Black History Month and the Road Still to Travel

I recently attended a Black, Asian and Minority Ethnic (BAME) network meeting in East London NHS Foundation Trust (ELFT) where I was moved by the warmth, care and laughter in the room. I was also moved by some sadness and stories which did not make me feel proud of what we do. I left feeling humbled by the willingness of colleagues to help to fix problems.

With this in mind I reflected on all our efforts over the years to address race inequalities, with some success. But the change is surprisingly slow. I reflect on what I as a BAME leader and other leaders could do differently. This is what I ask myself as a member of an NHS Trust board.

1.      Why does race equality matter? We should have difficult conversations which allow for disagreement, debate and struggle. We should not be comforted with reassurance like, “ ours is a colour blind organisation” or “ since we serve a predominantly white community this is not really a problem for us”.

2.      Is the Board diverse? Diversity brings challenge and richness to debate. It guards against the comfort of false assurance. If the board is not diverse and this may take time to address, do we ensure that we find other ways to bring diversity into the important deliberations in the boardroom?

3.      Are Non-Executive Directors (NEDs) bringing race equality into the board’s regular work? The Non-Executive role of scrutiny, assurance and support is crucial to the function of a well-led organisation. How rigorously do NED colleagues carry out their duties with regards to race equality?

4.      Are we, BAME board members stepping up? In addition to delivering the organisation vision, mission and strategy to the highest standards, we carry a further responsibility. We bring the BAME perspective into the board function. We also act as role models. As my colleague Lorraine Sunduza, Chief Nurse said, “I represent what is possible”.

5.      Do board members wisely use the precious time which brings us close to staff and patients? We use this time to listen and observe carefully. Do we look for examples of inclusion?  Are we sensitive to warning signs for concern? Can we make the connection between race equality, quality of care, staff wellbeing, patient safety and patient experience?

6.      Is it a struggle for the board? We should ask what kind of attention we pay to race equality. I suggest that if it is not a struggle we are not adequately addressing this issue.  

7.      Do we want to be in touch with the barriers and enablers which make a difference in our organisation? The board should celebrate well-earned successes and be aware when inevitable difficulties arise. 

8.      How open and transparent are we? The board should be able to tolerate being exposed at the same time as holding on to hope and solutions. The board should make sure it is held to account by those for whom it matters.

9.      Is race equality business as usual for the executive team? As we demonstrate collective leadership, we own race equality as a thread which runs through each aspect of our individual portfolios. A continuous improvement approach embedded in the way we do things can help to maintain hope for change and success.

10.   Finally, is race equality owned at the highest level of the organisation? I believe it should be and therefore must be firmly located in the CEO’s objectives. The Chair must also be rigorous in enabling the CEO to deliver expectations.


Dr Navina Evans is one of the first female, ethnic minority chief executives in the NHS. She led East London NHS Foundation Trust (ELFT) to become ‘Trust of the Year’ in 2016/17 and to be rated ‘Outstanding’ by the CQC

Navina’s interests include women and ethnic minorities in leadership, improving the way healthcare is delivered and her own experiences as a patient.