Promoting partnership working in the NHS

Cultural Ambassadors Project - Birmingham and Solihull Mental Health NHS Foundation Trust & Royal College of Nursing

A Cultural Ambassadors project in the West Midlands designed to tackle disproportionate rates of disciplinary action among black and minority ethnic (BME) staff, is to be rolled out nationally by the Royal College of Nursing (RCN) during 2016.

The challenge

The NHS is very diverse but national and local data shows that BME staff are investigated or disciplined more than white members of staff. The RCN conducted a number of workshops and focus groups locally in the West Midlands with BME staff to explore this issue.

Birmingham and Solihull Mental Health NHS Foundation Trust data showed that members of staff from a BME background were 1.4 times more likely to be disciplined. The organisation’s staff survey results indicated a disproportionate number of BME staff experience bullying and harassment. Evidence showed many incidents went unreported, due to a lack of confidence in the reporting process, and resulted in high levels of sickness absence and some poorly performing and divided teams.

The trust was approached by the RCN to participate in the Cultural Ambassador project. The project aimed to improve the experience of staff during the employee relations process, and reduce the number of BME staff being investigated or disciplined inappropriately.

The Trust and the RCN entered into a partnership arrangement to take the project forward. The aim of the project was to place an additional member of staff of a BME background (cultural ambassador), who had received training on cultural bias, on all investigations or disciplinary panels where a BME member of staff was involved. The cultural ambassador acts as a critical friend focusing on the detail of the process to make sure that it is fair, equitable and bias free. Cultural ambassadors are allowed to ask questions for clarity, however they are not there to provide direct additional support for the staff member but is a full member of the investigating team or the disciplinary panel.  

The process

Although Birmingham and Solihull Mental Health NHS Foundation Trust provides a number of forums for unions to represent their staff members locally in the workplace, this project was completely separate and came about as a result of a networking opportunity for the senior equality and diversity lead at the trust and one of the RCN’s senior regional officers. It was clear that consensus and partnership working was required, with equal ownership by both union and management colleagues.

The project was jointly presented to trade unions by the trust’s senior equality lead and RCN’s regional senior officer at the business as usual meeting. They also presented to the Trust Nursing Advisory Council, as this group has a high representation of staff on it. Both groups were given the background research conducted by the RCN, and the data analysis that was done by the trust to demonstrate the evidence for the project. It was agreed these groups would receive regular progress updates from the project and the final evaluation report.

To get the project fully implemented it was vital to get complete commitment and support from key internal partners to the project. Once this was done, the team asked for volunteers to receive training to become cultural ambassadors. This involved demonstrating certain competencies through an application and interview process. Out of 29 applicants, ten were selected for the project. The volunteers undertook a three-day cultural awareness training programme specifically designed for the project and a HR-led investigation training day to support their learning.

The employee relations administrative staff, HR and investigating managers were given a full briefing on the new policy changes and intentions. There was a trust-wide communication about the new initiative to all staff, and senior managers reinforced the message at all departmental staff meetings. Some amendments were made to the trust's disciplinary panel and investigation template letters, and cultural ambassadors were added to the list of contacts that were to receive reports where required or relevant. Cultural ambassadors are invited to panels on a voluntary basis, after checking they are not from the same area of work and there is no conflict of interest.

A communications plan was developed with the support of the communications team and this was complemented with additional learning to get first-hand information and qualitative evidence from the cultural ambassadors. The trust also carried out its own internal evaluation of the project through an electronic questionnaire to HR managers and cultural ambassadors.

The outcomes

As a result of the project, the trust has seen a reduction in the levels of sanctions imposed in comparison to 2014. There has also been a reduction of investigations from 32 to 26 cases involving BME staff. In addition, the trust has seen reductions in sickness absence.

It can cost the trust in excess of £70,000 for an investigation leading to a disciplinary when carried out at a band 8 level. The ability to prevent unnecessary investigations can bring substantial long-term savings to the trust. Feedback from internal evaluation showed that the behaviour of those leading investigations and chairing disciplinary panels can be different when a cultural ambassador is present. This can have positive impact on the outcome of a case.

The trust has seen an increase in requests from trade unions and staff members for a cultural ambassador to be present at panels, indicating that BME staff members have more confidence in the process when a cultural ambassador is present.

The project is already fully embedded into the employee relations process and is administered by the employee relations team. The cultural ambassadors initiative is transferable and will now be utilised at different points of the grievance and disciplinary process. It is also being considered when conducting root cause analysis of serious incident case reviews.

Top tips

  1. Use as many communication channels as possible so that all relevant staff are fully aware of new projects and initiatives.
  2. Continue to work in partnership through the whole project, from development to implementation to evaluation.
  3. Collect evidence, feedback and intelligence to inform a full evaluation of the initiative.
  4. Make sure that the aims and objectives of the project relate to the wider trust and departmental objectives.

Contact details

Bruno Daniel, Senior Equality and Diversity Lead, Birmingham and Solihull Mental Health NHS Foundation Trust -

Jane Paterson, Senior Regional Officer, Royal College of Nursing, West Midlands,