You are here
Good practice
Equality, diversity and inclusion good practice
Our Deans’ group regularly discuss and share initiatives. There has been a recent focus and a commitment to continue sharing good practice examples which have an equality, diversity and inclusion (EDI) theme. Each postgraduate dean and their teams have submitted a good practice item that others can learn from, reflect on and consider using or adapting for their region and for their learners.
EDI good practice items have been collated from across England. Additional resources will continue to be added to this area of the website as a central repository for sharing initiatives we think are useful to signpost and promote.
All items have an EDI theme, and they respond to some of the challenges or aim to promote EDI action, discussion, improvement and achieve a tangible difference.
Good practice items have been themed as:
Increasing Diversity in the senior educator group in the North West
There is a need to prioritise and improve the diversity of those in senior clinical educator roles. This will help ensure our senior faculty in NHS England better represents the NHS medical workforce including doctors and dentists in training.
In last year’s report we published the results of our survey of around 1,000 senior clinical faculty working within NHS England and provided information about the demographics of this group. The results gave an insight at regional and national levels of the diversity within our senior educator roles. As an example, the national data showed an under-representation when consultants grouped as Black Minority Ethnic (as taken from the summary WRES data – source 2020) were compared with BME staff in senior faculty roles.
Regional data has been shared and considered in each region to help inform local plans. This year we asked Postgraduate Deans to share examples of how they have acted upon this information with some examples provided.
North West
An inclusive recruitment process for senior educator roles including Medical Educators and Associate/Deputy Deans was implemented. This included consideration of lived experience and positional experience. This led to improvements in job descriptions, selection criteria and interview questions.
The overhaul of the recruitment processes and talent management will provide better opportunities for postgraduate doctors in training from underrepresented groups to contribute to learning environments. It will also provide tailored career opportunities for underrepresented groups.
This process was presented as a DEMEC workshop that led to sharing good practice. Educators who may not have previously applied for these roles are now considering these career opportunities. The application ratios for senior roles have increased and a wider diversity of applicants have applied. This had led to increased diversity and an improved skill set within the medical leadership team.
An EDI network has been established with postgraduate doctors in training leadership representation. This has exposed them to leadership opportunities with senior educators to help them consider these career options. To reach the widest group of good candidates is time-consuming and needs to be prioritised. Candidates need to see others in senior roles with similarities to themselves to feel enabled to apply.
Wessex
In General Practice Associate Deans and Training Programme Directors are asked whether they are interested in future senior roles and can be mentored by current Primary Care Deans or Heads of Schools. This also applies to senior trainers that we think may apply for roles in the future.
When advertising for Differential Attainment roles, advertisements specifically include that International Medical Graduate trainers/General Practitioners would be welcomed due to lived experience.
A lack of diversity was noticed in Wessex for this trainer group. There is now a BAME Associate Dean in the train the trainers slot whose network includes IMG trainers and there is active work to encourage those trainers to join the senior educators’ team. In addition, there is a webinar planned across the region targeting colleagues in non-training practices, especially in deprived areas, to become trainers and this may increase the number of diverse trainers and therefore senior educators.
It is apparent that role modelling can be the best way to attract more diversity. Since Dr Manjir Bodhe became Head of School, there has been a more diverse senior educator team in Thames Valley and hopefully this will also be reflected in Wessex too.
North East
There are several initiatives to support diversity in senior educator roles.In the North East an approach of positive action was taken. Applicants with one or more protected characteristics were encouraged, informally mentored and have been able to take on interim appointments to provide them with further skills and experience to become appointed into formal and substantive roles. The initiative was part of a Postgraduate Dean-led recruitment drive and resulted in our senior educators with one or more protected characteristic increasing from 50% to 66%.
Inclusive Educational Faculty Recruitment: Ensuring Best Practice
To help broaden the diversity of our education faculty to better represent the trainee cohort and the wider population we serve a guidance document and checklist covers the Key Principles of Inclusive Recruitment for educational faculty.
East of England – Reciprocal Mentoring Programme
As part of a regional EDI Strategy and commitment to foster a culture of inclusivity and cultural awareness across all levels, the East of England Deanery launched a Reciprocal Mentoring Programme for senior educators, and doctors and dentists in training from minority groups. Please read more on our website here
The Trans Gap Project
As part of a commitment to raise awareness of EDI themes the NHS England Deans’ EDI Committee has seen numerous education and training initiatives as well as broader issues in healthcare.
We would like to highlight the work of the Trans Gap Project, which raises awareness for postgraduate doctors in training and clinical faculty. We welcome reflections about supporting trans doctors to include in future faculty development, awareness raising or practical support.
Who we are
TransGapProject is a national research group that seeks to build an evidence base for how medical scores relate to the transgender community. The mission is to promote patient autonomy and improve healthcare outcomes for the gender-diverse community, as well as safeguarding clinicians with evidence-based practice.
Medical decisions are commonly aided by scoring systems based on binary gender identities, yet there is limited research to serve the healthcare needs of the transgender community. This is what we refer to as ‘The Trans Gap’ that can result in suboptimal care for transgender individuals. Depending on what gender is used in current medical scores, a trans person may: not qualify for kidney dialysis; may be underdosed in anaesthesia for an operation; may receive a different dosing regime for antibiotics with the potential for inadequate doses; may be offered blood thinning medication; may be under or over the legal alcohol limit whilst driving.
Our current focus is on producing six scoping reviews assessing: eGFR (kidney function), CHADSVASC (stroke risk), Ideal Body Weight (drug dosing), Alcohol Clearance, QRISK (cardiovascular risk), and Diabetes Risk.
Since its founding in November 2022, we have received national media coverage and awarded grant funding to develop research and grow our impact. We hosted an international conference in Bristol, where we delivered an audit workshop developing ideas for titles that could then be run nationally. The full list at https://transgapproject.wordpress.com - ‘Audit Recipe Book’. Listed below is a selection of educational-themed audits:
- Is training on LGBTQ+ healthcare mandatory for all staff in GP practices? How frequently is it provided, and was it developed with stakeholders?
- How many LGBTQ+ champions are there in each GP practice and do all practices have one?
- How often are transgender individuals referenced in medical revision questions and are these references based on stereotypes?
- What is the level of awareness and training on cultural intelligence among AHCPs, pharmacists and nurses?
- What is the level of training and comfort among clinicians regarding transgender healthcare?
- What is the level of interest among healthcare professionals in receiving training on transgender healthcare?
- What is the extent of information exchange between private and NHS healthcare providers in relation to transgender patients?
- Are healthcare professionals comfortable and confident in providing care to transgender patients, and what steps can be taken to improve their training and understanding of transgender healthcare?
We would specifically like to hear more from those working in primary care and have more voices of those healthcare staff working in community settings to guide our research.
Support us in championing research with real-world implications for transgender health and develop guidelines which will support healthcare professionals in their clinical practice. Please reach out to get involved with TGP to help perform, publish and present research or assist with running monthly talks on our “Trans Voices” or to provide expertise to our researchers in media training and academic writing.
Authors of this group include
Michael Niman, Otto Russell, Ben Sewell, Louis Davenport, Rebecca Harrison, Maria Salamanca, Duncan Shrewsbury
Want to get involved? If you have innovative practice with an EDI theme you can get in touch via england.wte.quality@nhs.net. We’re especially keen to publish and promote items that exceed standards and that are new and have had a positive impact.