they has taken action in respect of unlawful discrimination.
- Harassment, when unwanted conduct related to any unlawful ground takes place with the purpose or effect of creating an intimidating, hostile, degrading, humiliating, or offensive environment for the victim. This is not limited to physical acts and may include verbal and non-verbal communication and sexual harassment.
This ‘good practice guidance for preventing and addressing bullying and harassment in health and social care organisations’ published by the RCN, includes a sample policy at Appendix 1.
The BMA has produced guidance for employers and healthcare workers on the steps to take should incidences of discrimination against a healthcare worker occur. Several NHS organisations already have zero-tolerance discrimination and harassment policies in place, and these are readily available for review if you want help writing one for your organisation.
Policies and procedures are best reviewed and renewed consistently, to ensure that they keep pace with dynamic social and public policy. Learn more about handling a bullying, harassment or discrimination complaint at work and dealing with bullying, harassment or discrimination complaint at work.
Create a policy that addresses the inclusion of agency staff
Ensuring bank and agency nurses’ holidays and salaries are protected, in line with NHS Trust Agenda for Change will help to improve staff morale, build a greater sense of inclusion, and boost staff retention. Beyond salary protections, the policy should address the actions your organisation will take to foster a culture of belonging for all agency staff, including (but not limited to) cleaners, porters, locum staff and interpreters. Your policy should outline a commitment to ensuring all agency staff are welcomed and treated with respect, outlining the relevant processes for meeting this commitment.
Review your employee policies to ensure they reflect EDI best practice
Embedding EDI practice within an organisation can be achieved through improvements in corporate processes, including performance management, training and development, and organisational and people management processes. As a minimum, employers should review parental, discrimination, recruitment, and other employee-related policies. Policies and procedures should be reviewed annually to ensure that they remain relevant.
Here are some practical steps you can take to ensure that your policies are inclusive:
- To maintain accountability, state who is responsible for policy reviews at the top of each policy document, and how frequently the policy is to be reviewed and updated. Be sure to include these dates in internal calendars.
- Have a system of ongoing policy tracking. To analyse if any group is being disproportionately affected by a policy or process, collect anonymous demographic data. This is crucial in evaluating trends in the use and application of policies.
- Create a robust Equality Impact Assessment (EqIA) process - an approach designed to assess the impact of policies on different demographics. Conducting EqIAs will help to ensure all new policies and procedures are designed with inclusion at the core, and that any potential adverse effects can be noted and mitigated against. Find out more on the guidance.
- Each policy should exist in an accessible format, including making sure they are accessible to screen readers to ensure access is available to all parties.
- Use resources, like those published by CIPD, to follow EDI best practice.
- Create a clear discrimination and harassment policy that is included in onboarding and systematically reviewed. Take a look at the guidance.
- Consider how your organisation supports expectant and working parents, and those returning from parental leave.
Becoming a parent or returning from parental leave can be a difficult transition. It can take time to adjust, especially when people are first-time parents. Employers can lead by example in taking a proactive approach, with working or expectant parents about how they can be best supported. This can be done through one-to-one interviews, focus groups, or even during training and onboarding sessions.
GPs who are not directly partnered with the NHS may have more flexibility in terms of parental leave policies and support of working parents and parents-to-be. Research shows that better maternity and paternity policies with better paid leave encourages individuals of all genders to take parental leave, rather than that leave and responsibility falling unevenly on women. This in turn helps change the prejudicial narrative around women and time taken away from work for childcare, as well as positively reinforcing shared parental responsibilities. Where possible, GPs may wish to consider enhancing existing parental leave provisions, and offering flexible working opportunities.
Discuss EDI and upskill your organisation on current issues in EDI
Collaborate with independent EDI consultants to train your employees on how to engage in inclusive recruitment, dealing with microaggressions, conscious inclusion strategies, and other EDI training, including positive action schemes. EDI should also form part of hiring managers' performance reviews to maintain a level of accountability against your organisation's inclusion goals. For example, one goal could be to promote diversity and inclusion in their own teams. This goal could then be met by ensuring they promote the development and advancement of underrepresented groups in their own teams through professional development courses and training. They should ensure that time scales are aligned with this goal, as well as measuring the update of this development. More guidance can be found on FutureNHS.
It is imperative that organisations provide a ‘safe or brave space’ for their workforce to speak on matters that are important to them. While this can be a difficult task to navigate, Freedom To Speak Up Guardians provide independent support - this can be reassuring for staff who may not wish to discuss sensitive topics directly with a line manager.
GPs and PCNs - suggested actions
General practice leaders are always stretched for time. They often occupy multiple roles in the organisations they run, so allocating time in GP training to learn and talk about EDI will help raise awareness, open up conversations, and keep it on the agenda. Allocating just one hour of your regular training days to learn more about EDI can have a huge impact on your awareness and understanding of EDI and its importance to your organisation. There are many resources available to help engage employees, such as the NHS Academy bitesize learning, some of which are EDI specific.
Ensure your team and social events are inclusive
Always organise events with accessibility and inclusion in mind, so that team social events are welcoming for everyone. Unlimited has produced a useful and comprehensive guide on running accessible events.
Here are some ways to get started and support religious holidays and promote interfaith inclusion in your workplace:
- Identify an EDI calendar which incorporates religious holidays or identity-based observances (e.g., Black History Month) throughout the year. Send out a survey to better understand how employees want to be supported or want to celebrate different holidays and/or identity-based observances (e.g. offer flexible working during Ramadan);
- To raise awareness and promote inclusion, identify internal and external speakers to talk about the meaning of different religious holidays and identity-based observances;
- Recognise the practical elements of religious holidays (for example, does your office have a quiet and private space for prayer and meditation in the office?).
The National NHS Muslim Network recently published official guidance, to provide colleagues, line managers and senior leaders across the NHS with information on Ramadan and Eid.