Equality, Diversity and Inclusion: where have we got to?

I’ve blogged before on the work that the Authority’s doing on EDI and it’s time for an update.

Since we first started work on our approach to EDI, we’ve had an audit from Derek Hooper. He provided an invaluable analysis of the culture at the Authority and the actions that we could undertake to bring us to the level we want to be in this field. We then appointed Mehrunnisa Lalani to help us turn the ideas in his audit into a reality.

Since then, Mehrunnisa has been working with us to develop a programme of tangible actions that we can undertake and I’m delighted that we’ve now published our first action plan 2022/23.

There are three elements.

First, we need to gain a deeper understanding of EDI issues and how people with minority protected characteristics are actually impacted by the health and social care system. We’ve already had outstanding sessions on Trans and Disability issues and will be organising more. We’re also committing to developing a group of advisors from the various communities to talk to us and provide advice on the impact of regulation on them. Equality Impact Assessments can often be dry documents based on someone’s well-intentioned but uninformed view of likely impacts. We need to be informed by people who are themselves affected.

Then, we need to make sure that our own internal processes actively promote diversity within the organisation. This can be a challenging for a small, niche body, but we want to be a diverse place and one that welcomes and supports everyone.  We’ll be doing a lot of work this year on our processes but also on making sure that the actual experience of people applying to work for us and who work with us is improved and promotes diversity. 

We’re looking forward to welcoming an Associate Board Member from an under-represented demographic background to participate in our Board discussions. We hope this will have two benefits: we will benefit from their insights; and we hope that the experience will provide them with experience to go forward to further Board posts to make the governance of regulators more diverse generally.

We’ll also be working with the regulators to get information so that we can analyse our own decision-making around referring regulators’ decisions that are insufficient to protect the public to the courts. I’m delighted that the regulators have been so supportive so far in helping us achieve this.

Which brings me to the regulators and accredited registers themselves. We’re now in the third year of our EDI standard and we’ve learned a lot from assessing regulators against it. It’s time to refine our approach and to make our expectations clearer. We will be working on this during this year. These are some of the questions we expect to answer:

• What is the minimum information that regulators need in order to claim credibly that they have an understanding of the diversity of their registrants and the communities they serve?
• Can a regulator that has a significant disproportion of minority registrants in its fitness to practise process be regarded as meeting our standards? Is it enough that they’re doing work to address it?
• What do we expect regulators to do to ensure that their registrants are providing proper care to a diverse population?

We need to answer these questions this year. But the third point has become more urgent.

The NHS Race and Health Observatory has drawn attention to the fact of overwhelming health inequality experienced by BAME patients. What is shocking is that much of this can be down to ignorance among practitioners that different ethnic groups may not display symptoms in the same way, exacerbated by stereotypes.

I was also particularly struck by the experience of a Trans woman who spoke to Authority about her experience. She was asked about her experience of the health care system. She described particularly the sheer ignorance of many GPs about them – to the extent that support groups have to provide lists of ‘sympathetic’ GPs.  This is unacceptable and we will be challenging the regulators about how they ensure that their registrants are trained to understand the needs and characters of their patients.

So there’s a big agenda. We’ve done the thinking and the planning. I’m looking forward to getting stuck into the work and making a difference.