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Annual Equality Diversity and Inclusion Report 2022-2023

As a publicly funded organisation, Buckinghamshire Healthcare NHS Trust (BHT) is required to publish information annually on how it has met the Public Sector Equality Duty (PSED) and taken steps to eliminate unlawful discrimination, advance equality of opportunity for people with protected characteristics and foster good relations between those who share protected characteristics and those who do not. The information provided demonstrates how we have considered how our services and activities,  both as an employer and a service provider, affect people with different protected characteristics.

This report provides assurance to the Trust Board and to the Public that BHT is meeting its PSED obligations and continuing to promote an inclusive culture across the organisation. The report summarises our workforce equality, diversity and inclusion activity in 2022/23 alongside our PSED requirements and Equality Standards data. A separate report is published annually in relation to the PSED requirements for our service users.

Meeting the PSED Standards

  1. Part of meeting the PSED requirements is publishing information relating to employees who share protected characteristics. Our workforce data relating to protected characteristics of our colleagues is contained within this report. For the third consecutive year, we have reduced the number of colleagues with ‘undisclosed’ status on various protected characteristics. This is reflective of efforts to cleanse our workforce data and ensure we capture accurate demographic profiles of our workforce.
  2. Equality objectives for the Trust were published in 2019 and have been renewed in 2023 to reflect the NHS EDI Improvement Plan 6 high impact actions, which all NHS organisations are encourage to meet. We are committed to implementing these objectives as part of our duties and importantly, in line with our values as a Trust. A supporting action plan is included at the end of this document.
  3. We are required to publish information on work we undertake to eliminate discrimination and foster equal opportunities for those with protected characteristics. Analysis and recommendations relating to our Equality Standards are contained within this report.

What is our Equalities Data telling us?

Workforce Race Equalities Standard (WRES): Our data highlights continued improvements in recruitment, disciplinaries and access to training and development, with BME and White colleagues now achieving equivalent outcomes in these areas. Despite work to improve our recruitment outcomes for candidates, BME colleagues make up 32% of our Band 1-7 workforce but only 18% of the Band 8a+ leadership workforce; a percentage difference of 14%. This has increased from 5.5% difference in 2022. Experiences of bullying, harassment and discrimination increased for BME colleagues this year in all areas, including from patients where BHT performed worse than the NHS average. BME colleagues consistently report higher numbers of these experiences than White colleagues. In line with the NHS EDI Improvement Plan, reducing such instances will be a key focus for BHT this year.

Workforce Disability Equality Standard (WDES): Our data demonstrates an increase in the number of colleagues at BHT who have declared via ESR that they have a Long Term Condition (LTC) or disability compared to last year (3.4% in 2022 to 5.42% in 2023) . Colleagues with disabilities are experiencing equal outcomes in relation to recruitment and performance management, and more colleagues have been able to access reasonable adjustments within their roles (73.6% in 2022 to 77.2% in 2023). Incidents of bullying and harassment from patients increased in 2023 for colleagues with and without LTCs, with incidents being 4% higher for colleagues with LTCs. BHT is performing worse than the national average in this area, and colleagues with LTCs are also more likely to report experiencing harassment from their managers and other colleagues.

Gender Pay Gap (GPG): We are pleased to report an improvement (reduction) in both the hourly fixed pay gap between men and women for the mean pay gap –26.9% for f/y 2022/23, compared to 27.6% for financial year f/y 2021/22, and the median hourly fixed pay gap –15.5% for f/y 2022/23 compared to17.2% for f/y 2021/22. Analysis has identified that our gender pay gap is driven by a higher percentage of men in the highest quartile of pay, mainly due to significantly different gender splits within the medical & dental and administrative & clerical staffing groups.

However, there was an increase in our mean bonus gap this year, which has increased from 20.8% to 25.5%. There is also a 9% difference in the number of men and women who received a bonus for their performance in f/y 2022/23. Bonus Pay applies to fewer than 4% per cent of all our staff employed. This is because only certain medical staff (from within the consultant body) receive pay that is classified as bonus pay. A bonus pay element is awarded as a result of recognition of excellent practice over and above contractual requirements and has no gender bias. In f/y 2022/23 this payment was awarded equally to those meeting the criteria in line with national guidance and in agreement with the BMA.

Progress against Objectives

In 2020 we set four equalities objectives in line with our WRES & WDES data (page 9). We have achieved two of these objectives fully: there are now equal outcomes for BME and White candidates and disabled and able-bodied candidates in our recruitment processes. More work is required to improve the diversity of our senior leaders (Band 8b+) which is currently 17% BME compared to 32% of our overall workforce. Whilst we have previously made improvements against this objective, reaching parity in 2022, the percentage of BME Band 8b+ colleagues has declined whilst the total number of roles at this level has increased. We have also increased the diversity of our workforce through our successful recruitment of approximately 300 international nurses. Further work is also required to improve access to reasonable adjustments (currently 77%), despite making some progress in this area from previous years.

New Objectives

We are committed to meeting the new national NHS EDI Improvement Plan and implementing the six high impact areas to embed EDI work further into the organisation. Details of our progress against these areas is documented on pages 43-47. In keeping with these six areas, we have set two priority Equalities Objectives for BHT which also take into consideration our equalities data and progress to date. Our two priority objectives for the next three years will be:

  1. Embed fair and inclusive recruitment processes and talent management strategies that target under-representation and lack of diversity. Specifically, Improve representation of BME colleagues in AfC Band 8b+ roles to 24% or above by July 2026.
  2. Create an environment that eliminates the conditions in which bullying, discrimination, harassment and physical violence at work occur.​ Specifically, Reduce occurrence of bullying and harassment from managers and other colleagues by a minimum of 2% per year.

View full report by clicking on ‘Download Document’