The NHS Constitution<\/em> stresses NHS workplaces and patient care should be free of discrimination. Research strongly suggests how staff are treated (including whether they face discrimination) impacts on patient care, staff well-being and organisational effectiveness. Inclusion is the extent to which staff believe they are encouraged to contribute to the effectiveness of that group and where all staff believe they are valued members of the work group, and in which they receive fair and equitable treatment. Specifically, where diversity, including at senior levels, is underpinned by inclusion, it benefits staff engagement, retention, innovation, productivity and the safety and quality of care.\u00a0 Inclusive teams are more likely to be \u2018psychologically safe\u2019 workplaces where staff feel confident in expressing their true selves, raising concerns and admitting mistakes without fear of being unfairly judged[i]<\/sup><\/a> enabling efficient, productive and safe care. (4)<\/p>\n There is a wealth of relevant research:<\/p>\n You demand \u201cValue for Money\u201d but in doing so risk confusing efficiency and effectiveness. Abolishing EDI posts would save a few million pounds, but the cost in reduced effectiveness is likely to far outweigh any savings. For example, consider the consider cost of at least 150,000 NHS staff choosing to solely work as bank or agency staff, many because they feel they were treated unfairly in their substantive roles – especially black and minority ethnic workers, and women seeking flexible working arrangements. (10). It is unclear what \u201cvalue for money\u201d means when measuring the levels of harassment and even poorer career progression for ethnic minority staff, worse treatment of international recruits, higher agency costs, and teams where staff are less willing to admit mistakes, raise concerns or work collaboratively \u2013 the likely consequences of less attention to EDI.<\/p>\n There has been some progress on equality \u2013 for example the numbers of disciplinary cases involving ethnic minority staff have fallen substantially since 2017. Boards have become more diverse in recent years but the pipeline of more diverse senior managers remain precarious. Some organisations have developed more flexible working patterns to adapt to the changing needs of their workforces.<\/p>\n But in all these areas of progress, specialists in equality, diversity and inclusion alongside leaderships who understand and act on this evidence have played a crucial role in highlighting problems and signposting solutions.\u00a0 The cost is minimal and the benefits substantial.<\/p>\n You refer to equality being everyone\u2019s business. I agree, but research is resoundingly clear that progress depends on inclusive leaderships explicitly<\/strong> paying attention to EDI:<\/p>\n In every other challenge facing the NHS we know we need expertise that leaderships can draw on. Unless there are specialists and senior leaders who understand and challenge discrimination, who model the behaviours they expect of others, who pay sustained attention to these issues, then patient care, staff retention and engagement, innovation, creativity and staff well-being will suffer as will progress on challenging inequality in healthcare provision. Such evidence-based leadership is a cornerstone of the service improvement we all seek. There is certainly work to be done in ensuring work to improve equality, diversity and inclusion is always evidence based, but that requires precisely the expertise you demean.<\/p>\n Your office suggests we cannot afford such \u201cluxuries\u201d. The evidence powerfully suggests we cannot afford to not<\/u><\/strong> pay attention to it.\u00a0 (HBR 2019)<\/p>\n Yours sincerely<\/p>\n Roger Kline OBE, FRSA, Research Fellow, Middlesex University<\/p>\n [i]<\/a> Shore LM, Cleveland JN, Sanchez D. (2018) Inclusive workplaces: A review and model Human Resource Management Review; see also Edmondson, A (2018) The Fearless Organisation: Creating Psychological Safety in the Workplace for Learning, Innovation and Growth. Harvard Business School: Whiley<\/p>\n <\/a>REFERENCES<\/p>\n [ii] Dixon-Woods\u00a0M,\u00a0Baker\u00a0R,\u00a0Charles\u00a0K,\u00a0et al.\u00a0Culture and behaviour in the English National health service: overview of lessons from a large multimethod study.\u00a0BMJ Qual Saf\u00a02014;23:106\u201315.doi:10.1136\/bmjqs-2013-001947<\/a> See also M West (2021) (West M (2021) Compassionate Leadership: Sustaining Wisdom, Humanity and Presence in Health and Social Care.<\/p>\n [iii]<\/a> Roger Kline<\/a>,\u00a0 Duncan Lewis<\/a> (2019) The price of fear: Estimating the financial cost of bullying and harassment to the NHS in England. Public Money and Management Volume 39 2019 Issue 3<\/p>\n [iv]<\/a> Lucian L Leape<\/a>\u00a0,\u00a0Miles F Shore<\/a>,\u00a0Jules L Dienstag<\/a>,\u00a0et al (2012) Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians. Acad Med.\u00a02012 Jul;87(7):845-52.\u00a0doi: 10.1097\/ACM.0b013e318258338d.<\/p>\n <\/p>\n <\/p>\n\n
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