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City and Hackney CCG Workforce Race Equality Standard Report (WRES) 2018-2019

Explore the performance of City and Hackney CCG against NHS Workforce Race Equality Standard metrics, addressing disparities and promoting diversity in healthcare workforce. Learn how the CCG is progressing and the action plan for a more inclusive future.

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City and Hackney CCG Workforce Race Equality Standard Report (WRES) 2018-2019

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  1. City and Hackney CCGWorkforce Race Equality Standard Report (WRES) 2018-2019

  2. Contents 2

  3. About the Workforce Race Equality Standard (WRES) In 2014, NHS England and the NHS Equality and Diversity Council agreed action to ensure employees from Black and Minority Ethnic (BME) backgrounds have equal access to career opportunities and receive fair treatment in the workplace. It was agreed that a Workforce Race Equality Standard (WRES) should be developed, and in April 2015 it was made available to the NHS. All NHS organisations including CCGs, Trusts and CSUs as well as national organisations are encouraged to implement the WRES in an open and transparent way. The Workforce Race Equality Standard is a set of indicators that requires all organisations with NHS contracts, to demonstrate progress against a number of areas of race equality, including a specific indicator to address the low levels of BME Board representation. Simon Stevens, Chief Executive of NHS England, said: “The “business case” for race equality in the NHS, and for the Workforce Race Equality Standard, is now a powerful one. NHS England, with its partners, is committed to tackling race discrimination and creating an NHS where the talents of all staff are valued and developed – not least for the sake of our patients. We cannot afford the cost to staff and patient care that comes from unfairness in the appointment, treatment and development of a large section of the NHS workforce. We also know that research shows that diverse teams and leaderships are better for innovation and increase the organisational effectiveness the NHS needs. We know that we do best when healthcare organisations’ leadership broadly reflect the communities we serve. I welcome the support the Workforce Race Equality Standard has received and look forward to seeing the changes it seeks to achieve.” Simon Stevens, Chief Executive, NHS England

  4. Summary • City and Hackney CCG plans, buys and monitors most local health services for the population of the City of London and Hackney.   • The local population of the City of London and Hackney (Hackney in particular), is very ethnically diverse.  The ethnic composition of the community varies across Hackney localities, with Homerton and then the North East having the largest non-white British or Irish population.  Homerton locality has a particularly large black African and Caribbean community, while the North East contains a significant minority Indian population as well as large ‘other white’ and ‘other’ communities. The large number of residents classified as ‘other white’ and ‘other’ reflects Turkish and Kurdish, eastern European and Charedi orthodox Jewish people living in Hackney.  None of these groups are clearly identifiable using the Census categorisations of ethnicity. • This WRES report sets out the CCG’s performance against the nine mandatory NHS Workforce Race Equality Standard (WRES) metrics. This is the first time the CCG has been required to produce such a report, and therefore the data collected and the subsequent action plan form the baseline for future efforts to deliver improvements. • This year’s WRES results show that are a number of areas that require action: • The likelihood of White applicants being appointed compared to BME applicants from shortlisting. • One fifth of staff (20%) did not disclose their ethnic background. • BME representation in the workforce (33%) is under-representative when compared with the BME population of Hackney (between 44-53%). • BME representation in the Governing Body membership (23%) is under-representative when compared with the BME population of Hackney (between 44-53%). • An action plan has been developed with actions aimed at addressing the variances between White and BME staff experiences. • As part of the wider developments in the north east London commissioning landscape, the CCG is currently developing in a partnership known as the North East London Commissioning Alliance (NELCA) which brings together all the seven CCGs in north east London - City and Hackney, Newham, Waltham Forest, Tower Hamlets, Barking and Dagenham, Havering and Redbridge. Jane Milligan is the Accountable Officer and the executive lead for the North London STP – the East London Health and Care Partnership. • As City and Hackney CCG comes together with the other North East London and City CCGs in April 2021, our aim will be to work with the other CCGs to implement the NHSE Model Employer Strategy that asks NHS organisations to set targets for BME representation across the leadership team and broader workforce.

  5. WRES Indicators

  6. Local NHS Healthcare Providers’ and Compliance *Provider WRES Reports for 2018-19 are due for upload and publication by 27 September 2019 ** CQRG – Clinical Quality Review Group

  7. City and Hackney CCG Workforce: 1 April 2018 - March 2019 • Data from the 2015-18 City and Hackney Pharmaceutical Needs Assessment describes the local population of the City, and Hackney in particular, as very ethnically diverse. The 2011 Census data shows Homerton, North East and Shoreditch as having the highest percentages of BAME communities, 52.7%, 46.5%, 44.2% respectively. • What is the data telling us? • In 2017-18, BME staff were 38% of the workforce. This was between 6-14% less representative of highest percentages of populations belonging to BAME communities. • In 2018-19, BAME staff are 33% of the workforce which is a 5% decrease from previous year. However, one fifth of the workforce has not declared their ethnicity. Therefore it is difficult to accurately know the true percentage of ethnicities working for the CCG. • What have we done over the last year? • We have progressed with plans to introduce ESR self-service to enable staff to input their data in absolute confidence. • We have maintained our efforts to encourage staff to declare their ethnic status, highlighting the importance of doing so. • What are we planning to do in the year ahead? • Launch self–service ESR, encouraging staff to check and update personal details, including ethnic origin. • This report will now utilise 2017-18* and 2018-19 data to inform the 2019-20 Action Plan • Continue to monitor and review workforce demographics regularly and set appropriate objectives aligned to e.g. A Model Employer: Increasing black and minority ethnic representation at senior levels across the NHS. Developing Table 1

  8. Indicator 1: Percentage of staff in each of the AfC Bands 1-9 and VSM (including executive Board members) compared with the percentage of staff in the overall workforce disaggregated by: Non-Clinical and Staff/Clinical staff Developing • What is the data telling us? • Table 2 shows the percentage of the workforce within bands 1-7, 8-9 and VSM in 2017-18 and 2018-19. • The percentage of the BME staff in bands 8-9 decreased by 4% whereas the percentage for White staff increased by 13%. However the most significant increase was for staff that have not declared their ethnicity – up by 16%. • The percentage for bands 1-7 saw a decrease of 6 % for both BME and White staff and a corresponding increase of 11% for staff that have not declared their ethnicity. • The percentage of BME Staff and White Staff in Band VSM was constant at 50% in each year for each ethnicity. • What have we done over the last year? • On such small numbers, the statistical variance resulting from changes to the profile of VSM’s over this period has been disproportionately pronounced. • On that basis there has been no specific action taken in relation to this measurement, other than to monitor. • What are we planning to do in the year ahead? • This report will now utilise 2017-18 and 2018-19 results to inform the 2019-20 Action Plan. • We will continue to monitor and review workforce demographics regularly and set appropriate/relevant improvement Key Performance Measures (KPI’s) aligned to e.g. A Model Employer: Increasing black and minority ethnic representation at senior levels across the NHS. • Investigate implementation of reverse mentoring (as part of STP-wide programme) to foster an empathic and inclusive culture • Develop succession planning for Governing Body vacancies to support representation of the workforce and community. Table 2 Table:2

  9. Indicator 2: Relative likelihood of BME staff being appointed from shortlisting compared to that of white staff being appointed from shortlisting across all posts Developing Table 3 • What is the data telling us? • The Goal of this indicator is a neutral likelihood score of 1. The 2018 score for England is 1.6. • In 2017-18 there were 5 BME appointments compared with 12 White appointments. White candidates were five times more likely to be appointed than BME candidates At the shortlisting phase of recruitment, white applicants were 5 times more likely to be shortlisted than BME applicants. • In 2018-19 there were 4 BME appointments compared with 8 White appointments. White candidates were 3.2 times more likely to be appointed than BME candidates. White applicants were once again five times more likely to be shortlisted than BME applicants. • What have we done over the last year? • This is the first year the CCG has collated and analysed its WRES data, so there is no previous action plan to comment on. • What are we planning to do in the year ahead? • Audit current recruitment processes to identify and implement improvements, including a system of post appointment analysis of key deciding factors. • Access recruitment and selection training within an equality and diversity framework. • Aim for recruitment panels to be more diverse, with ideally a BME panel member on each occasion.

  10. Indicator 3: Relative likelihood of staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation (This indicator is based on data from a two year rolling average of the current and previous year) Achieving • What is the data telling us? • There was one formal disciplinary case recorded in 2017-18. • What have we done over the last year? • The CCG has creditably low disciplinary requirements as a consequence of its co-produced staff policies and procedures, which are aimed at resolving problems before they become formal matters of concern. • What are we planning to do in the year ahead? • Through HR, work with managers to ensure that decisions regarding commencing disciplinary action remain fair and transparent. • Continue to monitor this indicator by ethnicity to identify any trends over time. • STP-wide actions implemented for the other NELCA CCGs which may reinforce a positive approach to disciplinary policies and processes will be considered by City & Hackney CCG. Table 4

  11. Indicator 4: Relative likelihood of staff accessing non-mandatory training and CPD Achieving Table 5 • What is the data telling us? • The Goal of this indicator is a neutral likelihood score of 1. • In 2017-18 White staff were more likely to access training compared to BME staff (score: 1.86). However, in 2018-19 the likelihood of access is higher for BME staff than White staff (0.86) even though less BME staff accessed training. This is because there are fewer BME staff compared to White staff. • What have we done over the last year? • The CCG provides an £750 unconditional individual training allowance for all staff and actively encourages staff to use it through the appraisal process. • What are we planning to do in the year ahead? • Continue to encourage all staff to engage in non-mandatory training, but with particular regard to collation and analysis of data on equity of access.

  12. Indicators 5-6: City and Hackney CCG Staff Survey 2018-19 Developing Table 6 • Overall 78.6% of City and Hackney CCG staff responded to the staff survey. 48% were White staff, 22% were BME staff and 27% preferred not to say their ethnicity. The percentages are based on a percentage of BME staff / White staff that completed the staff survey. • What is the data telling us? • In January 2019 the CCG carried out a local staff survey that asked questions similar to WRES Indicator 6 but did not include WRES Indicator 5. • The results for WRES Indicator 6 show that there was a similar and low level of staff experiencing harassment, bullying or abuse from staff in the last 12 months for White and BME staff. • What have we done over the last year? • This is the first year the CCG has collated and analysed its WRES data, so there is no previous action plan to comment on. • What are we planning to do in the year ahead? • Participate in the National NHS Staff Survey to enable benchmarking across NHS Indicators by ethnicity. • Outcomes of the Local Staff Survey are to be addressed through actions built into and implemented through the CCGs’ People plan. • STP-wide actions implemented for the other NELCA CCGs which may reinforce a positive approach to bullying and harassment will be considered by City & Hackney CCG.

  13. Indicators 7-8: City and Hackney CCG Staff Survey 2018 Developing Table 7 • The percentages are based on a percentage of BME staff / White staff that completed the staff survey. • What is the data telling us? • In January 2019 the CCG carried out a local staff survey that asked  questions similar to WRES Indicator 8 but did not include WRES Indicator 7. • The results for WRES Indicator 8 show that there was a similar and low level of staff that experienced discrimination at work from a manager/team leader or other for White and BME staff. • What have we done over the last year? • This is the first year the CCG has collated and analysed its WRES data, so there is no previous action plan to comment on. • What are we planning to do in the year ahead? • Participate in the National NHS Staff Survey to enable benchmarking across NHS Indicators by ethnicity. • Outcomes of the Local Staff Survey are to be addressed through actions built into and implemented through the CCGs’ People plan. • Some STP-wide actions will be implemented for the other NELCA CCGs which may reinforce an overall positive approach to bullying and harassment.

  14. 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 Developing Table 8 • City and Hackney CCG Governing Body (GB) members are expected to be broadly representative of the workforce and the population they serve. • What is the data telling us? • In 2018, City and Hackney CCG's Governing Body membership reflected the City BAME population (21%) with 23% of the membership identifying as BME. The BAME Governing Body membership is currently not representative of the BAME population in Hackney that is between 38-53% • What have we done over the last year? • This is the first year the CCG has collated and analysed its WRES data, so there is no previous action plan to comment on. • What are we planning to do in the year ahead? • Continue to monitor and review Governing Body to workforce demographic ratio regularly and set appropriate/relevant improvement Key Performance Measures (KPI’s) aligned to e.g. A Model Employer: Increasing black and minority ethnic representation at senior levels across the NHS • Implement NHSE Model Employer Strategy – setting targets for BME representation across the leadership team and broader workforce.

  15. City and Hackney CCG WRES Summary Action Plan 2019-20

  16. Further Information Equality Diversity and Inclusion Team, NEL nelcsu.equality@nhs.net Comments and feedback can be sent to: Tim Wiseman Head of Operations City & Hackney CCG timothy.wiseman@nhs.net OR

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