Although senior levels of NHS leadership understand diversity is essential for innovation, cultural inclusion and maximising talent in the NHS, Danielle Oum, chair of Walsall Healthcare NHS Trust and co-chair of NHS Confederation's BME Leadership Network, points out that implementing it remains a challenge.
A recent report describing a decline in diversity in NHS leadership, particularly in non-executive directors[i], is a timely accompaniment to the high-profile prioritisation of this issue within the Interim NHS People Plan. It is clear to me that at the most senior levels of the NHS it is understood that diversity in leadership is necessary to facilitate innovation, enable inclusive culture and maximise talents, all of which are vital in the drive to deliver great care effectively and efficiently. However, implementing that high-level commitment to equality, diversity and inclusion is challenging as organisations across the NHS strive to deliver across a range of operational, financial and quality priorities, overseen by regulatory scrutiny. For many system or organisational leaders, diversity may seem theoretically important but, in the words of an ex-board colleague: “Hardly a priority in the scheme of things...”
Joining the dots so that the vision set out by national leaders becomes a reality across NHS organisations will require ongoing work by those already bought into the agenda. It will also need the NHS system to require delivery rather than the current tendency to focus on hearts and minds. I often think that if infection control was approached in the same way as equality, diversity and inclusion, “Now wash your hands” and “Bare below the elbow” would be promoted through opt-in seminars on the case for cleanliness. Albert Einstein once said: “Not everything that counts can be measured. Not everything that can be measured counts.” In the NHS however, equality, diversity and inclusion will count more if organisations are required to measure and report performance against clear metrics.
The challenge of achieving a diverse NHS leadership is ongoing. Progress is not linear; it can plateau or decline and so achieving ongoing progress will require clear articulation of purpose underpinned by strategies, policies and processes with champions helping to keep it on the agenda. Momentum needs to be maintained, efforts sustained, with innovation and acceleration required in order to achieve step changes along the way. As the NHS faces workforce shortfalls and responds to a changing and increasing patient need, the imperative of drawing upon leadership from across a wide pool of talent is clear.
“If you look at history, even recent history, you see that there is indeed progress. . . Over time, the cycle is clearly, generally upwards. And it doesn't happen by laws of nature. And it doesn't happen by social laws. . . It happens as a result of hard work by dedicated people who are willing to look at problems honestly, to look at them without illusions, and to go to work chipping away at them, with no guarantee of success — in fact, with a need for a rather high tolerance for failure along the way, and plenty of disappointments”. Noam Chomsky