Challenging the Talent Management Process in the NHS

Nazir Makda works for the NHS as a Diversity and Inclusion Lead. We first met when I was speaking at a lunch and learn event organised by the NHS. Nazir was there and we connected afterwards and got chatting. One thing that I was impressed with, and the reason I wanted to get Nazir on the show today, was that he has done a great job in the part of the NHS that he works in. I wanted to look at how he has created more equality in the organisation at a systemic level.

This sort of change management programme is something that I talk about in my book Inclusive Growth. In fact, I’ve got a whole chapter on colleague experience and design. It is about stopping initiatives that try to fix individuals and looking at the business policies, systems, culture and processes that are actually getting in people’s way and holding them back instead.

When Nazir was talking about the work he’s been doing at the NHS, I was intrigued and wanted to delve a bit deeper.

We began with Nazir letting me know a bit more about himself, his professional background, and what led him to his current role.

‘My career started in the private sector, mainly in retail management. Then, I stumbled upon equality and diversity. 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 excellent in the NHS. And as they say, the rest is history. So, I’ve been working in equality and diversity for 19 years and am currently the Diversity and Inclusion Lead for East Lancashire Hospitals NHS Trust.’

When I spoke to Nazir earlier to prepare for this interview, what we’re about to talk about stemmed from several frustrations being felt within his organisation. I asked him, ‘What were those frustrations that you had unearthed with your people?’

‘We have staff network groups, six of them. Our data on our workforce make-up showed a huge diversity deficit, particularly in senior roles. Data is important because it drives insights and helps you diagnose what you need to do differently to enable greater diversity.

Some themes around recruitment and retention were consistent across all the networks. And the staff survey highlighted disparities in the free-text comments. Statements around the saying it’s not what you know, it’s who you know. Some people remarked that certain jobs are earmarked, suggesting nepotism.

The leadership were quite removed from the frontline and not aware of the agenda. So I paired them up with somebody from an under-represented background to be reverse mentored. We had tried some things in the past, but it was not shifting the dial.’

It’s interesting that once those staff frustrations Nazir describes were surfaced, he knew he needed to go deeper and get into the systemic level. I asked him how he approached this.

‘What we did in the past was deliver things like unconscious bias. We found you can’t root out bias from individuals but what you can do is root out bias from systems, mechanisms and processes.

I organised a face-to-face event with representation from all of the six staff network groups and booked sessions across ten rooms. We had facilitators within those sessions, and the day was around looking at some of the recruitment processes separately to root out the bias.

There was one for attraction, and that group just talked about how there are barriers within the attraction process. For example, are we advertising in the right sort of magazines in the right kinds of communities?

There was another group for application. Then one for appointments and one for career progression. And although we had these four main themes, there were also sub-themes to each of these and they were discussed as well.

All of the information was collected. We then developed an action plan to address the barriers. I put some governance accountability in place with the introduction of a recruitment retention steering group to oversee this piece of work.’

It’s great that Nazir identified those four themes: attraction, applications, appointments, and progression and then each of those had a number of sub-themes underneath. I wanted to stay at the top level to keep our conversation straightforward, and I asked Nazir, ‘What were your main findings in the area of attraction?’

‘The key findings on attraction were that we used something called manager’s jobs. So, all their job postings were on this main portal, but there wasn’t any engagement with different people because different people have various barriers. Barriers for people with physical and mental impairments. Barriers for people who have literacy or numeracy problems. Barriers for people who have English as a second language. What we have to do we have to develop strategies to be proactive. We have open days within those communities to attract and showcase some of the vacancies we have in our trust.

Applications were quite challenging because, predominantly, the NHS only accepts applications through the online portal. It still discriminates where some people would like to fill in a physical copy.

We worked within the hierarchy of the NHS and they have now tailored and made huge improvements around the application process. You can have manual application processes put in as well. Some of it is around the reasonable adjustments of the application process and using virtual ways of sending the application and virtual ways of actually being interviewed.

Appointments were interesting because we analysed how people were being shortlisted. What we triangulated was that where you had independence in the interviewing panel, you were more likely to get a diverse sort of selection. We also changed the design of the interview to ensure that the right decision was made, that there wasn’t a group thing, and that there wasn’t bias within that process. And the impact has been significant because we’ve seen considerable improvements in the organisation’s diversity and make-up.

With progression, there was much frustration, particularly from our Black, Asian minority ethnic colleagues who go on quite a number of development programmes. They get lots of leadership training, but when it comes to acting up and secondments, they don’t get in.

We have looked at talent management in its entirety: appraisal and developing inclusive leadership programmes so that managers are aware of the challenges that, as a Black Asian manager, I think people face regarding career progression. Before the secondment, acting up posts would not be advertised globally across the organisation. They were sent to a few people, but now we’ve changed all that by insisting that the advert goes to everybody so that there’s equal opportunity to apply.’

What I like particularly about the process Nazir describes is that it’s very logical to me to break down the employee life cycle by focusing on those four key themes. I also liked the methodology used, bringing everyone together and booking out ten rooms to brainstorm with colleagues and things like that.

I asked Nazir, ‘Once you had unearthed the challenges people were experiencing under those four key areas, what were the improvements at that systemic level that you were particularly keen to address?’

‘It was interesting because we’d introduced some checks and balances and brought about some independence within the entire process. There was greater accountability to reduce groupthink or in-group bias. We started using a buddy system for new starters, and there’s a new starter review process too. After three months, we interview all of the new starters to reflect on their experience of the entire recruitment process and the onboarding process. That feedback and intelligence feed into improving the whole recruitment process.

We now offer the ability to raise an audit or access an audit. If somebody’s unhappy with the recruitment process and they felt discriminated against, or they didn’t get a fair opportunity, they’ve got the opportunity to raise a grievance. Now we can audit the whole recruitment process.

We also offer career development workshops for people who weren’t successful. 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 have been around how we now have a very comprehensive exit interview with people who are leaving because retention is a big feature as part of the NHS since we lose quite a lot of good people.

We have developed something called the behavioural framework. It encourages people to stay and discovers how they want to be treated within the work environment. Because of the impact of COVID, a lot of people want to work flexibly and remotely. We’ve got a very comprehensive, agile and flexible working policy to ensure that we attract quite a diverse group of people to work for the NHS. We’ve been able to challenge, as I mentioned earlier, our talent processes. These are significant because a manager is responsible for the progression of the individual. Looking at appraisal and how that’s implemented in terms of access to development is important. And we’ve also introduced some key model inquiry targets for reducing the diversity deficit.’

Nazir describes very targeted and specific interventions, which is different to what a lot of organisations do, which is that they’ll organise something without much evidence behind it. Then they get frustrated later on that the thing that they’ve organised doesn’t shift the dial. Whereas Nazir went in with a methodology to this. I think it helps to have that structure of listening to your people to find out what the challenges were, identifying the key themes and then coming up with a number of targeted solutions.

I asked Nazir what impact they’ve noticed since running this exercise and implementing those solutions?

‘It’s early days, 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. Six years ago, we didn’t have anybody from a Black Asian minority or ethnic background on the board. We now have four. So that’s an increase of 24%.

The NHS is also structured in a way where we have pay grading and we’ve seen increases in grades eight and above.

We’ve also improved against national equality standards that we have to meet. I think one of the biggest shifts has been in how our staff survey has demonstrated that we’ve made a real improvement in providing equal opportunities for career provision promotions. In the latter years, this was always quite a challenging indicator. We were below 50% of our staff believing that we offered equal opportunities for progression and promotion, but that’s gone up to 56% this year.’

Some positive results there lead me to the question that I ask everybody when they come on the show. I always ask my guests what does inclusive growth mean to them? I’m especially interested to hear from Nazir from his NHS and public service perspective because I talk to a lot of commercial organisations, and they say they want to be more profitable, better anticipate our customer needs and deliver better products and services and things like that.

I asked Nazir, from his health service perspective, what does Inclusive Growth mean?

‘For the NHS, it’s a no-brainer, Toby. There is a direct correlation between staff experience and patient satisfaction. It makes good business sense to recruit from within our local communities, so we can offer better service to our patients and service users.

We always say that our employees are our greatest asset. It’s about reaping the benefits of the diverse talent, which then enables our organisations to grow. This is a fundamental business case for the NHS because research suggests that diversity delivers 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 of our people, which helps drive innovation and creativity.’

What Nazir says reminds me that I’ve been working recently with a very big energy company. The chief executive has got this triangle model. He says that the number one priority 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.

He says, Staff first priority, customers and then shareholders.” so what Nazir says rings true to me.

Hopefully, this article has provided some interesting ideas, insights, tips and tricks that you can take back to your own organisation. If you would like to get in touch with Nazir and find out more about his methodology and how you could use that in your workplace, please reach out to him on LinkedIn. To talk to me about anything to do with diversity and inclusion, please connect either through my website or LinkedIn page.

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