Covid-19: a spotlight on equality, diversity and inclusion

Dr Nnenna Osuji 

Medical Director and Deputy Chief Executive, Croydon University Hospital, and FMLM Council Diversity and Inclusion Lead

Welcome to the first of many blogs on the theme of equality, diversity and inclusion. Issues of race and equality are understandably at the forefront of many of our minds, for multiple reasons. The atrocities captured on film resulting in the death of George Floyd and the spotlight shone on health inequalities as a result of Covid-19 reinforce what many of us have been alive to for some time. These follow on from the issues of gender pay and movements such as Me Too.  All ‘men’ may be created equal, but not all are treated equally and the impact of this has been demonstrated to scientifically, significantly alter mental and physical health, and have an impact on life expectancy. It is the sum of the small things – the micro-aggressions where through habitual recalibration, adjustments and adaptations we lose a little bit more of who we are in the desire to fit in, to not raise one’s head too far above the parapet. The term used is biological weathering and calling it out is important, but only if we are prepared to alter things.

The conversation at the moment is focused on race, often as a visible manifestation of difference, but it is not the only manifestation, nor indeed should race be used to attribute homogeny to heterogeneous groups of individuals. There is abundant data surfacing from workforce race equality analysis (WRES) which exposes the disparity in attainment/position based on race, particularly at senior levels of the NHS. Calculations which attempt to redress the numbers may potentially hit the target and miss the point if we lose the ability to understand and celebrate all that diversity and inclusion can bring.

Matthew Syed, in his book Rebel Ideas, writes about cognitive diversity and has really got me thinking. I have always promoted challenge as a healthy ingredient to avoid group think, yet believe there is much more to do - much more for us all to do - as medical leaders and managers to truly capture the requirement of actively inviting difference to the table, in order to have richer outcomes for complex themes such as health and care. Syed explains a concept around linear tasks which demand we appoint purely on meritocracy which may result in a lack of diversity but optimise performance. For complex tasks, exclusivity based on individual excellence reduces rather than enhances overall performance.  The opportunities to diversify thinking through engaging difference apply to how we co-design services (not purely aiming at the simple solutions but the solutions that target those that need it the most) and how we engage people – recognising difference as an asset and not a liability.  Watch this space as we debate further…