The percentage of chairs and non-executives on NHS trust boards from a Black and Minority Ethnic (BME) background has plummeted in the past decade, a new report has revealed.
Chairs and non-executives in the NHS: The need for diverse leadership, published today by the NHS Confederation, exposed ‘the material reduction’ in the percentage of women and BME chairs and non-executives across the NHS.
NHS Confederation said the report must be a ‘wake up call for the health service’ and sets out a series of recommendations for actions to take to make board representation more diverse.
In response, NHS England Workforce Race Equality Standard (WRES) implementation director Yvonne Coghill said that the NHS long-term plan has committed to making boards and the NHS leadership more diverse.
In 2010, the percentage of people from a BME background in NHS leadership roles was 15%. Today, it stands at 8%, the report found.
The percentage of women in chair and non-executive roles also fell from 47% in 2002 to 38% today.
During the past 10 years, the proportion of non-executive leaders with a disability has remained constant at between five and six percent.
The report – which analysed figures sourced from archived annual reports, academic reports, recent NHS Improvement reports, and the WRES data – attributes the lack of progress in diverse board representation to two factors. These are:
- Lack of an NHS body overseeing the appointment of chairs and non-executive directors. Following the abolition of the NHS Appointments Commission – which was responsible for overseeing the appointments to a range of NHS public bodies, promoting fair and balanced representation at board level – in 2012, no other NHS body took over the task, although NHS Improvement has some influence over appointments to trust boards for those foundations trusts in special measures
- The independence of foundation trusts. Introduced in the mid-2000s, foundation trusts were conceived as independent public benefit organisations, a type of no-profit organisation. This means that their non-executive appointments are not considered as public appointments, and are thus not subject to public scrutiny
Developing inclusive top teams
NHS Confederation director of partnerships and equality and NHS Equality and Diversity Council co-chair Joan Saddler said that although the NHS Confederation supports the autonomy of foundation trusts, the health sector must find ‘a way of developing inclusive top teams that provide example and leadership, and set expectations throughout their organisations’.
She said: ‘Chairs and non-executives heading NHS organisations must be accountable to and representative of the communities they serve and the staff for whom they are responsible.’
Walsall Healthcare NHS Trust chair and NHS Confederation’s BME Leadership Network co-chair Danielle Oum said that ‘history has shown that when there is structural change in the NHS, diversity of leadership reduces’, which is something that needs to be avoided in the development of integrated care organisations.
Actions to increase diversity and inclusion
The report, which was written by former Barking, Havering and Redbridge University Hospitals NHS Trust chair Maureen Dalziel, set out a series of recommendations, including:
- The appointment by NHS England and Improvement of a lead chair to work with the NHS Confederation and recommend actions to address diversity at NHS trust board level
- A review of recruitment search firms to make sure NHS organisations can choose from a list of candidates from diverse backgrounds
- The NHS Leadership Academy and Regional Talent Boards to support chairs and non-executives with guidance on governance and equality, diversity and inclusion
- Use Workforce Race Equality Standard (WRES) data to monitor progress
Ms Coghill said: ‘Thanks to the WRES programme, we have seen a steady increase in the number of NHS trusts that have more than one BME board member, and a new model employer strategy is providing further intensive support to improve diversity at all levels of local NHS organisations.’
NHS England pledged to allocate an extra £1m a year to the WRES programme to 2025 as part of the long-term plan.
Healthcare Leader reported last month that BME board representation doesn’t reflect the percentage of ethnic minority staff in seven of the eight NHS arm’s length bodies that submitted their 2018 WRES data, with the NHS Business Services Authority revealing it has no BME representative on its board.
In 2016, the NHS committed to 50% of women to sit on NHS boards by 2020 but movement on this has been slow, and it is likely that the target will be missed for women on boards across chair and non-executive director posts.