Let's Talk

Challenging the Talent Management Process in the NHS

Nazir Makda works as a Diversity and Inclusion Lead in the NHS. He came in to talk to me about the incredible results he has had in shifting the equality dial throughout the organisation by taking a systemic approach.

Speaker 1: Welcome to The Inclusive Growth Show with Toby Mildon. Future proofing your business by creating a diverse workplace.

Toby Mildon: Hello there. Thank you ever so much for tuning into this episode of the Inclusive Growth Show. I'm Toby Mildon, and today I'm joined by Nazir Makda. Now I met Nazir quite recently. Nazir works for the NHS and I was speaking at a lunch and learn event that was organized by the NHS and, obviously, Nazir was there and we connected afterwards and got chatting. And one thing that I was really impressed with, and the reason why I wanted to get Nazir on the show today was because, Nazir has done a really great job in the part of the NHS that he works at. Looking at how you can create more equality at that kind of systemic level. And this is something that I talk about in my book. I've got a whole chapter on colleague experience and design. And the whole chapter really is about trying to stop fixing individuals, but rather look at the business policies, systems, culture, processes that are actually getting in people's way and holding them back. So when Nazir was talking about the work he's been doing at the NHS, I was really intrigued and wanted to delve a bit deeper. So, Nazir it's really great to have you on the show today. Thank you for joining us.

Nazir Makda: Thanks Toby. Thank you for inviting me to The Inclusive Growth podcast, really terrific to be here.

Toby Mildon: So could we begin by you letting us know a bit more about yourself and your professional background and what led you to your current role?

Nazir Makda: My career started in the private sector, so I was mainly in retail management. And it was a kind of stumble upon equality and diversity. So I worked for the BBC and we did some collaborative work with the NHS and then one thing led to a conversation with one of the managers saying you'd be really good in the NHS. And as they say, the rest is history. So I've been working in the equality dynasty field for 19 years and I'm currently lead for diversity and inclusion for East Lancashire Hospitals NHS Trust.

Toby Mildon: Brilliant, so I know when we were talking earlier, this, what we're about to talk about today really stemmed from a number of frustrations that were being felt within your organizations. So what were those frustrations that you had unearthed with with your people?

Nazir Makda: Yeah. So we have staff network groups. We have six of them. And serve our data on our workforce makeup showed huge diversity deficit, particularly in senior roles. And data is important because it drives insights and helps you diagnose what you need to do different to enable greater diversity. So some of the themes across all of the networks are consistent around the recruitment and retention. And the staff survey highlighted disparities in terms of sort of free text comments that it's not what you know, it's who you know, and some people remark that certain jobs are earmarked, suggesting nepotism. So the leadership were quite somewhat removed from the frontline, not much aware of the agenda. So what I did was pair them up with somebody from an underrepresented background to be reverse mentored. We had tried quite a number of things in the past, but it wasn't shifting the dial.

Toby Mildon: Yeah. And I know that's how our conversation started originally, wasn't it? It was like the stuff that was being done wasn't shifting the dial. And then you were like, "Hang on a minute, we need to go deeper than this, we need to go into much more of a systemic level." I suppose, once those frustrations had been surfaced, what did you then organize?

Nazir Makda: Yeah. I think what we did in the past was deliver things like unconscious bias and what we found was you can't root out bias from individuals but what you can do is at a systemic level or you can root out bias from systems and mechanism and processes. So I organized a face to face event with representation from all of the six staff network groups. Booked out 10 rooms. We had facilitators within those sessions and basically, all of the day was around looking at some of the recruitment processes separately to root out the bias. So there was one for attraction. So group just talked about how there are barriers within the attraction process. Are we advertising in the right sort of magazines in the right sort of communities? There's one for application, one for appointments, and one for career progression. And although we have these four sort of main themes, there were sub themes to each of these so they were discussed as well. And then all of the information was collected. We developed an action plan to address the barriers. And I put some governance accountability in place with the introduction of a recruitment retention steering group that oversee this piece of work.

Toby Mildon: So obviously, it's great that you, I suppose identified those four themes. So there was attraction, applications, appointments, and progression and then each of those had a number of kind of sub themes underneath. Let's just stick at the top level now to keep things nice and simple. What were your main findings in terms of attraction?

Nazir Makda: Yeah. I think whatever the key findings or our attraction was we used something called manager's jobs. So all of their job postings were on this main portal, but there wasn't any engagement with different people because different people have different barriers. And there's barriers for people with, physical and mental impairments. There's barriers for people who have literacy or numeracy problems. There's barriers for people who have English as a second language. So what we have to do, we have to develop strategies to be proactive and actually have open days within those communities to attract and then actually showcase some of the vacancies that we have in our trust.

Toby Mildon: Brilliant. And what about applications then?

Nazir Makda: Yeah, the application was quite challenging because, predominantly the NHS only accept applications for the online portal, but, it sort of discriminates in terms that some people would like us to fill in a physical copy. So all we did, we worked with, so the hierarchy in the NHS and then the NHS have tailored and made huge improvements around the application process. So you can have manual application processes put in as well. Some of it is around the reasonable adjustments of the application process. So locking up virtual ways of sending the application and virtual ways of actually being interviewed.

Toby Mildon: Yeah, that's really cool. And then what did you find out for appointments?

Nazir Makda: Yeah. The appointments were interesting because, we analyzed how people were being short listed. And then what we triangulated was that where you had independence in the interviewing panel, you were more likely to get a diverse sort of selection, but then we also changed the construct of the interview to ensure that the right decision was made there wasn't group thing. And there wasn't bias within that process. And the impact has been significant because, we've seen huge improvements in the diversity and the make of the organization.

Toby Mildon: That's really brilliant. And then finally progression.

Nazir Makda: Yeah. So there's a lot of frustration, particularly from, our Black, Asian minority ethnic colleagues who go on quite a number of development programs. They get lots of leadership training, but when it comes to sort of acting up and secondments, they don't get logged in. So what we have done is lock talent management in its entirety about looking at appraisal, developing inclusive leadership programs so that managers are aware of sort of the challenges that Black Asian manager I think people face when it comes to career progression. Before the secondment acting up would actually sort of not advertise global across the organization. They were sent to a few people, but now we've changed all that by in insisting that the advert goes to everybody so that there's equal opportunity to apply.

Toby Mildon: No, it's all really good. And I think what I like particularly is that it's very logical to me. So you were breaking down the employee life cycle, if you like focusing on those four key themes of attraction, applications, appointments, and progression, obviously, that was broken down further. But also the methodology that you used, just bringing everyone together and booking out 10 rooms and brainstorming with colleagues and things like that. So once you had unearthed the I suppose, the challenges that people were experiencing under those four key areas, what were then some of the improvements that you've been able to make, particularly at that systemic level that you were particularly keen to address?

Nazir Makda: Yeah, I think it was interesting because we'd introduced some checks and balances and brought about some independence within the entire process. So there was a greater accountability to reduce group think or in-group bias. We started using a body system for new starters. There's a new starter review process. So after three months, we interview all of the new starters to reflect on their experience of the entire recruitment process, the onboarding process, and that feedback, that intelligence feeds into improving the whole recruitment process. We also offer now the ability to raise an audit or access to an audit. So if somebody's unhappy with the recruitment process and they felt that they, or sort of discriminated against or they didn't get a fair opportunity. So they've got opportunity to actually access, or raise a grievance. So we can audit the whole recruitment process. We offer career development workshops now for people who weren't successful so they can access those. Now, as you know, Toby, there are interdependencies for all this. And some of the impacts we've seen through the work that I've carried out with this methodology was around how we now have a very comprehensive exit interview because people now who are leaving, because without retention to be a big feature and be part of the NHS we lose quite a lot of good people.

Nazir Makda: So we also have developed something called the behavioral framework. It could stop... Encourages people to stay and how they want to be treated within the new work environment. And also now, because of the impact of COVID, a lot of people want to work flexibly and remotely and agile. So we've got a very comprehensive, agile and flexible working policy to ensure that we attract quite a diverse sort of group of people to work for the NHS. And we we've been able to challenge, as I mentioned earlier, our talent processes. And these are significant because a manager is responsible for the progression of the individual. So looking appraisal and how that's sort of implemented in terms of access to development. And also we've introduced some really key model inquiry targets for reducing the diversity deficit.

Toby Mildon: It feels to me like it's very targeted and specific interventions, and it's very different to what a lot of organizations do, which is that they'll organize something without much evidence behind it. And then they get really frustrated later on that the thing that they've organized doesn't shift the dial. Whereas you went in, well, you had a methodology to this, which I think helps to have that structure. You listen to your people to find out what the challenges were, identified the key themes and then came up with a number of really targeted solutions, which I really like. And what is the impact that you've noticed since running this exercise, and implementing those solutions?

Nazir Makda: It's early day, but we've had some really quick wins. We've achieved some of the model employer targets for Black Asian minority ethnic staff at senior levels. So six years ago we didn't have anybody from a Black Asian minority or ethnic background in the board. We now have four. So that's an increase of 24%.

Toby Mildon: Yeah.

Nazir Makda: The NHS is also structured in a way where we have grading. So we've seen increases in grade eight and above.

Toby Mildon: Yeah.

Nazir Makda: We've also improved in our sort of national equality standards that we have to fulfill the workforce grace and disability quality standards. So in metrics voluntary through we've improved. And I think one of the biggest sort of shift has been in how our staff survey has demonstrated that we've made a real shift in terms of the criminal intention. And it was a theme consistently annually, where the percentage of staff are reading that the organizers provide equal opportunities of career provision promotions has considerably improved. See in the latter years this was always quite a challenging indicator. And we were below 50% for people believing that we offered equal opportunities. We've included progression and promotion, but that's gone up to 56% this year.

Toby Mildon: Excellent. So there's some really positive results there, which actually leads us onto the penultimate question that I ask everybody when they come on the show is, what does Inclusive Growth mean to you? And particularly I'm interested to hear, obviously, from an NHS and public service perspective, because I talk to a lot of commercial organizations and they say things like, "Well, we want to be more profitable, better anticipate our customer needs and deliver better products and services," and things like that. But from a health service perspective, what does Inclusive Growth mean.

Nazir Makda: For the NHS, it's a no brainer, Toby. There is a direct correlation between staff experience and patient satisfaction. So it makes real good business sense to recruit from within our local communities. So we can offer really good better service to our patients and service users.

Toby Mildon: Yeah.

Nazir Makda: We always say that employees are our greatest asset. So this is about reaping the benefits of the diverse talent, which then enable our organizations to grow.

Toby Mildon: Yeah.

Nazir Makda: So really this is a fundamental business case for the NHS because research suggests that created diversity delivers sort of better results. So having a diverse workforce and creating an environment that gives everybody a voice that encourages people to contribute and also to bring their whole selves to work is how we really get the most out our people, which help drive innovation and creativity.

Toby Mildon: Excellent. Yeah. It reminds me, I've been working recently with a very big energy company and the chief executive has got this triangle. And he says that priority number one is to look after your own people and make sure your own staff are happy because they will make happy customers. And then those customers will deliver great results back to shareholders. So he's like, "Staff first priority, customers and then shareholders." So yeah, what you're saying rings true to me. So before we go, if the person listening to us right now would like to get in touch with you, pick your brains about the methodology that you used and how they could use that in their own workplace, what should they do?

Nazir Makda: Yeah. I think if people want to know about the methodology and they wanna implement this within their organization, I'm happy to connect with them on LinkedIn. So the easiest way would be to get in touch with me on LinkedIn. And it's my first name Nazir, and then my second Makda. And once you put down the search I think there's about three of us.


Nazir Makda: But only one of them works in the NHS.

Toby Mildon: Yeah. So we need to find Nazir Makda NHS and we can easily connect with you there. So Nazir, thank you ever so much for joining me today. I thoroughly enjoyed our conversation. And what I really like is your approach at getting equality and diversity and inclusion embedded into the kind of the DNA or into the NHS at that kind of systemic level, which is exactly the point that I make all the time to my own clients. And what I wrote about in my book as well. So Nazir, thank you ever so much for joining me.

Nazir Makda: Thank you, Toby, for having me and I really appreciate this opportunity to share sort of... And I hope people can actually learn from our experience.

Toby Mildon: Yeah, definitely. I hope they do. And thank you for choosing to listen to us today. Hopefully you've taken some really interesting ideas, insights, tips and tricks that you can take back to your own organization. As we just said, feel free to reach out to Nazir on LinkedIn or myself, if you want to discuss this approach and how you can apply it into your own organization. Until the next episode of the Inclusive Growth show comes up. I hope you take care of yourself. And I look forward to seeing you on the next episode. Thank you very much.


Speaker 1: Thank you for listening to the Inclusive Growth show. For further information and resources from, Toby and his team. Head on over to our website: @mildon.co.uk.

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