Quality and Standards Date: 18 July 2017

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1 Quality and Standards Date: 18 July 2017 Agenda item This report is for: Decision Discussion To Note History Title Workforce Race Equality Standard Report (WRES) Executive Director lead and presenter Director of Nursing Report author E&D Advisor The WRES is a contractual requirement with NHS England. Reporting on the WRES must be made on an annual basis, by no later than 1 st August. The report contains data relating to 9 indicators and makes a comparison against 2015/16 and 2016/17 outcomes. The data presented is aligned and calculated against the NHS England s Technical Guidance on the WRES The following impacts have been identified and assessed within this report Equality Quality Privacy Executive summary of key issues The 2016/17 data shows improvements in relation to 4 out of the 9 indicators relating to the relative likelihood of BME staff entering into formal disciplinary processes; experiencing of bullying, harassment and abuse from other staff; believing that the Trust provides equality of opportunity for career progression and promotion; and experiencing of discrimination at work from managers and other colleagues. Quality and Standards Committee is asked to support the report and the recommendations prior to the NHS deadline of submitting our WRES data and publishing our report. The recommendations can be summarised as below: Increasing the regularity of monitoring and reporting to Strategic Workforce Group and Q&S Committee so that we can demonstrate progress, reflect on what is working and recommend further actions for delivering improvements. Supporting the LDUs to engage with service users so that we can reduce prevalence of harassment / bullying and abuse towards staff, in line with our staff Wellbeing agenda. Assessing for any existing / potential bias in clinical and non-clinical career development pathways, Promoting expected standards of behaviour underpinned by our Bullying, Harassment and Dignity at Work Policy This report addresses these strategic priorities: We will deliver the best care We will support and develop our staff We will continually improve what we do We will use our resources wisely Page 1 of 14

2 We will be future focussed 1 The NHS Workplace Race Equality Standard (WRES) 1.1 Background and Introduction The WRES has been included in the NHS standard contract, and the Care Quality Commission (CQC) will now strengthen their consideration of performance against the Standard indicators in their inspections, under the Well Led domain Data is analysed to meet the requirements of nine indicators - 4 specifically for workforce data; 4 based on national staff survey; and 1 on Board composition. CQC look for evidence of Board level commitment to driving improvements against the Standard indicators The Trust has raised the profile of its commitment to delivering equality, diversity and inclusion outcomes, which has contributed to being the recipients of the Excellence in Diversity (Public Sector) Award in May Whilst the profile has been raised, there are areas for improvements that need to be made against the WRES indicators. These are highlighted in the within the recommendations contained within the report for each indicator. 2 Workforce Indicators 2.1 The standard indicators workforce data Trust s overall workforce profile as of 31 March 2017 not an indicator Data from the 2011 census shows that in our catchment area the Black & Minority Ethnic (BME) population makes up 8.3% of the overall total population. In this regard, the Trust s percentage of BME representation in the workforce exceeds the total overall percentage BME population. When we consider the overall BME working age population (18yrs-65yrs) in the Trust s catchment area (154,351), the percentage of our BME workforce against this working age population is 0.3%. Similarly, the percentage of the Trust s White workforce against the overall White working age population in (1,190,608) is 0.3%. These figures show parity between BME and White workforce from this perspective. In comparison to data, the Trust: Continues to maintain the same level of over-representation of BME staff compared to overall BME population in the catchment area, despite the fact that there is 1% drop in the total number of BME employees during Continues to maintain parity between White and BME workforce numbers in comparison to their overall respective working age population. Page 2 of 14

3 Staff not declaring their ethnicity has increased from 1.6% in to current 3%. We believe this is due to two issues: i) issues with the TRAC recruitment system capturing this information immediately after implementation and ii) poor quality data received when staff transferred into the organisation via TUPE (217 staff during 16/17). WRES Indicator 1: Percentage of staff in each of the Agenda for Change (AfC) Bands 1-9, VSM (including executive Board members) compared with the percentage of BME staff in the overall workforce. The purpose of this change is to help organisations to identify career progression blockages that surface within bands 1 7, in addition to potential blockages within the senior management bands. For this indicator, NHS England advises that organisations should undertake calculations separately for clinical and non-clinical staff. The indicator is calculated as below (and in accordance to NHS WRES Technical Guidance): (a) Number / percentage of BME and staff in overall workforce compared to the total number in overall workforce (b) Number of BME / percentage staff in AfC Bands 1 9 and VSM (Clinical and Non-Clinical) compared to the total number of staff in those bands. The data is based on substantive and fixed-term contracts; bank staff are not included. In reporting on this indicator, we have not included those who for whom we do not have declared ethnicity. It must also be noted that some staff, both White and BME, who may have two roles at different bands within the organisation, so they are likely to have been counted twice in our data. BME / White Workforce Number % White % BME % Not Declared 125 3% Total 4095 Band - Non Clinical Total White % White BME % BME BME / White % Difference Under Band % 0 0 0% Band % 25 18% 63% Band % 21 21% 59% Band % 9 4% 93% Band % 10 4% 91% Band % 8 9% 82% Band % 7 10% 81% Band % 7 13% 74% Band 8A % 1 4% 93% Band 8B % 0 0% 100% Band 8C % 0 0% 100% Band 8D % 0 0% 100% Band % 0 0% 0% VSM % 0 0% 100% Total % 88 9% 82% Page 3 of 14

4 Band - Clinical of which Non-Medical (NB - There are White employees who are not on AfC salaries and therefore are not included) Total White % White BME % BME BME / White % Difference Under Band % 0 0% 0% Band % 0 0% 0% Band % 22 28% 44% Band % % 58% Band % 27 10% 81% Band % 64 14% 71% Band % 67 9% 82% Band % 16 4% 92% Band 8A % 12 8% 85% Band 8B % 2 4% 91% Band 8C % 1 7% 87% Band 8D % 0 0% 100% Band % 0 0% 0% VSM % 0 0% 100% Total % % 76% Band - Clinical of which Medical & Dental Total White % White BME % BME BME / White % Difference Consultants % 32 19% 61% - of which Senior Medical Staff) Non-consultant career grade % 5 23% 55% % 12 28% 44% Trainee grades % 5 14% 73% Other % 1 13% 75% Total % 55 20% 60% Of the overall 11% of BME staff (458), 3.5% (16) are in bands 8-9 and VSM within both clinical and nonclinical posts. This is a 1.5% decrease in BME representation at those bands in comparison to when BME representation was at 5%. When we compare this to the current representation of White staff in Bands 8-9 and VSM, which is at 8.3% (291 of the overall White Staff population of 3512), we can see that the gap of representation is widening from when White staff representation was 7.3%. Page 4 of 14

5 The overall percentage difference between White and BME (i.e. the percentage of White staff minus the percentage of BME gives the percentage difference in representation) staff in Clinical and Non- Clinical roles are: - 82% in Bands 1 9 and VSM for Non-Clinical staff compared 84% during % in Bands 1-9 and VSM for Clinical (non-medical) staff. This remains the same compared to % for Clinical (medical & dental) staff compared to 56% during The percentage gap between BME and White staff has increased by 4% This percentage difference provides important information the greater the percentage difference, the greater the under representation of BME staff in the pay band and roles. From the data above, it is clear that the Trust has further progress to make The Equality and Diversity Advisor, supported by the Director of HR will: Assess what potential blockages there are for career progression within Bands 1 to 7 and senior management grades, and the reasons for these. Identify initiatives to limit potential blockages, including review of relevant policies / practices that related to the Trust s Talent Management Framework. Provide 6 monthly reports relating to the above to the Strategic Workforce Development Group and Quality and Standards Committee WRES Indicator 2: Relative likelihood of staff being appointed from shortlisted across all posts The relative likelihood of White staff being appointed after shortlisting compared to BME staff is 1.86 times the greater. This likelihood has increased from 1.32 times the greater during , which is a disappointing outcome. BME applicants were more likely to be shortlisted in 2016/17 (2313 shortlisted) compared to 2015/16 (780). The total number of shortlisted applicants increased from 3988 in 2015/16 to 8693 due to the significant increase in Trust recruitment activity. BME applicants were shortlisted 2.96 times more frequently in 2016/17 than in 2015/16 whereas white candidates were only shortlisted 1.98 times more frequently. This increased likelihood of shortlisting is not reflected in the likelihood of appointment. Although the relative likelihood indicates a negative outcome to this indicator for BME applicants during , there was a considerable increase in the proportion of BME applicants being shortlisted. Page 5 of 14

6 Through the Director of Human Resources: Continue to monitor the relative likelihood on a 6 monthly basis and provide report to Strategic Workforce Group on progress made, showing progress and / or recommending further actions to be implemented. WRES Indicator 3: Relative likelihood of staff entering the formal disciplinary process, compared to that of White staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation Timescale - Apr 16 Mar 17 White BME Not declared Number of Staff in workforce Number of staff entering the formal disciplinary process There was a decrease in BME staff entering into formal disciplinary processes from 11 during to 5 during BME staff are 0.96 time more likely to be involved in formal disciplinary process than White staff, compared to 2 times more likely during This is a positive decrease. Through the Director of Human Resources: HR Team continue to review disciplinary cases to identify any discrepancies between White and BME cases and use the learning gained to determine actions for the future. HR Team continue to work with managers to ensure that decisions regarding commencing disciplinary action are fair Indicator 4: Relative likelihood staff accessing non-mandatory training and CPD training Page 6 of 14

7 Of the total number of White Staff (3512), 37% (1309) accessed non-mandatory and CPD training as of March This is reduction from the 62% who accessed such training during Of the total number of BME Staff (458), 30% (136) accessed non-mandatory and CPD training as of March This is reduction from the 71% who accessed such training during The relative likelihood of White staff accessing non-mandatory training and CPD as compared to BME staff is 1.26 times the greater. This is an increase from when it was 0.87 times the greater. Through the Medical Director: Monitor access to the recently introduced Workforce Development fund by (a) BME access to the fund; (b) percentage of BME approvals; and (c) percentage of BME non-approval Monitor access to essential skills training by ethnicity. Provide 6 monthly reports relating to the above to the Strategic Workforce Development Group and Quality and Standards Committee, showing progress and / or recommending further actions to be implemented. 2.2 The standard indicators staff survey data National NHS Staff Survey findings. We have assessed data relating to each of the 4 staff survey indicators required for WRES. Data has been extracted from the National NHS Annual Staff Survey It is a WRES requirement that data in this section of the report should be related to the overall number of White and BME respondents as below: Overall total response to whole survey = 1952 Total White Respondents = 1671 Total BME respondents = 168 Total Ethnicity unknown = 113 a) For each of the indicators below, the total number of White and BME respondents to each question should be taken into account, and therefore the percentages are based on the total number of respondents to each question - not to overall number of respondents to the whole survey. WRES Indicator 5: Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or members of the public in the last 12 months. Total respondents to the question (2016) Total White Total BME Ethnicity Not Stated Answer 'Yes' 690 (37%) 598 (36%) 71 (43%) 21 (34%) Answer 'No' 1184 (63%) 1048 (64%) 96 (57%) 40 (66%) Page 7 of 14

8 Of the total number of BME staff respondents to this question, 43% (71 staff) experienced harassment, bullying or abuse from patients, relatives or members of the public, compared to 36% (598) of total White respondents. Overall, the relative likelihood of BME staff experiencing harassment, bullying or abuse from patients, relatives or members of the public compared to White staff is 1.2 times greater. The percentage of BME staff experiencing harassment, bullying or abuse from patients, relatives or members of the public increased from 41% in to the current 43%. This is a negative outcome. In contrast, the percentage of White staff experiencing harassment, bullying or abuse from patients, relatives or members of the public has stayed the same as it was during , at 36%. The relative likelihood of BME staff experiencing harassment, bullying or abuse from patients, relatives or members of the public increased very slightly from 1.1 times greater during to 1.2 times greater. Further analysis of this indicator, disaggregated by locality, has been distributed to the Senior Management Teams within the LDUs, with the expectation that localised engagement with staff and patient experience groups will result in targeted actions to reduce the staff experience of harassment, bullying or abuse from patients, relatives or members of the public. Through the Director of Nursing & Quality: Ensure support is provided to LDU s in staff and patient engagement, including engagement with service user representatives, to reduce the prevalence of harassment bullying or abuse. This is to be done through the organisation s commitment to the Staff Wellbeing Strategy (currently under review). WRES Indicator 6: Percentage of staff experiencing harassment, bullying or abuse from staff in the last 12 months. The staff survey contains two questions pertaining to this indicator as follows: In the last 12 months have you personally experienced harassment, bullying or abuse at work from managers?(q15b) In the last 12 months have you personally experienced harassment, bullying or abuse at work from colleagues? Q15c The calculations below combine the two questions: Total respondents to the question Total White Total BME Ethnicity Not Stated Answer 'Yes' 474 (25%) 412 (25%) 46 (28%) 16 (26%) Answer 'No' 1386 (75%) 1220 (75%) 120 (72%) 46 (74%) Of the total number of BME staff respondents to this question, 28% (46 staff) expressed that they experienced harassment, bullying or abuse from staff, compared to 25% (412 staff) of total White respondents. Page 8 of 14

9 The relative likelihood of BME staff experiencing harassment, bullying or abuse from staff compared to White staff is 1.1 times greater The percentage of BME staff who responded Yes to the question decreased from 34% in to the current 28%. This is a decrease of 6% which is positive. The percentage of White staff who responded Yes to the question also decreased from 27% in to the current 25%. This is a decrease of 2% which is positive. The relative likelihood of BME staff experiencing harassment, bullying or abuse from staff has reduced slightly from 1.3 times greater in to the current 1.1 times greater. Further analyses of this indicator, disaggregated by locality, has been distributed to the Senior Management Teams within the LDUs, with the expectation that through the development and promotion of Staff Charter and the Bullying, Harassment and Dignity at Work policy, improvements are made at a local level. Through the Director of Human Resources: Work is carried out to further promote the standards of behaviour expected by all staff, and support is provided to Senior Management Teams to disseminate relevant messages in line with Bullying, Harassment and Dignity at Work Policy. WRES Indicator 7: Percentage believing that trust provides equal opportunities for career progression or promotion. Total respondents to the question Total White Total BME Ethnicity Not Stated Answer 'Yes' 1026 (55%) 916 (56%) 79 (48%) 31 (50%) Answer 'No' 223 (12%) 187 (12%) 27 (16%) 9 (14%) Don t know 611 (33%) 530 (32%) 59 (36%) 22 (36%) Of the total number of BME staff respondents, 48% (79) believe that the Trust provides equal opportunities for career progression or promotion, whilst 16% (27) believe that the Trust does not. BME respondents who did not know amounted to 36% (22). In comparison, 56% (916) of total White respondents believe that the Trust provides equal opportunities for career progression or promotion, whilst 12% (187) believe that the Trust does not. White respondents who did not know amounted to 32% (530) The relative likelihood of White staff believing that the Trust provides equal opportunities for career progression or promotion compared to BME staff is 1.2 times greater. The percentage of BME staff that responded Yes to the question increased from 43% in to the current 48% - an increase of 5% which is positive. The percentage of White staff that responded Yes to the question remains the same as in at 56%. Page 9 of 14

10 The relative likelihood of White staff believing that the Trust provides equal opportunities for career progression or promotion compared to BME staff decreased slightly from 1.3 times greater in to the current 1.2 times greater. Overall BME staff have a better perception of the Trust s commitment to equal opportunities in career progression, than they did in Through the Medical Director: Assess Clinical and Non-Clinical career development pathways are free from existing / potential bias affecting BME staff, as part of the work to develop the Trust s Career Development Framework. WRES Indicator 8: In the last 12 months I have personally experienced discrimination at work from my manager/team leader or other colleagues. Total respondents to the question Total White Total BME Not stated Answer 'Yes' 159 (9%) 130(8%) 20 (12%) 9 (14%) Answer 'No' 1718 (91%) 1519 (92%) 144 (88%) 55 (86%) Of the total number of BME staff respondents, 12% (20) have expressed that they experienced discrimination at work from their manager / team leader or other colleagues, in comparison to 8% (130) of White respondents. Overall, the relative likelihood of BME staff experiencing discrimination at work from their manager / team leader or other colleagues is 1.5 times greater than White staff. The percentage of BME staff that responded Yes to the question has decreased from 20% in to the current 12 % - this is a decrease of 8 % which is positive. The relative likelihood of BME staff expressing that they have experienced discrimination at work from their manager / team leader or other colleagues has decreased from 2.5 times greater than White staff in , to the current 1.5 more likely. This decrease is encouraging for the Trust. Further analyses of this indicator, disaggregated by locality, has been distributed to the Senior Management Teams within the LDUs, with the expectation that through the development and promotion of Staff Charter and the Bullying, Harassment and Dignity at Work policy, improvements are made at a local level. Through the Director of Human Resources: Promote Bullying, Harassment and Dignity at Work policy via the local staff experience and engagement initiatives. Page 10 of 14

11 2.3 The standard indicators Board data WRES Indicator 9: Percentage difference between (i) the organisations Board voting membership and its overall workforce and (ii) the organisations Board executive membership and its overall workforce This indicator has changed from the previous reporting requirement. Indicator 9 now requires Percentage difference between (i) the organisation s Board voting membership and its overall workforce and (ii) the organisation s Board executive membership and its overall workforce The previously, the indicator required NHS Trusts to report on the percentage difference between the organisation s BME board voting membership and its overall BME workforce. White BME Ethnicity Unknown / Not Declared Overall Workforce 85.8% (3512) 11.2% (458) 3.1% (125) Total number of Board members by ethnicity Voting Board members by ethnicity (total 5) Non-Voting Board Members (total 8) 69.2% (9) 0.0% 30.8% (4) 80% (4) 0.0% 20% (1) 62.5% (5) 0.0% 37.5% (3) Executive Board Member 62.5% (5) 0.0% 37.5% (3) Non-Executive Board Members 80% (4) 0.0% 20% (1) Percentage Differences Voting Membership Overall % of BME staff in the workforce 11.2% % of BME voting members on Board 0.0 % % difference -11.2% Overall % of White staff in the workforce 85.8% % of White voting members on Board 80.0 % % difference -5.8% Percentage Differences Executive membership Overall % of BME staff in the workforce 11.2% % of BME Executive Membership 0.0 % % difference -11.2% Overall % of White staff in the workforce 85.8% % of White Executive Membership 62.5 % % difference -23.3% Page 11 of 14

12 During , the Trust had one BME member of the Board, who resigned prior to end of their term of office. This has impacted on the Board BME representation. During , the Board were successful in their application to the NHS Leadership Academy South West s Diversity Advantage Programme, and provided a placement to an aspiring BME non-executive member. However, the placement was not completed as the individual resigned due to personal circumstances, and this has also impacted on the BME representation on the Board. During , the Board recruited new members. The data above shows that 30% of the Board members have not declared their ethnicity. There currently no BME members of the Board, and therefore the percentage of difference between the overall BME workforce and BME representation on the board is -11.2%, compared to 4.9% in Through the Company Secretary: Corporate Governance continue to support the Board to attract the right skills and experience in Board membership, and promote membership to potential BME candidates 3 Next steps With improvements in 4 out of the 9 indicators, the Trust needs to maintain the momentum to ensure that we continue with this trajectory in our performance. The Trust must continue to develop and talented and cohesive workforce where staff diversity and equality of opportunity are seen as an asset to delivering excellent quality services. Where the Trust has seen a negative impact on the indicators, there is clearly further work to be carried out through support from senior leadership within the organisation. The lack of progress does not reflect the Trust s ambitions to meet its priorities. Currently, many initiatives are under way including Listening into Action, the establishment of the Workforce Development Fund, locality Staff Engagement Groups and the development of the Staff Charter. These initiatives are aimed at improving the way the Trust works with staff which will support staff engagement and ultimately impact on the quality of care it provides to service users. The recommendations within this report will be delivered through existing initiatives, so that WRES is considered in alignment with our aims for improvement in workforce and service delivery. 4 Future Reporting Six-monthly reports on the delivery of the WRES recommendations will be provided to the Strategic Workforce Group for discussion. An annual WRES report will be provided to the Board s Quality and Standards Committee during July of each year, for approval. The report and the relevant data will then be submitted to NHS England and published on the Trust s website by no later than 1 st August on an annual basis. Page 12 of 14

13 5 Recommendations Quality and Standards is asked to support and endorse the recommendations in the body of this report. The delivery of these recommendations will be overseen by the SWG with the timescales for delivery to be negotiated with relevant owners. Recommendations are summarised in Appendix 1 6 Conclusions The data for shows that improvements have been made in 4 out of the 9 WRES indicators, which is positive in comparison against WRES outcomes. Areas for improvement and additional focus have been identified and the Trust will embed this work through ongoing work programmes with the intention of seeing improvements in 2017/18 results. The recommendations have strategic sponsorship to drive improvements within 12 months against the WRES indicators. Page 13 of 14

14 Appendix 1 Indicator Summary of Recommendations Owners Indicator 1: Percentage of staff in each of the Agenda for Change (AfC) Bands 1-9, VSM compared with the percentage of BME staff in the overall workforce. (The purpose of this change is to help organisations to identify career progression blockages that surface within bands 1 7, in addition to potential blockages within the senior management bands) Indicator 2: Likelihood of BME staff being appointed from shortlisted compared to that of White staff Indicator 3: Relative likelihood of BME staff entering the formal disciplinary process, compared to that of White staff Indicator 4: Relative likelihood of BME staff accessing non mandatory training and CPD as compared to White Staff Indicator 5: Percentage of staff experiencing harassment, bullying or abuse from patients, relatives or members of the public in the last 12 months. Indicator 6: Percentage of staff experiencing harassment, bullying or abuse from staff in the last 12 months. Indicator 7: Percentage believing that trust provides equal opportunities for career progression or promotion. Indicator 8: In the last 12 months I have personally experienced discrimination at work from my manager/team leader or other colleagues. Indicator 9: Percentage difference between the organisations Board voting membership and its overall workforce Assess what potential blockages there are for career progression within Bands 1 to 7 and senior management grades, and the reasons for these. Identify initiatives to limit potential blockages, including review of relevant policies / practices that related to the Trust s Talent Management Framework. Provide 6 monthly reports relating to the above to the Strategic Workforce Development Group and Quality and Standards Committee Continue to monitor the relative likelihood on a 6 monthly basis and provide report to Strategic Workforce Group on progress made, showing progress and / or recommending further actions to be implemented. HR Team continue to review disciplinary cases to identify any discrepancies between White and BME cases and use the learning gained to determine actions for the future. Monitor access to the recently introduced Workforce Development fund by (a) BME access to the fund; (b) percentage of BME approvals; (c) percentage of BME nonapproval Monitor access to essential skills training by ethnicity. Provide 6 monthly reports relating to the above to the Strategic Workforce Development Group and Quality and Standards Committee Ensure support is provided to LDU s in staff and patient engagement, including engagement with service user representatives, to reduce the prevalence of harassment bullying or abuse. This is to be done through the organisation s commitment to the Staff Well-Being Strategy. Work is carried out to further promote the standards of behaviour expected by all staff, and support is provided to Senior Management Teams to disseminate relevant messages in line with Dignity at Work Policy & Staff Charter Assess Clinical and Non-Clinical career development pathways are free from existing / potential bias affecting BME staff, as part of the work to develop the Trust s Career Development Framework. Promote Dignity at Work policy via the local staff experience and engagement initiatives. Corporate Governance continue to support the Board to attract the right skills and experience in Board membership, and promote membership to potential BME candidates Dir. of HR Dir. of HR Dir. of HR Medical Director Dir. of Nursing Dir. of HR Medical Director Dir. of HR Company Secretary Page 14 of 14