Conclusion and Actions

Looking back at last year’s report

In 2022 we published our first HEEDs EDI Annual Report and committed to what we must do. This included:

• We will host an annual EDI Learner Assembly. We have now had three such learner assemblies, and this is embedded as core business. The findings and next steps are within this report.
• We will monitor our training of Faculty. Training of Faculty initiatives has been shared via Postgraduate Deans and HEE now monitor senior faculty EDI data. We now know the characteristics of our senior faculty, and show us what we suspected. We will work on our standard operating procedures and have a specific plan for faculty recruitment. Each Postgraduate Dean will need to have an inclusive recruitment plan to increase representation of senior faculty. This will also include monitoring training activity

We will undertake annual monitoring and next year extend this to all clinical faculty

• We will use our Quality Improvement Plan to hold ourselves to account: EDI is now a core focus of the Quality Standards and Framework. The Quality Framework has reported on self-assessment (what we ask our providers) and data (National Education and Training Survey as well as ARCP data). • We will publish what we do and our progress in an annual report. This year’s report features a range of EDI activity and helps us see how EDI is being considered across workstreams and areas of education and training.
• We will publish what we do and our progress in an annual report: This year’s report features a range of EDI activity and helps us see how EDI is being considered across workstreams and areas of education and training.

Conclusions and actions

We now have a much better picture of the landscape, and can target our actions to effect change for learners and our teams that education and train within the NHS in England.

We will continue to drive this work forward and plan to develop an EDI strategy for the whole of the medical workforce and career as part of the new NHSE.

We commit to working with all stakeholders and partners to deliver this important agenda to drive up the quality of training, ensure less discrimination with the aim of improving retention and morale so we can deliver our collective purpose to drive up care for patients.

This will be done by continuing the commitments from the two HEEDs EDI Annual Reports and make them business as usual:

1. An Annual Learner Assembly

2. Monitoring Protected Characteristics of our Clinical Faculty

3. Ongoing use and development of a refreshed Quality Improvement Plan in line with our findings to date

4. Commitment to the Publication of a 2024 Report

Development of EDI Plans as part of the Quality Framework based on local intelligence including:

• Using Self-Assessment from Providers to identify themes and actions, exploring the results from this year’s data and considering as part of the Quality Framework the effectiveness of existing policies and processes for raising concerns and enhanced international graduate inductions

• Using Data from our NETs and Trainee Information Systems to identify themes and actions

• An ongoing commitment to making EDI data available from across our work meaningful and accessible

• Mapping Items and themes from the 2022 and 2023 HEEDs EDI reports to inform themes and actions.

Delivery and Monitoring all Actions and Next Steps within the Report

The National Learner Assembly will:

• Continue to hold an annual National Learner Assembly.

• Use this as a collaborative platform for interested healthcare professionals.

• Keep making tangible progress in EDI by successfully using the existing HEE Quality Framework.

• Specifically encourage those of protected characteristics into positions of leadership.

• Improve awareness and pathways for raising concerns and feedback mechanisms where concerns have been raised.

Further Quality Improvement Plan Actions for Year 3 (2023/2024)

• Review the EDI metrics that have been collected in Year Two of the QIP implementation and agree what should be developed as strategic initiatives and business as usual.

• Ensure the relevant metrics are shared with Regional Teams so they can carry out further data analysis and triangulate with local initiatives and themes with an EDI theme and to agree actions based on their local requirements.

• Further actions for the QIP will be based on the conclusions and findings in this report. The QIP will be refreshed as an action for national and local offices to focus on themes and work streams related to EDI.

• Work with NHSE colleagues to incorporate relevant metrics in the EDI Workforce Plan.

Annual Review of Competency Progression and Fairer Training Cultures (Differential Attainment)

• Ongoing monitoring of data and local plans to reduce the attainment gap.

• Continued focus on access to support provided with a focus on reducing variability through local monitoring and sharing good practice.

• Improved enhanced induction and early support through local monitoring and sharing good practice.

Characteristics of HEE Senior Clinical Faculty

Under-representation has been identified as a priority area with an ambition to increase participation of our faculty. Actions to support this will include:

• All Postgraduate Deans to consider their recruitment approaches as a result of this data (overall national and local data).

• A refresh of our approach to recruitment. • Showcasing how we use the data so that educators see value in them declaring their characteristics.

• Whilst maintaining the option not to declare, encouraging a safe and supportive environment and system where individuals feel able to share should they wish to.

• Continued review of the data.

• Commitment to measure annually to observe any trends, changes and improvement in participation.

Sudden Deaths of Doctors in Training

• An annual publication of the protected characteristic data.

• Development of a plan to reduce data gaps.

Specialty and Associate Specialist Doctors Areas for development

• Strengthening the SAS tutor and SAS advocate role and recognising the SAS tutor role through education programme activities (EPA).

• Working alongside the GMC and AOMRC to improve workplace conditions, value and support career progression of SAS doctors and Leadership opportunities and extended role for SAS doctors.

• Strengthen CESR programmes and work alongside training programmes to facilitate SAS doctors’ re-entry to training programme and flexible career and training opportunities.

• Ensure that opportunities for consultants are also available to SAS doctors. If SAS doctors work in general practice, (GMC proposals) define training and support mechanism to enable this.

Recruitment Data Analysis

• Publication and EDI interpretations of the commissioned Statistical Analysis In Recruitment.

Gender and Disability Pay Gap

• A repeat of data collection in 2023/24.

Examples of Good Practice

• Ongoing commitment to sharing EDI good practice initiatives, resources and strategies across the Postgraduate Dean network.

• Building a repository on the national website of good practice.

Study Leave

• An update from the working group on their oversight for ensuring fairness of distribution and an update on the standardised ‘Leave Manager’ programme which is being rolled out through HEE’s Local Offices.

NETS

• We continue to work with NHE England colleagues towards joining up education quality data like NETS with quality data from other areas of the service.

• Within this report, we have drawn attention to the ‘unknown’ respondents who are unwilling to include details of their protected characteristics in their NETS responses. We need to explore ways to better understand and engage this group, encouraging survey completion and the raising of concerns so action can be taken.

• Further analysis of all the characteristics may reveal a group who may require targeted support and intervention.

• Relating to discrimination and bullying, Further analysis of all the characteristics may reveal a group who may require targeted support and intervention.

• Postgraduate Deans and their Quality teams will look at this data for their regions and their programmes and put in place relevant actions as part of their Quality Improvement Plans to ensure continuous improvement in EDI issues for all learners occurs.