This series of articles appears weekly and presents my recommended Seven Survival Steps for black and ethnic minority staff working in the NHS, but may have provide a wider focus for discussion. The articles are excerpts from a forthcoming handbook, and provide highlights of each chapter.
Step 3 Keep your roadway clear
It is now well known that BME NHS staff are twice as likely to face disciplinary procedures, and one study found that more than 60% of the midwives in London subject to disciplinary procedures were black , and all ten that were eventually dismissed were from a BME background. Research has also shown there is little link between the professionalism of BME staff, and adverse outcomes. Institutional and structural racism in the NHS, embedded in organisational leadership, line managers, and colleagues, form a toxic combination.
Leadership in NHS organisations must commit to taking action to improve this situation, and the introduction of the Workforce Race Equality Standard (WRES) into the NHS in April 2015, will focus attention on this.
One of the WRES metrics is:
Relative likelihood of BME 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. NHS .
Organisations are now expected to demonstrate progress against this metric over time.
So as many factors are outside the control of BME workers, are there any protective factors or steps that can be taken? There may be an argument that BME NHS staff should not be asked to consider specific steps they can take, and that it is entirely for organisations and leadership to take measures to bring about change. But the argument here is that BME workers, even when excellent, are still at a disadvantage.
It is therefore a recommended survival measure to take steps to keep your roadway clear, and useful to know this at the start of an NHS career.
Three of a total of seven recommended actions only are presented here due to word limitation.
1) Compassion checker
People take jobs in the NHS for many reasons; it is unrealistic to expect that everyone was motivated by a calling or vocation. For many, it is a job, and there is nothing wrong with that. But everyone working in the NHS must remember that the primary purpose of their jobs is for the benefit of people who use the NHS services. It is necessary therefore to always act in ways that reflects this. For some this means adherence to a professional code of conduct, but mostly it is about treating people as you would wish to be treated.
Cultural, racial and ethnic backgrounds can be barriers to achieving good relationships between some staff. If you are from a BME background, and particularly if you have a strong cultural identity in the workplace, you may find some colleagues feel they don't or can't understand or communicate with you. Allegiances, cliques, friendship groups can easily form, with decisions made behind the backs of those that should be included. If you are from a BME background, some of these factors may be compounded for you and there are rules you will may need to play by:
a) Make sure there is an open forum where decisions are formally made, that you always attend, even if you feel frozen out.
b) Record-keeping/documentation - If you are concerned about decisions that you should be a key part of, ensure there is written evidence of your inclusion or omission in making the decision. Write an email asking for confirmation, or ensure clinical records, or decisions taken in meetings are documented and up to date. Also, make sure there are records of any discussions you have with your supervisor, documenting any concerns you have.
c) Informal communications - It is critical to get involved in the informal conversations in the workplace, and keep consistent with it. Success with this depends on others being willing to engage with you at this level, so focus on those that will engage so you can always demonstrate willingness.
d) Socialising - again, as with informal communications in the work settings, it is really important to participate in some of the social activities that take place outside work. Some teams go out each week, others less frequently. To never join in is seen as problematic, yet some teams organise events that only appeal to a some members. Consider joining forces with another team member to organise a team event, something you know you will enjoy, and everyone else will also.
Achieving a good job performance is critical to survival as open to disciplinary action if management decides this is the case. Judgements about your performance will be subjective, so do what you can to make sure your job performance is of a consistently good standard. Linked to job performance are the essentials of a good record of attendance, a satisfactory sickness record where your health allows it, and timekeeping (arrival at work, and arrival at meetings).
This Survival Step isn't about never putting a foot wrong, because developing is about learning and growing from experience where you don't already have the expertise. BME staff have the right to do this learning in an equal way with all NHS staff.
I have walked that long road to freedom. I have tried not to falter