Race bias at Brighton hospital flagged up again in official report

Racial discrimination has been flagged up again at the Royal Sussex County Hospital in Brighton in an official report.

The Care Quality Commission (CQC) said that the problem had been raised by staff and their representative groups.

In a report published today (Thursday 10 August) the CQC said: “Representative groups described a lack of corporate acknowledgement of discrimination and inequality issues and little change over the last 12 months.

“The lack of equitable access to promotion was again raised by members of the BME (Black and Minority Ethnic) Network citing recent changes in the management of soft FM (facilities management) services as an example of bias.

“This has resulted in a further review of the soft FM management of change process by the trust and a pause in implementation. Concerns on this issue have been raised by staff.

“The role of outdated human resource policies and their inconsistent application in exacerbating inequality was highlighted in our last report.

“The human resource team have responded with a comprehensive review of policy and revised training of teams and managers.

“Representative groups viewed that there had been a lack of engagement in the development and review of these policies.

“BME staff again indicated the lack of equitable access to training and leadership initiatives. The trust did not maintain data indicating the equality of access to leadership programmes.

“Staff in focus groups indicated that staff themselves had not been suitably trained to manage the diversity of patients they treat leading to an inability to manage difficult situations and support staff who have been abused.

“The latest staff survey results rank among the worst nationally.

“Overall the organisational culture and the management of equality remains a significant obstacle to the trust improvement plan.

“We observed improvements in local directorate governance arrangements but the complexity of the operational model continues to lead to a lack of clarity in terms of accountability, alignment of strategy and consistent dissemination of information and direction.”

The CQC cited the most recent NHS-wide staff survey which suggested that racial bias was worse in Brighton than most parts of the country and that the problem had been getting worse.

The CQC said that “32 per cent of white staff and 74 per cent of black and minority ethnic (BME) staff reported experiencing harassment, bullying or abuse in the past 12 months”.

The watchdog said: “This was worse than the median average for acute trusts. For white staff, 82 per cent believed the trust provided equal opportunities for career progression or promotion but only 64 per cent of BME staff agreed with this statement while 8 per cent of white staff and 21 per cent of BME staff had personally experienced discrimination at work, worse than average.

“Results from the NHS staff survey question ‘In the 12 last months have you personally experienced discrimination at work from manager/team leader or other colleagues?’ showed 8 per cent of white staff had experienced discrimination compared to 21 per cent of BME staff.

“The national average of BME staff experiencing discrimination was reported as 14 per cent which showed the trust was performing worse.

“There was a clear policy around staff behaviours in regards to equality and diversity and bullying.

“Staff we spoke with felt there was a ‘zero tolerance’ approach and a new policy had been produced on race equality and bullying in the workplace.

“If patients behaved in an unacceptable manner a letter was sent to the patient explaining it would not be tolerated.

“We saw information displayed advising staff of the trust’s Black and Minority Ethnic (BME) Network, emphasising that ‘discrimination’ would ‘not be tolerated’.

“There were also details of the ‘listening ear’ service for BME staff that had experienced abuse or harassment.

“The 2016 NHS staff survey question ‘Percentage of staff believing that the organisation provides equal opportunities for career progression or promotion’ showed staff felt opportunities were not always equal.

“Responses from white members of staff showed 82 per cent felt there were equal opportunities which was worse than the national average of 88 per cent.

“However, only 64 per cent of BME staff reported the same opportunities which was also worse than the national average of 76 per cent.

“In the recent 2016 NHS staff survey we saw that (the) ‘percentage of staff experiencing harassment, bullying or abuse from staff in last 12 months’ was 32 per cent.

“This was worse than the average of 25 per cent for acute trusts and an increase on the 2015 result which was 29 per cent.

“The percentage rates from white and BME staff were similar with 32 per cent and 37 per cent respectively.”

The BME Network at the Royal Sussex said: “The CQC report published last year highlighted the concerns of the BME Network regarding the institutional racism that exists and the failure of the trust board to address this.

“Today’s report highlights feedback from the BME Network notably that there is ‘a lack of corporate acknowledgement of discrimination and inequality issues and little change over the last 12 months’.

“It is the conclusion of CQC that ‘overall, the organisational culture and the management of equality remains a significant obstacle to the trust improvement plan’.

“As the trust board of Western Sussex Hospitals (WSH) NHS Foundation Trust had only just taken over leadership of BSUH (Brighton and Sussex University Hospitals) at the time of the inspection, CQC decided that ‘it was not pertinent to complete a full assessment of trust wide leadership’.

“That being said, the CQC report does acknowledge that an extensive programme of change is required to bring about improvements and it anticipates that change will be achieved by the new management team.

“The CQC’s confidence in the management team is not shared by the BME Network.

“Since taking over on (Saturday) 1 April 2017 the new board has made no attempt to engage with the BME Network and has in fact declined invitations to meet with us.

“Furthermore, the chief executive took the decision to dismiss the trust’s race equality lead and chair of the BME Network, Dr Vivienne Lyfar-Cissé, from her role as associate director of transformation on (Wednesday) 28 June 2017.

“As a result of this, the BME Network created a petition calling on the chairman Mike Viggers to reinstate her: https://www.change.org/p/mike-viggers-reinstate-vivienne.

“It remains the position of the BME Network that the race equality workforce engagement strategy, which was jointly launched by the trust board and the BME Network in October 2014, provides an effective and efficient process by which the trust board can address the institutional racism that exists.

“The CQC inspection report acknowledges that the action plan for the Workforce Race Equality Standard, which is based on the approach of the above-mentioned strategy, was under way but not fully established.

“Although CQC has acknowledged that the progression of this action plan is the responsibility of the executive leadership, the BME Network has no confidence that the trust board will deliver on this, given the dismissal of the associate director of transformation and the total lack of engagement of the BME Network by the trust board.

“The agreement in place between WSH, BSUH and NHS Improvement clearly states that ‘NHS

Improvement continues to be responsible for the oversight of BSUH’.

“It is because of the BME Network’s lack of confidence in WSH to address the institutional racism that exists that we again call upon NHS Improvement to work in partnership with the BME Network to ensure the trust delivers on its statutory obligations concerning race equality.”