Equality & Diversity Review

Report by Mr Surinder Sharma

REVIEW OF THE IMPLEMENTATION OF EQUALITY AND DIVERSITY POLICIES, PRACTICES AND COMPLAINTS HANDLING & ORGANISATIONAL STRUCTURES OF THE UNIVERSITY HOSPITALS OF SOUTHAMPTON NHS FOUNDATION TRUST

The External Review Terms of Reference which I was sent were:

AIMS & OBJECTIVES

·  To review the Trust’s approach to managing BME complaints with a particular focus on the management of employee relations cases relating to BME staff. Identify ways that could have been improved or managed differently going forward.

·  To review how the Trust has progressed the 2011 BRAP review, what is still outstanding and advise how this should be taken forward.

·  To assist the Trust in seeking views from a wide range of BME staff to ascertain what they think the Trust does well and what it could do better or differently to enable them to feel valued and fully engaged.

BACKGROUND TO THE REVIEW

I was contacted in January 2014 by Mr Ram Jassi, Chair of the Equality Inclusive Network (EIN) at the University Hospitals Southampton NHS Trust (The Trust) to see if I was available and willing to conduct an independent, impartial and transparent review of the implementation of equality and diversity policies, practices, complaints handling and the effectiveness of organisational structures.

I was invited to visit and meet with key stakeholders within the Trust on13th March 2014 by Ms Judy Gillow, Director of Nursing, who was commissioning the external review of the Trust’s approach to Equality and Diversity. Judy Gillow in her email note to me of 26 February 2014 also sent me the Terms of Reference (TOR) for the review which had been agreed by a Trust Oversight Group which consisted of Ms Judy Gillow – Director of Nursing and Commissioner of the Review, Ms Lena Samuels – Lead Non-Executive Director, Mr Ram Jassi – Chair of the EIN Group and Ms Alison Thorne-Henderson – Director of Human Resources. I was informed that the TOR had been approved by the Trust Board and had the full support of Ms Fiona Dalton – the Chief Executive Officer of the Trust.

PURPOSE OF THE REVIEW

This external review is intended to assist the Trust to develop its approach to equality and diversity; to identify further areas of work that will help inform the right actions and focus; to further develop collaboration with and the confidence of the BME staff and the EIN Group alongside the diverse staff network groups; and finally to inform the development of a strategic plan going forward.

On 13 March 2014 I met with Ms Judy Gillow - Director of Nursing, Ms Fiona Dalton – the Trust Chief Executive Officer, Ms Lena Samuels – Trust Lead for Equality and Diversity and Non-Executive Director, Mr Ram Jassi – the Chair of the EIN Group, EIN Group Members, Ms Alison Thorne-Henderson – the Trust Director of Human Resources, Mr Steve Harris – Trust Deputy Director of Human Resources (Operations), Ms Gayle Byrne – Director of Quality in one to one conversations, and then various other Trust employees at an organised informal lunch within the Trust. The purpose of this visit was to introduce myself to the various key stakeholders within the Trust, to assure them and win over their trust and confidence that I was being recruited by the Trust to conduct an impartial, independent and transparent review. I had no connections with anyone at the Trust or was not biased in any way. By the end of the day I was given the impression that all the stakeholders I had met were content and happy with me conducting the review. Following this, around Easter and afterwards, I had a number of conversations with Ms Judy Gillow and then gave some dates from the middle of May to mid-June when I was available to visit Southampton and conduct the review. Further I requested and was granted an independent person, agency PA, , to assist me with the review and take down notes of the interviews. ably organised my diary to carry out interviews for Trust employees who wanted to contribute to the review and were able to see me.

I have now had a chance to see copies of the previous iterations of the draft Terms of Reference for this independent review of Equality & Diversity which was to be commissioned by the Trust. These show that originally there was going to be only ONE external review. This Equality & Diversity review was going to include , its subsequent handling, investigation, outcomes and further complaints regarding the outcomes of the initial investigation. Prior to this review, EIN members, had also raised concerns about the outcome of the investigation into .

The day I commenced the review on 19 May, 2014, I was informed by Ms Judy Gillow and Ms Fiona Dalton that the Trust had engaged a , a freelance HR Consultant, to separately review the investigation, its terms of reference, its outcomes and the subsequent handling of the complaint of by . .

I was also informed that there were two other internal reviews that had been undertaken by the Trust. The Trust had completed, in collaboration with EIN members, a review of 17 specific cases where concerns had been raised regarding management of employee relations matters with individual BME members of staff. This report was just being finalised when I commenced this review. This was conducted by the Trust HR Director, Alison Thorne-Henderson.

A further and separate review was also taking place on overall trends, incidence and themes to identify any specific learning. This review was jointly being conducted by the Director of Quality – Ms Gayle Byrne and the Deputy HR Director – Mr Steve Harris.

STRUCTURE OF THE REVIEW- Evidence Gathering

I conducted 69 face to face interviews with employees of the Trust representing a cross section of staff by grade, variety of job function, staff working in different parts of the Trust (Corporate, Divisions A B C D), and job families, Clinical and Managerial, Nursing, Midwifery, Clinicians and Board Members.

28 of the staff members were from Black & Minority Ethnic backgrounds, 48 women and 21 men. These interviews were conducted over 10 days from 20 May until 10 June 2014. Initially I saw members of staff who had requested to see me but as the review progressed I also requested to see other staff, who had not come forward to participate in the review. I had to see some staff members twice as we could not cover all the issues in the initial interviews or saw them at the end of the day when there was ample time to discuss the issues as part the interview. Although I requested to see some members of staff particularly , they were unavailable despite offering them a number of options.

I also conducted desk research from the materials that were supplied to me by the Trust, the Staff Networks, and documents that I had requested as the review progressed. Some of the information and statistics that I had requested could not be supplied due to a time limitation and administrative work load implications.

WHY IS THE USE OF TERMINOLOGY IMPORTANT?

It is important to be clear and understand what is being said and meant by employees/managers or when terms are used by the Trust in drafting or creating policy or procedures. Employees/Managers in the Trust use a variety of terms when it comes to describing its policies and the measures undertaken to implement equality and diversity initiatives. I am not entirely certain of the shared understanding amongst all parties concerned of the meaning when certain terms or words are used in connection with or describing equality and diversity initiatives, policies and practices.

The definitions, according to the Oxford Dictionary, are:

Equality: The same in number, size, degree or merit, same for all or everyone, treat everyone equally, having the same rights or status in being equal.

Diversity: variety or varied, different, dissimilar, difference, differing kinds, introducing variety – valuing difference.

Inclusion: inclusive, including all, to include – treat as part of the whole, ie equal participation.

Human Rights: those rights that belong to all people, the human race, having characteristic of humankind.

Discrimination: detect, draw or make certain distinctions (for example, between people), distinguish from or between. Exceptional treatment against, or in favour of, observant of or giving due weight to differences.

For the Trust’s employees difference includes that of the 9 Protected Characteristics – sex, race, disability, age, religion or belief, marriage and civil partnership, sexual orientation, pregnancy and maternity and gender reassignment.

Victimisation: to treat unjustly or harshly, treat someone with cruelty and vindictiveness, single out for punishment or unfair treatment.

Bullying: coercing others with fear, to persecute or oppress by force or threats.

Harass: to create trouble, annoyance and/or attack repeatedly, to persecute.

Positive Discrimination: making distinctions in favour of certain groups in society, normally to rectify past or historic disadvantage.

Affirmative Action: to take action to affirm, expressing approval in favour of groups of society in employment, education, training, etc because of past or historic disadvantage.

Positive Action: to bring someone to the same level, or correct a disadvantage. Bring someone up to “a level playing field”, supporting disadvantaged group with necessary skills, knowledge, training, other attributes, etc to be able to apply for jobs with.

WHY IS EQUALITY & DIVERSITY IMPORTANT FOR UHS?

The Trust needs to explain clearly and articulate a case as to why it is important to implement equality and diversity. There are normally three reasons given why equality and diversity is important to an organisation or institution:

a)  Socially and Morally the Right Thing To Do

For a public sector organisation it is socially and morally the right thing to do. To reflect the local population it serves within its workforce which better understands their needs, wants and aspirations. For a universal service provider like the Trust it is the right thing to do. The NHS is there to provide a service and/or treatment for everyone regardless of the ability to pay. This is at the core of its ethos and why the NHS was established in 1948.

b)  The Legal Duty

This is encapsulated by the Equality Act 2010 and subsequent amendments since then. There is a legal duty to recruit, retain and treat all employees fairly. Not to discriminate against anyone in employment, provisions of goods, facilities and services, education and training, bullying, harassment and victimisation. This legislation outlaws discrimination of people who are covered by the Nine Characteristics. There is also the Public Service Duty covering all Protected Characteristics which the Trust is positively charged with in giving “Due Regard” to, in all its functions and duties:

·  the elimination of discrimination, harassment and victimisation

·  advancing equality of opportunity between people from groups in society

·  fostering good relations between people of different groups in society.

The tool that most organisations use to implement this duty by having a proactive action plan to implement Equality & Diversity for the organisation covering all aspects, ie employment, service provision, outreach work in working with and consulting communities, funding or procuring services from other organisations. Further, organisations use an evidence based “impact assessment” toolkit to look at its policies and practices and their positive or adverse impacts on sections or groups within their population, locally or regionally. This is a positive and proactive duty on all public sector organisations which is not understood well, or implemented or put into practical practice on the whole by them.

c)  Business Case
Many private sector organisations have adopted the business case developing and implementing equality and diversity because it is economically beneficial to do so, for example, it delivers bottom line business benefits.

In the Public Sector organisations tend mostly to use the legal duty and the moral and social reasons for implementing equality and diversity. However, there are real business benefits for public sector organisations in delivering and implementing equality and diversity. These are:

·  In providing effective and efficient services tailored to meeting the needs of their populations at the first time as it saves money, time and staff resources for both - in this case for the Trust and patients/service users and their carers. So understanding the needs and wants of their “customers” (patients/service users) and tailoring the Trust’s services to meeting their needs saves time, resources and money for both.

·  By using employees/staff resources effectively saves time and money. By treating staff with dignity and respect, and by valuing them, implementing flexible working patterns, in meeting staff and organisational needs saves on staff turnover, absenteeism, helps staff retention, increases staff morale and loyalty, and a sense of belonging enhances with “staff going the extra mile” (giving up discretionary effort over and above the contractual duty) and it saves on organisational time spent on grievances, disciplinary and Employment Tribunal cases. There is a clear link in which staff feel well treated, satisfied and empowered, deliver better patient/customer services. There are studies that have been conducted that underscore this – Sears Retail Organisation in the US etc. Staff feel proud of working there and act as positive ambassadors externally for the organisation.