Can Do Health & Care - NHS Uncomfortable Truths Report

Part 1: WHY as system leaders we need to address culture to improve outcomes | 15 A great deal of differential attainment is due to communication, crossed wires and cultural differences. We are all different but embracing those differences is not everyone’s cup of tea. The greatest area of concern in this country is someone saying they have concerns about you. People said that about me early in my career, I was sent on a linguistics course, but my language scores showed I am an expert user of English so there was no need. There are wider systemic issues here. The number one reason for referrals is differences in communication and perception. “Rather than working antagonistically we must work together in synergy to accept each other’s differences.” The overseas workforce will be 50% of the workforce in the next 10 years but representation in management leadership spaces is only 17%, so there is a big gap. In 75 years of the NHS there has always been a glass ceiling. When I came to Clacton and took over a surgery assessed to ‘require improvement’ a leader in the CCG asked me to ‘humble’ myself; if there is a block right from the entry point of your work, how can you progress that conversation further? Being a brown man with a beard, you are profiled as a ‘towel-head’ first, so as well as the colour of your skin you have to overcome that too. First people see you, then they speak to you, and only if they like what they hear will you have an opportunity to get to the next level. “The NHS is standing on the shoulders of its international workforce.” This is uncomfortable but it is the reality for the overseas workforce and has been for a very long time. Harprit: The overseas workforce has, does, and will always make up a large proportion of our workforce. But the NHS gets it wrong. I ask organisations to put themselves in the situation where you go abroad to pull staff from organisations that are also struggling with their own healthcare workforce, you bring them here and separate them from their families and their friends, you have no affordable housing for them, you pay them at the lowest possible scale not taking into account their previous experience, and you put them in a stressful environment with no support, teams who don’t want them and have prejudices and racism against them. That’s what we are doing.

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