The NHS has benefitted from having a diverse workforce over the past 70 years. That’s something for is all to be proud of. But diversity isn’t just about race, faith, gender or sexuality. There are many types of diversity that help to make our public services better.
The importance of ethnic diversity in our public services was brought in to sharper focus earlier this year by the Windrush scandal. But I think it’s also important to recognise how the diversity of skills in our NHS too. We would be poorer without that diversity, but we could do much more to ensure we benefit from it.
It’s been long recognised that diversity at board level generates better leadership. But If you asked ten people on the street what an allied health professional (AHP) does, you would get a blank look from the majority.
Alarmingly, in a world where doctors, nurses and hospital beds have become the political currency of the NHS, most politicians would be left scratching their heads when posed the question too. Its small wonder that AHPs are so under-represented in senior roles in our NHS.
In Foundation Hospital Trusts that under-representation has been institutionalised by the ring-fencing of Medical Director and Nursing Director posts on boards, largely to the exclusion of other health professionals. Don’t get me wrong, I think having doctors and nurses on hospital boards is a good thing, but if you want to have a diversity of medical experience and if you want to disrupt the group-think which holds back the creative thinking the NHS needs to serve patients well, then you need more AHPs around the boardroom table too.
We know that AHPs are a crucial group of health workers, like occupational therapists, chiropodists, dieticians and podiatrists who, through their work in early intervention, save patients from being admitted to hospital in the first place. We also know that physiotherapists, speech and language therapists and many other AHPs help to rehabilitate you from your illness and reduce the length of your stay in hospital.
The whole phalanx of AHPs that make up around 170,000 health workers have a particularly strong understanding of the patient’s pathway from early intervention through primary and secondary care, through hospitals and post hospital care too. So why are we so rarely seeing them in leadership roles?
Why is it that the NHS does not reach beyond the traditional pools of doctors, nurses and administrators? Our country has a diverse AHP skills base, a base that is equipped to join up services for the patient between community settings and our hospitals. That kind of expertise is crucial if we are to stop people turning up in droves at A&E departments and if we are to smooth a pathway away from unnecessarily long stays in hospital.
The Allied Health Professions Federation recently met with the Health Minister Philip Dunne MP, and then his successor Caroline Dinenage MP, after the reshuffle. We were following up our representations to the Faculty of Leadership and Jeremy Hunt about the need to transform leadership in the NHS, in part by removing the restriction that prevents AHPs from becoming executive directors of Foundation Trust Hospitals.
To be fair to the Ministers, they were good meetings, although we need to monitor progress in this area carefully. We know we have a shared problem. But, at a time when Brexit is swallowing up all the government’s legislative bandwidth, there will be no parliamentary time to change rules that act as barriers to AHPs taking seats around some of the major decision-making tables. The AHPF will press on, to ensure the scale of the problem is recognised, and that remedies are found.
But until we find a way of getting the most out of the rich diversity of talent and knowledge at senior levels in the health service, we won’t see the full range of benefits from early intervention or rehabilitation that is quietly being delivered each day by Allied Health Professionals.
To change the narrative, we will need to change the mindset on boards in our Health Service. After all, we know that the NHS is not just about doctors, nurses and hospital beds. This isn’t about special pleading for AHPs. This is about acknowledging that the diversity of people and skills in the health service workforce has made it stronger over the last 70 years. To tap in to that at leadership levels is not just the right thing to do, it’s an important way to improve patient care.