Day 2 - 2019 CNO Summit

1. Workforce Race Equality in Nursing and Midwifery
Sheila Lloyd – Chief Nurse in the North West
On behalf of:
Yvonne Coghill CBE OBE FRCN (Hon) Fellow KCL
Director - WRES Implementation Team
NHS England

2. Content
• Background
• Facts and figures
• Chief Nurses serving our diverse British society
• Next steps: views from the audience on how to close the gap

3. The 1st Principle of the NHS Constitution
The NHS provides a comprehensive service, available to all irrespective of gender, race,
disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and
maternity or marital or civil partnership status. The service is designed to diagnose, treat
and improve both physical and mental health. It has a duty to each and every individual
that it serves and must respect their human rights.
At the same time, it has a wider social duty to promote equality through the services it
provides and to pay particular attention to groups or sections of society where
improvements in health and life expectancy are not keeping pace with the rest of the
population.

4. 6 more Cs necessary for race equality
• Clarity – That race equality and equity are absolutely the right thing to do
• Certainty – That something needs to be done about it
• Civility – Treating all people, patients and staff with respect and dignity
• Collaboratively – Working together and across boundaries to improve equality
• Cooperatively – Cooperating with people that might have different views
• Connectedness – A feeling of being connected to all nurses regardless of background

5. As at 31 March 2018, 20.5% (71,648) of the 348,678 NHS Trusts and CCG nurses,
midwives and health visitors were from a BME background.
National NHS nurses, midwives and health
visitors by ethnicity - 2018.
The data used for this paper was taken from the NHS Workforce Statistics website.
The data is for NHS Trusts and CCG’s in England only. Primary care, Support Organisations and Central Bodies are excluded.
The data excludes Nurses working for agencies.
BME White Unknown
Headcount 71,648 263,065 13,965
% 20.5% 75.4% 4.0%

6. Nurses & health visitors in the NHS are more diverse than the England population they
serve. People from a BME background are more likely to be a nurses, midwives and
health visitors compared to their representation in the population.
National NHS nurses, midwives and health
visitors by ethnicity - 2018.
Organisation
% Nurses in NHS
trusts and CCG’s
2011 Census
BME 20.5% 13.6%
White 75.4% 85.4%
Unknown 4.1% 1.0%

7. Nurses, midwives and health visitors numbers
2016 - 2018
7
There were 2,582 (1.0%) less white
nurses, midwives and health visitors
in 2018 compared to 2017
In contrast, there were 3,146 (4.8%)
more BME nurses, midwives and
health visitors in 2018 compared to
2017

8. National nurses, midwives and health visitors
by AfC bands and ethnicity: 2018
8
20.5% of nurses and
health visitors are from a
BME background.
BME nurses are
significantly
underrepresented in senior
pay bands.

9. National nurses, midwives and health visitors
AfC Band 8c – Band 9, 2018.
9
There are 22 BME
nurses and health
visitors at Band 8D
and 5 at Band 9.
There are 10 BME
Executive Directors of
Nursing (February
2019).

10. Progress so far
• In 2015 Ambulance Trusts, London and Nursing were identified as priorities for race
equality
• Only 10 Chief Nurses in England
• Glass ceiling at band 7
• Positive action must be taken to make a difference
• WRES Model Employer will support improvement: published January 2019
• Nurses instrumental in improving equity in the NHS

11. Evidence based model for improving BME
representation across the NHS workforce
11
Leadership and cultural
transformation
Positive action and practical
support
Accountability and assurance
Monitoring progress and
benchmarking
Representative workforce
at all levels across the
NHS

12. Recruitment targets for leadership diversity:
National targets for nurses, midwives and
health visitors
Notes
The analysis uses 2018 data for trusts and CCG’s.
BME proportions are recorded as a total of known ethnicities.
The targets account for staff leaving each band each year.
.
Band 8a 10.7% 1263 1266 2529
Band 8b 8.4% 237 365 602
Band 8c 6.4% 74 174 248
Band 8d 5.8% 22 60 82
Band 9 4.1% 5 21 26
Total BME staff in AfC
band by 2028 to reach
equity
Proportion of BME
workforce in AfC pay band
Current number of BME
staff in AfC pay band
Number of extra BME
required over the next 10
years to reach parity

13. Six key priorities – NHS Long Term Plan & WRES
• Trust boards review their WRES data and understand their performance.
• Deliver improvement strategy with targets performance managed by Trust Board.
• Set-up a programme of development that includes: stretch projects; shadowing
opportunities; coaching sessions; and action learning sets.
• Ensure middle-managers engagements (matrons, ward managers, specialist
nurses, consultant nurses).
• Review recruitment processes to ensure full equal opportunities are being
adhered.
• Establish a BME staff group/forum that has a direct line to the board

14. Thoughts from our BME Chief Nurses

15. For the NHS to reach equality in BME
representation across the workforce pipeline by
2028.

16. Questions to the audience
• Have you seen Model Employer: Increasing black and minority ethnic representation at
senior levels across the NHS document?
• Have you discussed at board level what this means for your organisation?
• Do you have an improvement plan for your Nursing and Midwifery workforce?
• What do you need to support you and your organisation to achieve a stretching but
achievable ambition

17. Thank you from:
Yvonne Coghill CBE OBE FRCN (Hon) Fellow KCL
and the BME Chief Nurses