NSHCS response to open letter about Black, Asian and Minority Ethnic trainee numbers

Last week the National School of Healthcare Science received an open letter from our STP community looking at how we can help to redress current inequalities in the lives, prospects and opportunities for people from Black, Asian and Minority Ethnic backgrounds. Where contact details were available, we have already written individually to everyone who had signed the open letter by 3pm on Friday 17^th July 2020. However, we also wanted share our response with all of our colleagues in healthcare science to let them know about some of the work the School is undertaking and ways it will work going forward to address the issues raised in the letter.

We would like to acknowledge the appalling death of George Floyd in Minneapolis, USA on 25^th May this year. This event and subsequent developments during the COVID-19 pandemic has brought to the forefront of our politics and into the centre of our society the issue of systemic racism.

Recognising the broad reach of this issue, the School and Health Education England (HEE) are clear that we will listen, learn and work with Black, Asian and Minority Ethnic and other colleagues to play our part in ending racism and discrimination wherever it may exist.

Firstly, we want to tell you about some of the initiatives that we are embarking on to contribute to and build on the work that needs to be done. These initiatives are only the beginning of the work to be done:

In the School, we are talking openly about BlackLivesMatter and are setting up relevant groups to ensure that Black, Asian and Minority Ethnic staff feel they are heard and represented fairly and openly in every way. We are fortunate in the School to have many talented, brilliant and highly valued staff who are from Black, Asian and Minority Ethnic backgrounds as well as many other minority and diversity groups.
Many from the Black, Asian and Minority Ethnic staff in the School sit on HEE Black, Asian and Minority Ethnic networks and every support for ideas and work emerging from these networks will be given.
We are setting up an Equality and Diversity forum within the School. Our Black, Asian and Minority Ethnic colleagues in the School would like this forum to be wider than Black, Asian and Minority Ethnic issues, however the issues we are discussing in this correspondence will be central to the work of this group.
We will ensure that a staff member is established in a dedicated position for Equality and Diversity within our staffing structures who will be integral to all our processes going forward. We have already begun the process of commissioning work to examine in depth our recruitment processes to ensure that they are open, accessible, and transparent as possible.
We will work to ensure that our examination and other processes and deliverables are equally open, accessible, and transparent.
The School will work on initiatives with NHSE/I and office of the CSO to develop the above ideas and engage with the wider workforce.

Secondly, we want to address the requests raised in the open letter.

Disclose the diversity and ethnicity of total and successful applicants for each specialism and cohort.

We are happy to publish on our website the ethnic demographic data for the trainee cohorts that entered the programme in 2019 and 2018, by specialty. You can find the data here – https://nshcs.hee.nhs.uk/publications/ethnic-demographic-data-for-the-stp-trainee-applications/html/

For previous cohorts we have access only to aggregated data. We have previously analysed this data and reported it as part of our governance, and we are happy to publish that previous analysis on our website. However, in accordance with data protection legislation we are required to delete personal data within a reasonable time of not using it for the purpose it was collected for, and we no longer hold the raw data before 2018. We cannot therefore re-analyse the data and break it down into specialties. Despite not having data beyond 2018 we feel that there is sufficient data there to identify current trends and start to address any potential future issues.

Disclose how interviewers are selected, and how many were from Black, Asian and Minority Ethnic backgrounds in each of the cohort years.

When HEE’s commissioners invite employers to put forward their requests for new trainees, one of the conditions is that the employing department should supply at least one interviewer. The School coordinates the interview event on behalf of the healthcare science profession; but the interviewers are put forward by the employers. They participate in a voluntary capacity. The process requires interviewers to be registered Clinical Scientists and they are, therefore, bound by their professional code of conduct. The School provide guidance and briefing, before and during the event, and this includes briefing about protected characteristics and unconscious bias. However, we do not select the interviewers ourselves, and we do not monitor their ethnicity (or other characteristics such as age, gender, disability, or sexual orientation). The diversity of the interviewers reflects the diversity of the current senior workforce in healthcare science. Going forward, we would be happy to discuss with the scientific community whether it feels that the ethnicity and other diversity and equality characteristics of interviewers be recorded.

As a first step to full transparency of this process active steps will be taken to encourage more recently qualified Clinical Scientists from Black, Asian and Minority Ethnic backgrounds (in particular, alumni of the STP) to participate in the recruitment process. If you are in a position to help train, recruit, assess, and most importantly, inspire and support other individuals into a healthcare career please sign up here. – https://nshcs.hee.nhs.uk/get-involved/express-an-interest/

Add anti-racism training and unconscious bias training as a prerequisite to performing interview duties.

Currently, we include raising awareness of unconscious bias and signpost all assessors taking part in our programmes final assessments, the IAPS and the IACC to a Royal Society video on understanding unconscious bias.

We are working with HEE and external companies to source further anti-racism and unconscious bias training that will be included in all elements of stakeholder engagement with the School as part of our wider emphasis on equality and diversity training and addressing inequality in whatever form it may manifest itself.

We are also working to provide anti-racism and unconscious bias training as part of the Train the Trainer packages for STP Training Officers and HSST Supervisors, which will take place online this year.

Incorporate anti-racism training to the MSc Professional Practice module and extend current Professional Practice competencies to include trainee reflections on racial discrimination.

The STP curricula are driven by the HCPC Standards of Proficiency for Clinical Scientists which state the standards of practice which Clinical Scientists must uphold to maintain registration. The HCPC is currently consulting on proposed changes to the Standards of Proficiency where promotion of diversity and ending discrimination is also evident and we will work with the HCPC.

Our curriculum is designed by scientists, scientific leaders, experts in each specialty field as well as those representing the core elements of training. Lay representatives are also embedded in the curriculum development process. We will expand our lay representative group to ensure that as far as possible Black, Asian and Minority Ethnic and other protected characteristics groups are represented. All the lay representatives currently engaged with the curriculum review process have completed equality and diversity training. Our curriculum is currently under review, including the core curriculum taken by all Trainees which features the module currently called Professional Practice/Introduction to Healthcare Science. Through the review process we are seeking to strengthen the promotion of inclusive practice, awareness of unconscious bias and encourage Trainees to reflect on all elements of practice, both positive and less so. We want to encourage Trainees to consider the professional and personal standards required of a Clinical Scientist throughout their training and ultimately the NHS Constitution which guides us all in providing an NHS which “belongs to us all”. We are considering elements of discriminatory practice with all specialty review groups and will continue to raise this issue. We would also encourage signatories to write to their trusts’ lead healthcare scientists to submit support for these ideas during the next stakeholder review stage of the curriculum review process.

The curriculum holds indicative content which is provided to the STP Universities. Universities each use their own materials to develop contents for lectures based on the themes outlined in the indicative content. We would suggest Trainees use their voice in student feedback surveys to encourage STP Universities to consider the materials they are using. We will now undertake a survey of how they are incorporating issues of race and inequality in their teaching. We will, subject of their permission, publish the results.

We are also working with HEE and external companies to provide anti-racism training as part of the STP induction package, which will take place online this year.

Facilitate a collaborative meeting with Black, Asian and Minority Ethnic trainee representatives and members of NSHCS to support policy changes.

This is something we are very keen to initiate and support. In the Trainee Representative Group meeting on Friday 17^th July we spoke about each regional network creating a Black, Asian and Minority Ethnic regional representative position. We will then invite each Black, Asian and Minority Ethnic regional representative to attend a Black, Asian and Minority Ethnic trainee network meeting with the School.

Our web development team are also looking into the opportunity to create an online forum that would sit on our website for Black, Asian and Minority Ethnic trainees to communicate with each other and share their thoughts and experiences.

Concluding paragraph

Within the wider context of the complex contributors to this issue we recognise that the School has a role to play, as outlined in the open letter, to improve Black, Asian and Minority Ethnic representation in healthcare science and we are committed to working with you to achieve this. As demonstrated by the creation of the open letter itself, a significant resource that healthcare science has in tackling this issue is our healthcare scientists themselves. Perhaps the greatest way to increase the diversity in applications is for you as current STP trainees and STP alumni to reach out and help raise awareness of the role of healthcare scientists in the NHS and the career opportunities available. We want to encourage all signatories to become STEM ambassadors and In2Science Mentors. You can find out more about the different ways you can encourage applications here – https://nshcs.hee.nhs.uk/healthcare-science/help-to-promote-healthcare-science-to-the-public/

The National School of Healthcare Science recognises that the new ways of working and developing all aspects of scientific training to be open, fair and inclusive to everyone will take time. We understand that this sustained process will involve yourselves and many others.

The School is your national deanery for training of healthcare scientists, we are part of the healthcare science community in the NHS. We hope that your letter and our response clearly shows that our aims are shared and that to be successful we will need to work together. We are absolutely committed to doing so and look forward to working with you to achieve our joint objectives.

With best wishes,

Professor Berne Ferry, Head of NSHCS
Jane Lynch and Namir Al Hasso, STP Training Programme Directors

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