A clinical commissioning group (CCG) has been told to appoint an ‘experienced’ equality, diversity and inclusion (EDI) specialist, after a review found evidence of ‘microaggressions’ and ‘insensitivities’ towards ethnic minorities in the workplace.
The independent culture review of Surrey Heartlands CCG, which made 21 recommendations, said the EDI specialist would need to design and deliver ‘mandatory’ equality and diversity training, to be repeated every three years, in a bid to dismantle unconscious bias and prejudice.
The review heard about the use of ‘derogatory terms to describe minorities’ in some offices, after interviews with 120 employees, and that these behaviours have ‘largely gone unchecked’.
This had led to black, Asian and minority ethnic (BAME) workers becoming reluctant to speak up, the report said.
It also found evidence of repelling BAME listening events – claiming disbelief of their worth and importance – and reports of ‘pushback’ against the Black Lives Matter movement, with sections of the CCG workforce responding with statements like ‘all lives matter’.
Discrimination against other groups
The review also found grounds to indicate the existence of favouritism, and even nepotism, which it said ‘due to the largely white nature of the CCG’ may deny opportunities for BAME people.
The report added that the executive and senior leadership were not representative of the communities they serve in terms of race and ethnicity.
The review also heard evidence of discriminatory behaviour towards other groups, with some employees referring to people as ‘pikies’ or ‘chavs’ and the term ‘retards’ being used for people with learning disabilities. Others reported comments that could clearly be interpreted as homophobic, the report said.
Staff with disabilities and long-term health conditions also highlighted ‘a lack of sensitivity to their specific needs’, it added.
Professor Duncan Lewis of Longbow Associates, who conducted the review, concluded that there was no evidence for ‘widespread discriminatory practices perse, although there is evidence for microaggressions and insensitivities’ to BAME people, and towards other people with protected characteristics as defined in the 2010 Equality Act.
He recommended that the EDI training programmes be designed and implemented by November 2021 and wherever possible these should be carried out face-to-face rather than online.
Bullying and aggressive behaviour
Elsewhere, the review found ‘substantial evidence’ of bullying from a small number of managers, colleagues and a senior leader, as well as ‘aggressive’ and ‘manipulative’ behaviour – which the report said had led to some staff experiencing anxiety and depression as a result.
It said incivility and disrespect were ‘commonplace’ in some teams and appear to have gone unchallenged ‘because of a historical lack of will by the executive and HR to grasp the seriousness of these issues’.
Professor Lewis also concluded that the CCG, which is made up of four former CCGs that merged, has displayed ‘tribalism’, with two legacy organisations widely reported as having ‘aggressive and dominating cultures which are seen as harmful by others’.
‘There is widespread distrust and even dislike between some elements of the legacy CCGs,’ he said in the report.
The review did however find managers and management ‘varied significantly’ across the CCG, as there were some ‘wonderful management practices demonstrating empathy, compassion and genuine management competencies’.
The CCG said that it fully accepted and will implement the recommendations of the report.
‘We think it’s important to make the report public to demonstrate transparency and to make clear our intention to work with staff to create a much more inclusive and collaborative culture where such behaviours will not be tolerated,’ the statement said.
In a letter to all CCG staff, the chair of the governing body, Dr Charlotte Canniff and the interim accountable officer, Dr Claire Fuller, said: ‘The report makes difficult reading, but it is important that we both recognise and acknowledge the content and the distress that has been experienced by many of you, for which we unreservedly apologise.
‘We acknowledge the concerns raised by staff within this report, particularly microaggressions experienced by colleagues from a Black, Asian and Minority Ethnic (BAME) background and that these and other poor behaviours have not always been acted on in a timely and appropriate manner.’
They added: ‘On behalf of the whole senior leadership team we would like to make it clear that this behaviour will no longer be tolerated, and we will work with you to develop a more inclusive, less hierarchical and positive culture of transparency that will move our organisation forward and make it an enjoyable place to work.
‘It is important to note that the report has also highlighted areas of positive practice; managers who demonstrate empathy, compassion and good management skills; our mental health first aiders as a real strength; and a genuine desire on behalf of many managers to demonstrate real compassionate leadership.’
The review made 21 recommendations to Surrey Heartlands CCG, including:
Formally acknowledge the concerns raised by staff over microaggressions towards colleagues from black and minority ethnic (BAME) backgrounds, which should happen immediately.
Also, formally acknowledge that staff have experienced and previously raised significant concerns about the behaviours of some SHCCG (including legacy organisation) staff and apologise for not having acted to address their concerns in a timely and appropriate manner.
Appoint an experienced executive member with responsibilities for workforce matters as soon as practicable.
Create a recruitment and retention strategy that ensures the workforce represents the communities it serves and enables staff from minority backgrounds to be exposed to opportunities.
Appoint a full-time staff member as the freedom to speak up guardian (FTSUG) and develop a number of voluntary guardian roles to support this.
Review systems for job advertisement, recruitment and appointment immediately. A panel to be set up to scrutinise all requests for new appointments to ensure compliance with banding and transparency of opportunity, and all openings and promotions to be internally published.