by Yinka Makinde – 25th October, 2019

Do the NHS’s diversity struggles in senior positions stem from a limited pool of suitable candidates, or do they stem from a lack of support for people from BAME backgrounds to reach senior positions (against the current odds)? Does the system limit people, or do they limit themselves? In a month where the Shuri Network held its first meeting for women of colour working in digital health, and NHSX pulled down a job advert for a senior position amid diversity concerns, Yinka Makinde explores the issue within the ranks of the NHS.

October was Black History Month. The NHS always plays its part in observing this celebration of the achievements and contributions made by black minorities across health and care, and as part of the celebration, I had the privilege of speaking at the inaugural Shuri Network London meeting.

The Shuri Network was founded by two inspirational women of colour – Dr Shera Chok and Sarah Amani – and is the first NHS network of Black Asian and Minority Ethnic (BAME) women in health tech and digital health. It aims to develop a more inclusive leadership community that reflects the diversity of the NHS workforce, support career progression and identify authentic role models, particularly in underrepresented groups such as Allied Health Professionals (AHPs) and nurses. It is a joint project with NHS England, NHS Digital and Health Education England (HEE) as part of the Building a Digitally Ready Workforce (BDRW) programme, and supports all women of colour.

Having had the pleasure of attending the Network’s incredible launch at the Digital Health Summer School in July, which blew the audience away and left a lasting impression, I felt compelled to get involved and contribute to its mission. My brief was to share the story of my career and how I have navigated the corridors of influence to get to where I am today.

I found this really hard to prepare for. One of the most difficult talks I have delivered to date, in fact. Identifying times where race or gender inequality may have either helped or hindered my progress felt near impossible. Impossible because, despite me being a woman of colour, I have tried to always reject the ways my African heritage could potentially negatively influence my career strategy or decisions. It has never prevented me from applying for a job or reaching out to someone in power. I think much of this attitude is down to the way my parents raised me to think  “the sky is the limit.” But they suffered tremendously from explicit acts of prejudice throughout most of their working lives in the UK.

My parents suffered tremendously from explicit acts of prejudice throughout most of their working lives in the UK.

I am mindful that my conscious decisions may not have been the only influence on the path of my career so far. Being a victim of acts of discrimination – explicit or otherwise – can influence the way people subconsciously feel, and therefore act. It can affect our choices without us even realising. It is well-documented, for example, that women are less likely than men to put themselves forward for promotions, feeling they must do more, achieve more, to be deserving. If we do not see people that look like us in positions of power or influence, we may not be able to visualise ourselves there. We feel we do not deserve a place at the table. The same is of course true of people of colour.

Being a victim of acts of discrimination – explicit or otherwise – can influence the way people subconsciously feel, and therefore act. It can affect our choices without us even realising.

The recent conversations played out on Twitter this month, about a Chief Nursing Information Officer (CNIO) job vacancy published by NHSX, is a stark reminder that this is a very real issue. We need to progress beyond rhetoric on this very serious matter, that affects the 20% of the NHS workforce that is non-white (according to Government stats on NHS workforce published in 2018). The advert was pulled down due to public challenge that the requirements listed inadvertently discriminated against BAME nurses because they asked for proven and significant leadership experience at Director and/ or Board level.

The issue here is not about the need for proven and significant leadership experience for a national CNIO job.

The core issue here is that, as one person pointed out, less than 10 BAME nurses across the country have the experience to apply. It does not follow that few BAME nurses have reached this position because of a lack of competence, if we subscribe to the logic outlined above.

Whether or not the number is accurate, the point was well-made. We are not actively supporting and growing a pipeline of talented people of colour working in the NHS to take up more middle and senior management positions, which would prepare and make them eligible for senior level roles such as CNIO (and CTO, which has also been recently advertised), when they come up. There are multiple and potentially complex reasons behind why this pipeline has not yet been supported, and I do not profess to know what they are. However, creating more internal or inter-organisation placement and secondment opportunities, and ensuring that personal development plans clearly articulate leadership goals and action plans for those with that ambition may help. We should be actively pushing these ambitions forward, not curtailing them by inaction, or worse, discouragement. Job descriptions that capture portfolio skill sets and perspectives, rather than assuming a traditional career path, may also help to attract a more diverse field of applicants.

BAME women are as talented, skilled, professional and smart as anyone else – it is not unusual. 

I think one of the reasons the audience was so blown away at the launch of the Shuri Network is that six women of colour shared their perspectives on diversity in an exquisitely powerful way; they stripped away raw emotion, hostility and pity, and packed their stories with factual representations of their experiences, and delivered them with passion. It made me feel immensely proud that this group of women represented me. They are equally suitable to be considered for roles in high places.

The Power List 2020 – naming Britain’s most influential people of African and African Caribbean Heritage, was launched this month. Names are still to be revealed at the time of writing, but the 2019 Power list recognised several NHS staff, including  Dr Ian Nnatu, Joy Odili, and Jacky Wright. These individuals, their peers, the work of organisations like the Shuri Network, NHS recruiters, NHS England, HEE and the supporting bodies, must work with integrity to support and propel people of colour into growth positions that allow them to fulfil their real potential and purpose.

Just like those on the list, we have real power that will benefit organisations, and we deserve to fulfil it.

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