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Making Race Equality stick in a PCT. Our commission - re-drafting the scheme building involvement: communication and connection Senior Executive commitment Staff workshops Linking to corporate objectives and business plans

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Making Race Equality stick in a PCT

  • Our commission - re-drafting the scheme
  • building involvement: communication and connection
  • Senior Executive commitment
  • Staff workshops
  • Linking to corporate objectives and business plans
  • limited priorities, clear commitments, lead responsibilities

Su Kingsley, STRAD Consulting


2: Figure A: PCT Dimensions

Finding their way



Organisational Maturity


External Challenge

Structural Chaos





New Borns

mainstreaming at different levels
Mainstreaming at different levels



What do you want to achieve - Maturity

Values & beliefs


Systems and processes in place to deliver - Structure


Impact of the external environment - Challenge


Su Kingsley, STRAD Consulting

steps to competence
Steps to competence

Unconscious competence


Conscious competence



Conscious incompetence

Unconscious incompetence

Su Kingsley, STRAD Consulting


Learning model: Implications for implementing RRAA

Conscious incompetence

Conscious competence

Unconscious incompetence

Unconscious competence

Will implement RRAA if told how and what to do - unlikely to learn or make further connections

Will work hard to set up processes for RRAA, but unlikely to integrate into strategic or operational plans

Proactive in raising and reviewing equitable access, appropriate services delivery and community consultations

Collects & uses monitoring data

Invests in staff training

Clear vision & strategy for how diversity is integrated throughout the organisation’s processes and people

Data systems support integration

Community is fully involved in service planning & development

Su Kingsley, STRAD Consulting

not rocket science
Not rocket science…

…more marathon running

Su Kingsley, STRAD Consulting


Learning model - where are most NHS organisations?

‘Conscious incompetence’

Working on competence -

‘conscious competence’

Unconscious incompetence

Becoming competent

Late majority

Early majority

Early Adopters



Adoption curve descriptions

Su Kingsley, STRAD Consulting


Applying adopter characteristics to NHS organisations

2nd/3rd wave developments

request guidance on implementation

join established developments

will seek to apply ‘good practice’

Don’t initiate developments

wait for circular/guidance

compliant - follow instructions

strongly influenced by peers

need support -

likely to implement form rather than spirit

Early members of collaboratives

participate in pilot programmes

Leaders & members of learning partnerships

Potential for good practice

Resistant to change until instructed

will not introduce new practices unless

they are made a requirement

require heavy performance management

do not respond to good examples

Participate in national pilots

linked to DoH

associated with research centres

‘transformational project’ leaders







Early Adopters

Early majority

Late majority


Su Kingsley, STRAD Consulting

success factors
Success factors
  • Leadership
  • Applying corporate values
  • Senior diversity specialist
  • On-going support and training
  • Systematic integration into all business functions

Su Kingsley, STRAD Consulting



Finding their way


No vision, framework or plan

Lacks systems & procedures -Survive by following instructions

unclear of local needs

Risk management not on the agenda

Systems & processes at early stage

Struggling to develop partnerships

Culturally Risk averse

Link local health needs into national priorities

Clear vision - prioritise national and local agenda

Delivery systems in place

Able to manage risks

Focused on meeting local health needs

Good at sustaining partnerships

Dimension 1: “Organisational maturity”

Implications for implementing RRAA

Require instructions - will implement RRAA if it is a low risk ‘must do’

Will only do what they perceive as being a national requirement

Need to be shown how to connect race equality with other aspects of business

Need to see RRAA as explicit national priority

Encouraged by being shown benefits of RRAA implementation

Will follow lead of influencers, examples of good practice

Opportunistic - may seek resource for implementation

Need to understand how RRAA helps meet local health needs

May be innovative - potential source of good practice

Will be influenced by lead of significant others

Su Kingsley, STRAD Consulting




New Borns

PCT welded onto structure of former Community Health Services Trust

Not yet thinking through new role(s) - struggling with commissioning

Inherited problems - policies, practice, premises

Regurgitated CHS policies & procedures

Built from predecessor Primary Care group(s) - reinventing everything!

Lacks history of experience as former organisation - little former development to build on

Lacks skills & capacity - also struggling with commissioning role

No organisational history - context of total change throughout local health economy

Leadership recently appointed

No organisational memory

Lack of systems and procedures

Dimension 2: “Structural Chaos”

Implications for implementing RRAA

Likely to take procedural approach

May have previous policies and structures to rely on

Will be seen to comply - letter more than spirit

Need to be pushed to implement RRAA

Need to be shown benefits

Need information to involve stakeholders

Opportunity to integrate RRAA into planning and systems development

Need to be stimulated to recognise opportunities to implement RRAA

Su Kingsley, STRAD Consulting





Serious financial constraints

High deprivation indices

High staff and population mobility

pressure to address race equality

Balancing the books with difficulty

Adequate local health economy infrastructure

No major financial challenge

Stable population

Staff retention good

Involved public

Dimension 3: “External Challenge”

Implications for implementing RRAA

Will need to see specific benefits of implementing RRAA in terms of the rest of the ‘must do’ agenda

Need to be convinced of need for population data and encouraged to use it

Attention likely to be focused on national priorities

Will implement RRAA if it is identified on the list of ‘must do’ requirements; difficult in mainstreaming

Potential to work effectively within local health economy

Have capacity to invest in systems to deliver race equality: e.g. ability to collect & use ethnicity data

Unlikely to be under pressure for change locally - need external stimulus to initiate action

Su Kingsley, STRAD Consulting

opportunities for integration
Opportunities for integration…..
  • Business plan, Corporate Objectives
  • Local Development Plan
  • Service and Financial Framework (SaFF)
  • Clinical governance framework
  • National Service Framework implementation plans
  • Health Improvement Programme
  • IWL - workforce plan, retention and recruitment strategy
  • Patient and Public involvement

Su Kingsley, STRAD Consulting

core principles of our approach
Core principles of our approach
  • Builds on your existing work
  • Links to mainstream targets and objectives
  • Action focused
  • Sets achievable priorities
  • Reviewable

Su Kingsley, STRAD Consulting