Our anti-racism project is co-led by Catherine Dale, Programme Director of Patient Safety and Pearl Brathwaite, Project Manager in our Accelerated Access Collaborative team. We hear from Pearl and our CEO Rishi Das-Gupta on what they have learnt from the project since its inception in December 2021.
1. Sometimes you don’t know you have a problem until you talk about it.
The HIN is a great place to work, and we employ people who commit to our values and want to improve care and health for all. We have an agreeable environment, but recognise that our teams don't yet reflect the diversity our local south London community.
What we’ve realised is that sometimes you don’t know you have a problem until you talk about it. We started a conversation following George Floyd’s murder in 2020, speaking to staff to understand the impact of race and racism on people working in the HIN and the communities we work with and serve.
We realised that our individual experiences of life, work and community have been and continue to be impacted by race, and that we wouldn’t have spoken about it without this opportunity.
2. It starts with conversations in a safe space.
Our underlying approach has been to create a psychologically safe space which embodies the HIN values of being brave, open, together, kind, and different. We listened to perspectives from across the organisation. We discussed case studies, stories, and relevant news to highlight the issues and understand how our perspectives differ as a result of our experiences.
To aid internal discussion, we used a liberating structure framework to encourage the various themes to ask three questions: What? So What? Now What?. This structure is designed to help facilitate the gathering of facts ("what?"), make sense of those facts ("so what?"), and understand what we can do next ("now what?").
This worked well for us because our teams tend to want to fix problems. Teams identified a challenge in moving to action and the "now what?" too quickly, because of the vast amounts to explore in the "what (is the issue)"’ and the "so what (why is it important)?".
Practically it takes time to have these conversations and we had to set aside time to do this. This meant that we were making an active choice to engage in this work and appointed a trusted external facilitator to guide some of these organisation-wide conversations.
The series of conversations were:
- How we talk about our ambitions in becoming an anti-racist organisation;
- How we talk about the impact of racism on individuals and the community that we serve;
- How we seek to influence others, in our everyday lives and outside of the HIN.
3. Expect the conversation to be difficult at first, but easier over time
This topic brings people's experience to the fore. It helps to be clear that this can be an emotive and deeply personal subject… so it will probably make people uncomfortable. It challenged our unconscious bias and beckoned us to become vulnerable and open to change.
There still exists a general worry around terminology, fear of getting it wrong and a fear of destabilising something that is working. Language is important and can trigger emotional responses, so it was important to recognise that we might make missteps and invite people to talk about the impact of language use on them. When it came to language, we wanted to agree a common terminology that we use to talk about this. Black and Asian Ethnic Minority, Minority Ethnic, BAME and Global Majority are some of the terms we have collectively chosen and discussed. We are still learning.
We have heard from a colleague, who took a secondment before the anti-racism programme launched, about the impact she noticed on returning to the organisation. She observes that the values of the organisation are the same, but we now have deeper and more confident conversations about race, racism and health inequality.
4. Recognising progress keeps everyone going
On this journey we need to stay motivated. We did this by sharing progress with our colleagues and keeping up to date with our commitments, vision, and ambitions for the organisation. We asked ourselves:
- Is this sort of change measurable? Changes are incremental, and we are committed to seeing constant change in our meetings, projects and interactions, as opposed to one standalone project.
- What metrics should we set and why? Measuring change is important to keep enthusiasm for the programme and to justify ongoing focus, commitment, and budget. Our evaluation team is helping to capture change via quantitative and qualitative means.
- What about the change that can’t be measured? When we hear conversations have gone well, we reflect and highlight good practice. A recent example, as shared by Rishi, is a training opportunity that was shared with leadership only. However, as the leadership team is not very diverse we decided to share the training more broadly to give the opportunity to a wider group of applicants. This is not a conversation or decision that would have taken place without our anti-racism work.
Change is incremental and we need to take stock from time to time. Though we have highlighted the impact of talking and having conversations, we recognise it doesn’t end here. After listening to views from across the organisation we have been able to identify action that is needed to make incremental change. We will move safely towards this.
We hope to share more with you as the work progresses.
Rishi and Pearl