Health and care organisations are well positioned to make a difference to inequalities in health, and I believe that our workforces are central to shaping the health outcomes of the population. Through the work we are doing at NHS SCW we have first-hand experience of working with NHS trusts who recognise the integral connection and opportunity to drive meaningful change in addressing health disparities across the population through promoting equality, diversity, inclusion and wellbeing within the NHS workforce.
While there is the Public Sector Equality Duty in place, I am heartened by how organisations are courageously committing to genuinely improving cultures and environments because it is important to do so.
Health Inequalities are the unfair and avoidable differences in people’s health outcomes. The term also refers to the impact of where people live, socio-economic factors, protected characteristics, and whether they are socially excluded (e.g. homelessness) and on people’s access, experience and outcomes in health and care. Under the Health and Social Care Act 2022 there is a statutory obligation to improve people’s inequalities of access, experience and outcomes in healthcare.
Trusts are applying Core20PLUS5, the evidence-based approach to inform action to reduce healthcare inequalities. COVID-19 further highlighted health inequalities in society and NHS England National Healthcare Inequalities Improvement Programme (HiQiP) issued guidance setting out priority areas to address health inequalities. I have seen a variety of ways innovative changes are being implemented to not just meet their statutory duties but to make a meaningful difference to people.
In addition to directly addressing inequalities in healthcare provision, the NHS is further able to contribute to tackling health inequalities through working with others to influence the determinants of health and as a significant economic factor in its own right. NHS SCW is working with organisations locally, regionally and nationally, providing support and transformation services to address health inequalities in the workforce. We offer support to design and deliver interventions to improve equity, diversity, inclusivity (EDI) and wellbeing for staff can enhance our understanding of barriers and opportunities and can be upscaled for patients, service users and communities.
How is NHS SCW working with organisations to do this from an EDI and wellbeing perspective?
Equality – Through ensuring opportunities for all with workforce practices and policies the NHS can transform as an organisation. Our approach begins with reviewing the available data and insights. For example, what can be improved for women, people experiencing menopause and parents? We work with employers to understand Workforce Race Equity Standard (WRES), Workforce Disability Equality Standard (WDES) and Gender Pay Gap reports. We provide guidance on fair recruitment practices and good working conditions. Additionally, as anchor institutions NHS organisations have connections to local populations and have a significant influence on the health and wellbeing of communities.
Embracing diversity as a strength – More diversity and culturally competent workforces leads to better interactions with patients and health outcomes. This can be achieved through working in partnership with communities. We support the NHS in reviewing data and insights (what do you know about your workforce and local community?) understanding the demographics (what are the rates of ethnicity and deprivation?) and engagement (what are staff experiences? Are there staff networks to collaborate and co-produce?) to find solutions to enhance social value, particularly around supporting recovery from COVID-19 and workplace conditions.
Inclusion – It is possible to create a culture and environment to foster a sense of belonging among workforces. We offer development opportunities, facilitating and training staff to increase awareness and skills through programmes such as our Building a Culture of Conscious Inclusion. In addition, we create bespoke solutions for health inequalities, race, gender, LGBTQIA+. Developing employee engagement will infuse inclusivity into the care we provide to the people we serve.
Wellbeing – All of the equality, diversity and inclusion activities will nurture workforce wellbeing. Poor employment is linked to the fundamental causes of health inequality. Gallup identified 'career’ as one of the five dimensions of wellbeing (alongside social, financial, physical and community) illustrating that the work we do, how much we enjoy it and have a sense of purpose, can influence our overall health and wellbeing. NHS as the largest employer in Europe means the employees are the community.
Therefore, it makes sense that workplaces can positively or negatively impact individuals, teams, workforces and the local communities. When organisations support employees with their health and wellbeing through actions such as investing in employee wellbeing and better employee engagement, this can lead to increased resilience and reduced sickness absence and higher performance and productivity.
We work with organisations to support employee wellbeing through embracing the seven elements of the NHS health and wellbeing model of improving personal health and wellbeing, (professional wellbeing support, data insights, environment, managers and leaders, fulfilment at work and relationships for a thriving workforce) to further contribute to reducing health inequalities.
Nationally, trusts and systems are required to report on health inequalities. There is not a one-size-fits-all solution to reducing health inequalities as there are unique challenges in each individual setting. There are a variety of unique approaches that can be taken and some principles that can be applied.
Many trusts are finding that investing in their EDI and wellbeing of their workforce is the foundation to understanding and ensuring that they have a richer, more authentic approach. While they are separate and distinct from each other, it is worth considering how focusing on EDI and wellbeing can contribute to and enhance health equity in your organisation, community, system, region and nationally.
To find out more about how NHS SCW can support you with EDI and wellbeing and health inequalities
