An Ethnic Minority Groups Perspective - Florence Nightingale ...

Leadership Through CovidAn Ethnic MinorityGroups Perspective

Leadership through COVID: An Ethnic Minority Groups Perspective

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INTRODUCTION

Thinking of COVID-19 can often conjure upnegative connotations especially in relation tothe impact on ethnic minority groups, patients,communities and staff. This publication is anopportunity to share a different and upliftingperspective.

The Florence Nightingale Foundation deliversthe Aspiring Directors of Nursing (ADONs)Programme as part of their scholarship. As partof their COVID-19 response in March 2020, theybegan the Ethnic Minority LeadershipProgramme. A group of 22 ethnic minoritynurses joined. Some of the stories of theseexceptional leaders are presented in thispublication and captured on film. The aim is toinspire and challenge other ethnic minoritygroups leaders to come forward and dare todream the impossible.

At the end of this publication is summary ofthe calls to action from the leaders we feature.Play your part in this by reflecting on these andalone or with your teams and report youroutcomes to the CNO and CMidO EthnicMinority Groups Action Plan Future NHSCollaboration workspace. Together we canmake the difference.

INTRODUCTION WELCOME FOREWORD ANGELAKNIGHT JACKSON MARSHA JONES JABU CHIKORE

INTRODUCTION

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HOW WE DESCRIBEETHNICITY

https://future.nhs.uk/system/login?nextURL=%2Fconnect%2Eti%2FCNOBMEActionPlan%2Fgrouphome



3Leadership through COVID: An Ethnic Minority Groups Perspective

It fills me with immense pride to hear thepositive stories of ethnic minority nurses andmidwives, some of whom participated in theNightingale Frontline Leadership SupportProgramme. The Foundation is committed togiving ethnic minority nurses and midwives avoice. We are acutely aware of the challengesthey face, all magnified by the pandemic.

Ethnic minority nurses and midwives havebeen disproportionately affected by COVID-19,yet selflessly put themselves on the frontline tocare for patients. It is therefore our duty asnursing and midwifery leaders to recognise thissacrifice and equip them with the skills toprotect themselves and to excel in their rolesand reach their potential. The FlorenceNightingale Foundation supports ethnic minoritynurse and midwife leaders today and developsthem for tomorrow.

Professor Greta Westwood CBECEO, Florence Nightingale Foundation

WELCOME

STATEMENT OF SUPPORT

INTRODUCTION FOREWORD ANGELAKNIGHT JACKSON MARSHA JONES JABU CHIKORE

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4FOREWORD

and midwives that we are committed toadvancing the nursing and midwifery professionsby nurturing all the talent available. We willcontinue to work to ensure all nurses andmidwives are valued and respected, and haveequality of opportunity irrespective of theirethnicity. The leaders in this publication aretestament to the exceptional talent within ouramazing professions.

Hilary GarrattDeputy Chief Nursing Officer for England

FOREWORD

This publication celebrates some of our mostexceptional ethnic minority leaders, who havegrown through adversity with a commitment anddetermination to develop their leadership duringan extraordinarily challenging time. Some of theseleaders have secured promotions, new posts orassignments and have had an impact on manylevels during this time.

Their stories capture their personal reflections,charting their journey to leadership andchampioning healthcare practice and services forthe patients and the public they serve. During thepandemic we have seen leadership and leaderstruly tested. Professional and personal issues haverequired an extra level of compassionatecomradeship and resilience. We have lost toomany colleagues who have died with COVID andmany of the leaders in this publication haveexperienced the effects of such tragic loss. I paypersonal heartfelt condolences to all who haveexperienced the loss of colleagues and loved ones.

I extend a special thank you to my team andthe Florence Nightingale Foundation (FNF) whohad the foresight to commission the FNF EthnicMinority Groups NHS COVID-19 leadershipprogramme. The programme has sustained (andcontinues to sustain) leaders through theseadverse times. Finally, I want to remind all nurses


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Several terms have been used, by governmentand more generally, to refer to the collectiveethnic minority population. These include ‘blackand minority ethnic’ (BME), ‘black, Asian andminority ethnic’ (BAME) and ‘black and ethnicminority’ (BEM). These terms have beencriticised on a number of grounds, including forexcluding national minorities, for suggestingthat black people (and Asian people, specificallythe South Asians with BAME) are raciallyseparate from the ethnic minority populationand for including under a single labelheterogenous groups with little in common witheach other (Wikipedia Dec 2020).

Most recently, in March 2021 the CabinetOffice gave guidance around writing aboutethnicity and recommended that ‘We use ‘ethnicminorities’ to refer to all ethnic groups exceptthe White British group. Ethnic minorities includewhite minorities, such as Gypsy, Roma and IrishTraveller groups.’

In this booklet where individual stories referto BAME or BME, as stated above this isacceptable as this is a self-definition. Wheretitles are used e.g. on the front cover theCabinet Office guidance and the newterminology 'ethnic minority' is used.

For the purpose of this publication,

participants were given the opportunity to self-define, hence both BME and BAME has beenused in keeping with individual choice.

Further Notes

ReferenceBradby H (2003) Describing Ethnicity in HealthResearch, Ethnicity & Health, 8 (1): 5–13

Cabinet Office (2021) | Writing about ethnicity

Further ReadingUse of language: race and ethnicity | AdvanceHE (advance-he.ac.uk)

Please, don't call me BAME or BME! - CivilService

HOWWE DESCRIBE ETHNICITY

HOW WE DESCRIBE ETHNICITY


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https://www.ethnicity-facts-figures.service.gov.uk/style-guide/writing-about-ethnicity

https://www.advance-he.ac.uk/guidance/equality-diversity-and-inclusion/using-data-and-evidence/use-of-language-race-ethnicity#:~:text=Both%2520there%2520terms%2520have%2520their%2520limitations%252C%2520including%253A%25201,people%2520have%2520chosen%2520to%2520identify.%2520More%2520items...%2520

https://www.advance-he.ac.uk/guidance/equality-diversity-and-inclusion/using-data-and-evidence/use-of-language-race-ethnicity#:~:text=Both%2520there%2520terms%2520have%2520their%2520limitations%252C%2520including%253A%25201,people%2520have%2520chosen%2520to%2520identify.%2520More%2520items...%2520

https://civilservice.blog.gov.uk/2019/07/08/please-dont-call-me-bame-or-bme/

https://civilservice.blog.gov.uk/2019/07/08/please-dont-call-me-bame-or-bme/


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One thing I would like to change is how the talent management processcurrently works, with progression dependant upon one individual: anecdotalevidence suggests managers are the blockers to ethnic minority groupsprogression.

My ask would be that the talent management ‘conversation’ is developed as a360° view of talent, utilising different perspectives, to ensure a fairer processaround suitability for progression through the ‘talent management gateway’.

Angela has responsibility for the leadership and management of

professional nursing development programmes in the CNO’s team. She

talks about the importance of mentors and sponsors, and the creation of

the first national CNO and CMidO Ethnic Minorities Action Plan.

Head of Nursing Development ProgrammesChief Nursing Officer’s team

ANGELA KNIGHT JACKSON

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Angela was born to Jamaican parents, who arrivedin England in 1955 as friends on the same ship andmarried in 1956. Growing up in Sheffield, Angelasays, racism was rife. However, she had a solid homelife, rooted in a strong Christian faith and the needto embrace opportunity.

It was stressed to Angela that in Jamaica some ofher family were in the professions, and she shouldemulate them. “That sowed the seeds for oureducation – we were expected to succeed.”

Things went fairly smoothly for Angela in theearly stages of her nursing career. She decided on aHealth Visitor role, and did well, but was soonlooking for further challenges. She completed both aBachelors and a Masters degree, then tried to moveon from her Health Visitor role.

Things now became more difficult, and shewasn’t even getting constructive feedback from theinterviews she attended.

The year-long Beacon Leadership Programme in2004-5 proved to be a defining moment, exposingAngela to things she hadn’t really been aware of,such as organisation culture, the effects ofoppression, negotiation and influencing skills,emotional intelligence and the importance ofnetworks.

Armed with this leadership insight, she began tolook at nurse leadership through a research lens,

progressing to a Lead in Nursing and Allied HealthProfessions, followed by a corporate role, withresponsibility for research leadership in a PrimaryCare Trust.

The Beacon Programme had been a real catalystfor her, she says: “Because the course opened myeyes, I wanted to open other people’s eyes.” Shebecame a coach, mentor and action learning setfacilitator, roles she continues to enjoy.

Her leadership, clinical and research experiencealso allowed her to move into the post of WestMidlands Clinical Senate, hosted by NHS England, in2013. She thrived on the challenge of the role, butagain found it difficult to progress further; sherealised that glass ceilings existed throughout thesystem, even at senior levels, and was frustrated atnot being able to move on to a more senior role.

Angela applied for the Florence NightingaleFoundation Leadership Scholarship and wasaccepted on her second attempt in 2019. TheScholarship exposed her to a whole new grade ofleadership, at a much more strategic level, andhelped her appreciate the importance of networksand influencing, and where she might fit into thisnew world.

The Clinical Senate was suspended when thepandemic took hold, and Angela requested that shebe redeployed to the CNO’s team, in order to be in

“Because thecourse opened

my eyes, Iwanted to openother people’s

eyes”

ANGELAKNIGHT JACKSON


INTRODUCTION FOREWORD MARSHA JONES JABU CHIKORE

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“It was astressful,

harrowing time,but even throughit I was able to

hold my own as aleader anddevelop”

then also the deaths. It was at that time I resolvedto reach out to my nursing and midwifery colleagueswith some kind of solution. If that’s leadership… I’mnot sure. It was for humanity. Nurses go to work togive care. We don’t go to work to be exposed to thethreat of death.”

Meanwhile, the Chief People Officer had alsobeen engaging with staff on a national level, andfound there were five recurring themes emerging.Angela mapped these findings with the nursingresponse.

As a result of this collaboration, Angela was ableto create the first ever CNO Ethnic Minorities ActionPlan, which was agreed at the end of July 2020.Whilst it is COVID-specific, she says, it is also entirelytransferable, dealing with the protection of staff,engagement, representation in decision making,rehabilitation and recovery, and communicationsand media. It is Angela’s hope that, post-COVID, itcan be developed into a Strategy.

Angela feels she has blossomed as a NurseLeader during coronavirus: “I had wanted todevelop but just kept getting blocked. Then, beingthrown into this very complex environment workingat national level - it was a stressful, harrowing time,but even through it I was able to hold my own as aleader and develop. I’m just amazed!”

Given the scale of the ongoing pandemic, Angela

a nursing environment. This exposed her to theissues arising nationally.

One of the first opportunities in Angela’sportfolio when COVID-19 hit, was that of leadingthe Ethnic Minority Groups ADON/M FNF COVID-19Leadership Programme as an enabler, whilst alsotaking part - a unique position she regards as a hugeprivilege. The one-to-one virtual RADA sessionhelped her develop her virtual verbal and non-verbalcommunication skills and ‘personal presence’, shesays, and the co-consulting sessions were a chancefor everyone to bring to the table the issues theywere grappling with.

As time progressed, it became obvious thatCOVID-19 was affecting a disproportionate numberof ethnic minority groups colleagues. The reality ofCOVID-19, the horrendous deaths and thedisproportionate effect on the ethnic minoritygroups community “were like a black cloud hangingover us,” says Angela. Colleagues were sharingharrowing stories with her: “One minute they wereworking with someone… Then they might be offsick, or worse still die. That had an impact on me.”

Angela knew that the first response must be tolisten to what was being experienced on theground. A series of calls was set up with the regions,and the fear amongst staff was tangible: “I’ll neverforget the harrowing stories… the helplessness and




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“This is biggerthan COVID-19...

it is aboutholding true tothe principle ofthe NHS of

universality andequality for all”

feels ambivalent about celebrating herachievements. She also questions whether she wouldhave achieved the Head of Nursing DevelopmentProgramme post, had she not already been on theteam and proving herself at a national strategiclevel: “All the stars were aligned for me to apply.Had I applied from outside, I’m not sure howsuccessful I would have been.”

Angela is a big advocate of mentors, and has hadmany of them herself. Jacqueline Dunkley-Bent,Chief Midwifery Officer, was one of them, andAngela says her support cannot be overestimated.“She epitomises the struggle and the fight, andhelped me challenge my thinking, and decide on mybest fit within the organisation,” she says.

There is now a move to encourage people tobecome sponsors, those leaders who go a stepfurther, by opening doors to opportunities fordevelopment and challenge. Hilary Garratt, DeputyChief Nursing Officer, acted as Angela’s sponsor,and the combination of mentor and sponsor was,she says, immense.

The Aspiring Director of Nursing (ADONs)programme has been invaluable during COVID-19,Angela says. On a personal level, it gave her a senseof achievement to work with outstanding ADONswho were keen to be on board despite theunprecedented demands on them. More broadly,

she is clear that the programme gave much-neededsupport to nurses dealing with COVID-19 on a dailybasis, something not all her colleagues benefittedfrom.

Despite her achievements, Angela knows thatthere is far more work to do. She would like to seezero racism in the NHS. This is bigger than COVID-19, she says; it is about holding true to the principleof the NHS of universality and equality for all – staffas well as patients.

She has a simple message to younger nurses whowould like to follow in her footsteps: “If you havethese ambitions, go for it. But do it intelligently.Whatever your passion is, follow it. Go for yourpassion!”




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MARSHA JONES

Marsha’s work combines her varied experiences as a teacher, nurse andmidwife. She describes how she is driven by the need to achieve thebest possible outcomes for patients, and how the ADONs Programmehas helped her career to progress.

Deputy Chief Nurse - Epsom and St Helier University Hospitals NHS Trust

What I would like to see in the health and social care system is for the Equality,Diversity and Inclusion (EDI) agenda not to be seen as burdensome, but ratheras core to our business and carrying equal weighting with other issues.

Diversity of people brings richness of thoughts, innovation and productivity.My ask is that NHS Trust leadership teams should be held to account whenthere is no year on year improvement of their WRES indicators, and there arepoor experiences for staff from ethnic minority groups backgrounds. The CQCshould engage specifically with ethnic minority groups staff as part of theirassessment in validating the Trust WRES indicators, as part of Well-led.

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With an interest in mathematics and nutrition,health literacy and public health, Jamaican-bornMarsha was very particular about the area ofnursing she wanted to work in. She asked herselfhow she might make most impact on public health,and decided this could be through midwifery: if youwant to improve public health, she says, the firststep is to influence a mother and her child. Thisinfluence will then naturally extend to thehousehold, then to the extended family and theninto the community.

Marsha entered nursing management “bydefault” she says, and when she became a MarySeacole Scholar her interest in health inequalitiesgrew. She was sorely aware that women fromethnic minority groups backgrounds had lessfavourable outcomes than their white counterparts,especially in postnatal care and services.

Her journey to becoming a nurse leader hasbeen driven by the awareness that “there are notmany people in senior roles who look like me”. TheAspiring Directors of Nursing (ADONs) programmecame along at just the right time, as ironic as thatmight sound: when it began, Marsha was strugglingwith COVID-19 herself. She managed to stay athome throughout, with what she describes as‘extraordinary primary care support’ – somethingshe feels fortunate and privileged to have

experienced.While she was ill, her friends supported her, andsignposted her to some daily online sessions aboutpreparing for promotion during COVID-19. Marshaadmits “I had a little inner chuckle at myself - ‘Lookat me fighting COVID-19 and I’m here thinkingabout promotion!’ – but it energised me. If you’reat home not feeling well, when you’re engagingwith something else distracting you, it is a help.”

Her first session on the ADONs programme waswith Jackie Holder, the facilitator for theprogramme, and Marsha threw herself into itwholeheartedly. One thing about the session wascrucially important, she says. “What made it moreimpactful was that Jackie is a black woman. I wasn’thaving to think ‘Okay, do I have to build a rapporthere? Do we have any cultural differences?’ Thosethings get in the way.”

The programme’s sessions had a big impact onMarsha. She found that they gave perspective to alot of the things that were happening around her –the conflicts and challenges that everyone wasexperiencing. They also helped her to focus onpossible career steps and how to prepare forinterviews. On the back of these sessions, she beganto seek out new opportunities; she is to begin aDeputy Chief Nurse post as well as taking up aNurse Fellowship at NHSE/I.

“I am very awarethat there are

not many peoplein senior roleswho looklike me”

2/4MARSHA JONES

MARSHA JONESINTRODUCTION FOREWORD ANGELAKNIGHT JACKSON JABU CHIKORE

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“I’ve had a voiceand expressed

my concerns, andI’ve been able togalvanise others”

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invaluable from a leadership perspective.About the programme generally, Marsha says:

“It has snowballed and I feel this energy will go onfor a while.” Marsha now has her sights set on aChief Nurse role, but her ultimate ambition, shesays, is to be a Chief Executive.

The ADONs programme has highlighted the factthat lots of ethnic minority groups nurses are readyfor the next step on the ladder. When people don’tprogress, Marsha points out, it isn’t because theydon’t want to – it’s because the opportunities don’tpresent themselves fairly and equitably. “If the nextrung on the ladder is missing, we’re not going to beable to step on it,” she says. “And rungs are missing,especially for black staff.”

The solution lies in energising those already atthe top to pull others up with them, and inenergising each other. And mutual support is vitalin the environment in which ethnic minority groupsnurses exist. “How do you keep yourself containedand focussed so that you’re not derailed by thebullying and distractions that will come your way?”asks Marsha, “Because we have a lot of that.”

COVID-19 made Marsha realise that ‘everyonewas in it together’, regardless of skin colour – it wastough for all involved. Frontline staff in patient-facing roles, she points out, were the ones mostbadly affected – and a disproportionate number of

Marsha knows that the programme has helpedher from a career perspective, but she says that ithas helped her equally to have more of an impact inthe workplace: “The sessions helped me to stophiding my light under a bushel. I’ve had a voice andexpressed my concerns, and I’ve been able togalvanise others.”

She got active in the West HertfordshireHospitals NHS Trust Staff Network and took on theinterim Chair role. She believes the Networkachieved in three months what would usually havetaken a year.

The Network’s ‘Safe Space’ sessions have beenparticularly important during COVID-19, offeringhuge mutual support. They have been a caring andcompassionate place for staff to express themselves,allowing their concerns to be raised with theirorganisations, to show the true reality of workingthrough the pandemic.

Marsha says that her management style is tolead very much from behind: “I think that’s partlycultural. You never blow your own trumpet.” So shetries to make her work speak for itself. She hasbegun to participate in other programmes, and hasgiven online talks to the Malawi NursingAssociation, the Nursing Association of Jamaica, andthe Nigerian Nursing Association. She is finding avoice and a way to tell stories, which has been


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“If the next rungon the ladder ismissing, we’renot going to beable to step on it.And rungs are

missing”

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them were from ethnic minority groupsbackgrounds, probably because these are thepeople who miss out on opportunities to progress.

So how did COVID-19 affect Marsha in herleadership role? “It made me reflect, and I wasmore vocal. Things I might have turned a blind eyeto or thought didn’t affect me… No, this was aboutthe collective, not the individual. This is abouthumanity, and if I don’t add my voice, theconversation may have a valid point missing.”

Keen to help others to find their voice, Marsha,as part of the team, managed to secure £50,000from NHS Charities, to fund five CulturalIntelligence Workshops, for a total of 100 nurses.Sixty of the participants will be ethnic minoritygroups staff, with the remaining forty being non-ethnic minority groups leaders working withethnically diverse teams. Participants will beencouraged to speak up, and will learn how tointeract and treat others, in the knowledge thatthey are “speaking to someone who looks likethem, and who cares”.

She sums up how she would like to beremembered, with a quote from Maya Angelou:‘People will forget what you said, people will forgetwhat you did, but people will never forget how youmade them feel.’ She would like to be rememberedas someone who spoke the truth, and would go the

extra mile to deliver the desired outcomes for thosein her care.

For the next generation of ethnic minoritygroups nurses, she has this message: stay focussedon yourself and where you’re going, choose yourcircle carefully, and never allow anyone to validateyou. Above all, she says, be true to yourself,because authenticity is fundamental to effectiveleadership.

Marsha feels she has been enabled to find hervoice by a combination of the pandemic, theinjustices it has highlighted, and, crucially, by theADONs programme. “I already had the car,” shesays, “but the programme was the fuel!” She wantsto know where things go from here: “It has igniteda fire in us. Are we just going to put that fire out?We have to ask ‘What’s next?’ There has to besomething next.”


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JABU CHIKORE

Jabu is new to his post, and is responsible for implementing the mentalhealth strategy for his hospital. He was previously Head of Nursing atBarnet, Enfield and Haringey Mental Health Trust, where hisresponsibilities during COVID-19 extended to infection control, staffwellbeing and support, patient support and service-user involvement.

Assistant Chief Nurse /Mental Health Lead NurseUniversity College London Hospitals NHS Foundation Trust

One thing I would like to change is to ensure that people from ethnic minoritiesare included in the recruitment process so that all available talent is recognisedand appreciated.

My ask is that it is made a requisite that you cannot pass the Well-led domainof the CQC inspection if you are unable to demonstrate that you have an activeprogramme to increase the percentage of ethnic minority groups staff inleadership positions (8a+) and there is evidence of the outcome.

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Born and raised in Zimbabwe, Jabu was encouragedto become a nurse by his mother, a nurse andmidwife herself. He was not convinced that hewould make a good nurse, or a successful one, butthought he’d “try it for a bit”. He fully expected tobe able to tell his mother “I told you so!”

Jabu came to England to begin his nursingtraining, and opted for Mental Health Nursingbecause he couldn’t stand the sight of blood –“Little did I know!”, he says. After qualifying in2000, he immediately secured a post at Chase FarmHospital. It has all been a bit of a rollercoaster ridesince then, he says.

After working as a ward manager for six orseven years, Jabu felt he needed more. “I got to thepoint where I felt I needed to influence theprofession more than I did then,” he explains. “Ialso got to the point where I thought ‘There’s roomat the top. Why not me?’ So I started thinkingabout how to make that leap and be moreinfluential.”

Having completed an MSc in Leadership andManagement, he was able to move from a Band 7post to a Band 8a. He gained satisfaction fromhaving more influence over how services were run,and began to ask himself why he shouldn’t do this alot more. And whilst he says he feels better suitedto influencing services, rather than the overall

picture, he would not say no if someone offeredhim a role as a Chief Executive!

The Aspiring Directors of Nursing (ADONs)programme gave Jabu the opportunity toexperience a more corporate environment, and tolearn what was expected in the board room, as wellas the opportunity for networking widely. Theprogramme offered a good support structure andenabled a crossover of opportunity and the freeexchange of ideas.

It was particularly useful during COVID-19, hesays, giving the participants a valuable supportstructure. It was also a chance for time away fromthe workplace. “That space alone is brilliant,” Jabusays. “You get the opportunity to shut down fromeverything and concentrate on your owndevelopment and improvement.”

And the relationships that have developedthrough the programme have been especially useful:“We’ve pushed one another always to aim for more.If a job comes up, we post it on our WhatsAppgroup and encourage one another to go for it.”

Jabu singles out the support given by PaulReeves and Hilary Garratt from NHS England andNHS Improvement. They made an effort to bringthe programme to the attention of all Chief Nurses,and to encourage candidate diversity.

It has been hugely positive, Jabu says, to know

“I got to thepoint where I

thought ‘There’sroom at the top.Why not me?’”

2/4JABU CHIKORE

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JABU CHIKOREHOW WE DESCRIBEETHNICITYWELCOME


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“We’ve pushedone another

always to aim formore”

3/4JABU CHIKORE

Jabu feels he has grown professionally as a resultof the extra demands of the pandemic. “The turningpoint for me was when I found out one of our staffhad passed away due to COVID,” he says. “Initially,it had just been statistics, but this hit home. Ineeded to think about how to change outcomes forstaff, and especially for BME staff.”

He immediately began to focus on goals tosupport BME staff, including the types and use ofPPE in place. He was also very concerned to offerpsychological support to staff, to ensure theirwellbeing. An office was cleared to create abreakout room, complete with beanbags, so thatstaff could relax. A psychologist was also on standbyto offer support, and the whole team receivedresilience coaching.

His colleagues on the ADONs programme allsupported each other too. “We had sessions wherewe just talked about the difficulties of running aservice through COVID-19, and said ‘The buck stopshere’. I’d only been in the post for six months,” saysJabu. “It was a learning curve, to say the least!”

It took a single day to re-purpose the service andre-organise staff, bringing people in fromcommunity services to work on the wards. Theresponse from the staff was very impressive, andhighlighted how much they value patient care andwanted to keep services going.

that there has been this focus on developing stafffrom ethnic minority groups backgrounds, and theacknowledgment that much more needs to be doneto get ethnic minority groups nurses up the careerladder.

The programme has also been an open forumfor discussion: inequalities have been highlighted,acknowledged, and discussed openly, and peoplehave contributed their ideas on how to improvethings across the board.

COVID-19 has, says Jabu, highlighted theinequalities suffered by ethnic minority groups staff.He was asked to lead the Ethnic Minority GroupsNetwork, and this highlighted the difficulties andinequalities people were facing in relation to COVID-19.

Jabu became something of a figurehead for hisTrust: “It gave me an opportunity to influence howstaff were looked after during COVID-19, but it alsogave me a support network.” Jabu was able to takeconcerns to his Trust, and influence its response tothe coronavirus at the highest level.

This led to a support structure being planned,which included the addition of ‘Freedom to SpeakUp not out’ guardians. “It catapulted my positionfrom Head of Nursing to being BME chair leadingthe BME strategy with the Trust as a whole,” saysJabu. “I grew up in a day!”

JABU CHIKOREINTRODUCTION FOREWORD ANGELAKNIGHT JACKSON MARSHA JONES

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“It gave me anopportunity toinfluence how

staff were lookedafter during

COVID-19, but italso gave me a

supportnetwork”

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Jabu says that he couldn’t have survived if ithadn’t been for his staff, and their loyalty anddedication. “It became a two-way process,” he says.“As much as I support them, they supported me.Even when things were very difficult, they keptcoming in.”

He admits that he would get upset duringlockdown when he saw people out and about andputting other people at risk, having experiencedfirst-hand the effect COVID-19 was having on hisstaff and services. And whilst he appreciated the‘clap for carers’ at first, the novelty soon wore off. “Ifelt the government wasn’t doing enough to listento us,” he says, “and they’re still not doing it.”

Whilst the coronavirus has broughtunprecedented challenges, Jabu says that it has alsotransformed the service and enabled it to embracetechnology, in a way that would normally havetaken years. “There has been lots of change for staffand services too,” he says. “We won’t go back towhere we were before.”

Everyone has had the licence to think about newways of doing things: patients who need a face-to-face appointment are prioritised, whereas otherscan benefit from a Teams meeting or a phone call.The new system has actually enabled the Trust toreduce its waiting list, even during the pandemic.

“As a member of the BME Men in Nursing

Group, I am keen to encourage more men intonursing as a career, as well as into senior roles. I’dlike my legacy to be to inspire more male nurses tofollow in my footsteps, and I’d like to see more BMEnurses in similar positions to me,” says Jabu. To thatend, he is actively involved in the mentoring andsupport of ethnic minority groups staff, to helpthem achieve higher things.

And his message to anyone wanting to follow inhis footsteps is simple: “If you think big, think bigger!”

JABU CHIKOREINTRODUCTION FOREWORD ANGELAKNIGHT JACKSON MARSHA JONES

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HANNAH SPENCER

Hannah tells us about the unique challenges of being mixed race, howshe found her perfect fit on the ADONs programme, and how theprogramme has helped her career to blossom.

Head of Nursing - Women’s Health and Paediatric DivisionAshford and St Peter’s NHS Foundation Trust

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One thing that needs to change (with regard to ethnic minority groups staff)is the lack of equity in ethnic minority groups recruitment and leadershipdevelopment.

An ask of people – an action that they can take – is for leaders and recruitersalways to have an ethnic minority groups staff member on any selection andrecruitment panel and in all steering groups for leadership developmentprogrammes.


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Born in Yorkshire to a Scottish father and aJamaican mother, Hannah describes her veryblended background. Her mother’s parents wereboth mixed race themselves, with Israeli, Eritreanand Jamaican heritage, and racially Jewish roots. “Aregular Mary Seacole is what I like to call myself,”Hannah says. “She is someone I affiliate myself withquite closely.”

In her teens, the family moved to the south eastof England. Hannah was uncertain about the careerpath she wanted to take. She consideredpsychology, but her parents – both psychologiststhemselves – strongly discouraged her. Sheconsidered mechanical engineering, and studiedmaths and physics at A level, but decided againstthat path. Eventually, scrolling throughopportunities on UCAS, she spotted Child Nursing.“It just popped out at me, and there was thismoment of ‘That’s what I’m going to do’. I’vealways loved working with people, and especiallychildren, but prior to that, I’d never consideredchildren’s nursing as a career.”

Hannah trained at Ashford & St Peter’s, thentook a job in London doing a variety of rotations.She spent time at the National Burns Unit,eventually becoming a sister, and then went to theBUPA Cromwell – “That’s where I started my‘Florence Journey’,” says Hannah. She became a

Florence Nightingale Scholar in 2019. Shesubsequently began in an interim senior post andprogressed, later becoming Paediatric DirectorateManager.

In late 2019, now back in the NHS, her boss toldher about the 8c Symposium for aspiring EthnicMinority Groups Nurse Leaders. Although she wasonly an 8b, Hannah’s boss encouraged her to apply.Hannah says “I thought ‘You know what? Theopportunity’s there, I’m going to grab it’.”

Hannah’s reason for wishing to be a NurseLeader is simple: if your chair is not at the table, youhave no right to complain about what’s being saidor done; if you want action you have to beprepared to be part of it. “For me,” she says, “thevoice of children and young people, and the voiceof nursing, is an incredible thing to be part of, and ifwe’re not prepared to put our voice out there,we’re saying we’re not prepared for change. AndI’m prepared for change – that’s why my voice is atthe table.”

Before the opportunity to take part in theAspiring Directors of Nursing (ADONs) programmepresented itself, Hannah says she would distanceherself from ethnic minority groups events: “As amixed race person, I’ve spent my life being told I’mnot black enough to be black and I’m not whiteenough to be white.” When her boss told her about

“If we’re notprepared to putour voice outthere, we’re

saying we’re notprepared for

change. And I’mprepared forchange”

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“I am a leader,and I am in a

BAME category,and it’s

important to bethat champion”

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you’re not that’. People like to put other people inboxes, Hannah says, and if you are someone whodoesn’t fit into a box, it can be quite challenging.

Hannah admits that other ethnic minority groupsdevelopment opportunities had probably been opento her before, but that she would deliberatelywithdraw herself from them, because of herprevious experiences. It is obvious, though, that theADONs programme has been a good fit for her. “It’sbeen incredible,” she says.

One of the main issues the programme hashighlighted for Hannah is the disproportionatenumber of ethnic minority groups nurses at juniorlevels, which does not translate to more seniorposts. “I think we have an obligation to look atthat, and do something about it,” she says. “Weneed to develop and promote ourselves, notbecause of our colour, but because we are highlyskilled professionals who have a right to thoseposts.”

Hannah feels she has found her voice as a NurseLeader during the coronavirus pandemic,participating in discussions and calling things out ina way she probably wouldn’t have done before. Shesays she’s been hesitant about speaking out onethnic minority groups issues before, becausepeople don’t think of her as being from an ethnicminority groups background, and it isn’t a label she

the programme, Hannah determined that, worstcase scenario, she could “sit at the back, keep myhead down and get through it”.

However, when the time came, Hannah felt totalacceptance for who she was. “There was this ‘Youhave an incredible heritage – we recognise yourheritage. You belong here.’ That was the first timein my life I’d experienced that. So in itself that wasincredibly powerful.”

The programme has, says Hannah, given her theopportunity to meet some incredible leaders, whohave co-consulted and coached her, and held her toaccount, pushing her further than she thoughtpossible. “My career has developed, my skills haveblossomed and I’ve found a group of womenwho’ve lifted me up as a proud BAME Nurse Leader,which I’d never experienced before.”

Hannah believes her experience of never havingfound a place where she was comfortable issomething common to many mixed race people.Growing up in Yorkshire, her mother wasconsidered black, and it had never occurred to herthat her mother was technically mixed race. In theWest Indies, things are very different, says Hannah:“If you’re black, you’re black. There are differentshades of black but that’s how it goes.” Moving tothe south east as a teenager was the first timeHannah experienced the attitude of ‘You’re not this,

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“It has been areally upliftingfew months inthe middle of amassive storm.

It’s beenbeautiful”

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has for herself. “But I am a leader, and I am in aBAME category,” she says, “and it’s important to bethat champion, because if we don’t have championsat this level, then how do we give a voice to thepeople who want to get to this level?”

There are two tenets that Hannah says informher life and work, and that she would like to passon. The first, from Sports Psychologist Jamil Qureshi,is about how one degree of change can re-set yourdestination; the second, from a Hillsong women’sconference she went to in 2019, is: “Where fear offailure tempts you to take a seat, riskcourageously.” At 32, Hannah is probably one ofthe youngest Senior Nurse Leaders in the country –a position she regards as a huge privilege. Shewants her own team to ‘dream big’ and to knowthat there are no limits to their own progress.

Looking back, Hannah admits that when she andher colleagues were first invited to take part in theprogramme “there was this weight in the room thatwas tangible – a heaviness of ‘How do we share thistruth and keep ourselves safe?’.” But as theprogramme has progressed, people have beenproud to share their stories.

Participating in the ADONs programme duringCOVID-19 has, says Hannah, “been a really upliftingfew months in the middle of a massive storm – it’sbeen beautiful”. Hannah says that her experiences

of the Florence Nightingale Foundation have alwaysbeen very positive, and of the ADONs programmeshe says “The opportunities to meet and discuss,and support and be supported by other seniorBAME leaders, has been incredible.”

She is keen for other people like her to takeopportunities when they present themselves, and totake them at face value. It can be tempting, shesays, to think ‘I’m only being given this opportunitybecause I’m black, or mixed race, or Asian or BME’.“But you need to shake off that label, take thedevelopment for what it is, and grow yourself as anindividual.”

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BINA JUMNOODOO

Bina talks about confronting imposter syndrome, and the simple buteffective way she encouraged her frontline staff to share their feelingsduring COVID-19.

Head of Nursing - East & North SBUHertfordshire Partnership University NHS Foundation Trust

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One thing I would like to change is for ethnic minority groups staff who maybe at 8a and above to have an active sponsor at a senior level who will createopportunities for that ethnic minority groups staff member to develop and tocreate more exposure and hopefully more opportunities.

My call to action is for every senior leader, regardless of ethnicity, to seek highpotential ethnic minority groups 8a and above staff and to develop a sponsoringrelationship with them as outlined above.


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Born in Mauritius, Bina’s first passion was teaching –she loved to teach, and to be around other people.When she came to England, she was unsure of thedirection she wished to take, and consideredpsychiatry before deciding on mental health nursing.“It was always about helping others and what Icould do to make other people feel good andrecover,” she says. She was particularly affected byseeing her grandparents – previously so capable andindependent – growing older and needing morehelp. “I thought ‘Really? People get that old?’, andit just made me think there was this compassion andcaring in me from day one.”

Bina was drawn to the idea of nurse leadershipby the desire to make a change, and to be in theposition of being able to influence things in apositive manner. She likes to think outside the box,and challenges herself to do so. And she knows shehas the ability to bring other people with her: “Ididn’t say to myself ‘I’m going to get there becauseit’s my ambition’; I want people to be with me andfeel the same way. It’s about collaborative, collectiveleadership, working together to achieve that.”

One of the successes of which she is most proudis her part in the development of the NursingAssociate role. “I know I am a leader, and I bringpeople along with me, and together we share thesuccess.”

The thing Bina has most valued about theAspiring Directors of Nursing (ADONs) programmehas been the opportunity to hear other people’sstories, and to recognise that everyone was in thesame boat: “It has been very much about how wehave managed the challenges differently, andoffering support to each other,” she says.Importantly, it has also reminded her of the neednot to neglect her own self-care, when the demandsof COVID-19 might have caused this to take less of apriority.

The programme could not have come at a bettertime, Bina says. It was a space that offered thesupport she needed and enabled her to talk toother people experiencing the same pressures shewas. The participants were able to share their ownways of working, and to challenge each other in aprofessional and non-confrontational way.

Being from Mauritius, which is very multi-cultural,Bina says that people’s colour had never beensomething she’d thought about. Until, that is, shedecided to apply for the Head of Nursing post.“Somebody said to me ‘If you get that post, you willhave broken through the glass ceiling. But bemindful, if you don’t, how you’re going to feelabout it’.”

Imposter syndrome began to set in, and Binabegan to ask herself whether she really was capable

“I know I am aleader, and Ibring peoplealong with me,and together we

share thesuccess”

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“I mustn’t thinkthat because I’mblack or Asian orIndian, I won’tget there. I needto look at how Ican do thingsdifferently”

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people will engage in conversation with you and tellyou exactly how they feel.” Bina believes this was amuch more helpful environment for the staff thanformal psychological support would have been.

The Leadership Programme gave Bina anenhanced self-awareness, she says, and an ability tospeak openly about her experience of COVID-19.She was aware that many of her staff were fromethnic minority groups backgrounds, and wereworried about coming to work, or taking the virushome to their families. But at the same time, shewas feeling the same fears and vulnerability: “I wasscared going to work sometimes. I would pray formyself, and pray for others – ‘Please don’t let thisvirus get to me, so that I can still carry on with myjob to support others’.” Bina’s priority was to ensurethat her staff had all they needed, such as PPE andflexi hours arrangements, to enable them to cometo work and care for their patients.

Bina would like to be remembered as someonewho was never phased by anything that happenedat work, and as someone who would be there foranyone who needed her, at any time of day. “Thestaff know I am there to support them,” she says,“and I always have an answer for them, and find away to get the information for them, or find asolution with them.”

Whatever you need to do, to get where you

of filling this post effectively after all. She securedthe post and people were pleased with her. “Butlately, I’ve been more aware of women talkingabout the level they’re at and that they have to dothat extra bit more to make sure their face fits,”she says.

This has reinforced the imposter syndrome, buther training has equipped her to face the challenge:“It helped me understand that it’s up to me to makea difference. It’s up to me to get a good sponsor toopen the door for me, and not think that becauseI’m black or Asian or Indian, I won’t get there. Ineed to look at how I can do things differently.”

Bina has been aware of her great responsibilityas an ethnic minority groups nurse leader during thepandemic. There are a huge number of ethnicminority groups staff on the lower grades in MentalHealth, and they are the group at greatest risk fromthe virus. It has been important to her that her staffknow that she is standing up for them and speakingout at meetings on their behalf. She made sure thatindividual risk assessments were carried out for allstaff members, and that their needs were met.

And whereas senior staff would be quick to askfor one-to-one psychological support, this is moredifficult for more junior staff. Bina’s solution wassimple but highly effective: “I got pizza on the ward,got food around the table. Because that’s where

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“I got pizza onthe ward, got

food around thetable. Becausethat’s wherepeople willengage in

conversation”

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want to be, you should do it, says Bina. Don’t letanything get in your way to prevent you gettingthere, and you will get there. It’s partly aboutknowledge, skills and qualifications, she says, but it’salso about your respect for others, yourunderstanding and your ability to put yourself intheir shoes.

Bina admits that it hasn’t been an easy ride: it’sbeen challenging, and it certainly isn’t a nine-to-fivejob. What’s important, she says, is to enjoy whatyou do and to know that you’re making a positivedifference to other people’s lives.

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LINDA CHIBUZOR

Linda talks about how her harrowing lived experience of her mum'smental illness drove her to become a Mental Health Nurse, and how itstill motivates her today. She also reflects on the serious effects ofbullying in the workplace.

Deputy Director of Nursing and QualityNHS Milton Keynes CCG

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One thing I would like to change is the disproportionate number of ethnicminority groups nurses who are dismissed and referred to the NMC, followingNHS Trust disciplinary hearings, appeals and conduct cases.

My ask is that NHS Trusts ensure that the panels for these disciplinary hearings,appeals and conduct cases always have a ethnic minority groups representativeon them to ensure that there is fair treatment for ethnic minority groups staffand that the panel represent diversity to assist in understanding ‘extenuatingcircumstances.’


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From an early age, Linda remembers, she wanted towork in health care, and to help people. At school inZimbabwe, she and her friends would fight overwho would have what role when they grew up,vying with the boys to become an ambulance driver!

However, her career path was ultimately decidedby harrowing lived experience. Her mother hassuffered long and enduring mental illness, and Lindawas her carer as a teenager. In Africa, she says, thementally ill are subject to shocking treatment: “Igrew up as one of those children who other peoplelaughed at - ‘That’s the mad woman’s daughter’ –but what really upset me was the treatment that mymum received.”

From the age of 14, she was very clear what shewanted to do, and was supported and guided byher aunt, herself a nurse. Linda came to Englandand went straight into nurse training. From thebeginning, she was clear of the pathway she wishedto take, and clear that she wanted to be anExecutive Director of Nursing.

Linda worked in a number of settings acrossmental health - care homes for people withdementia, the prison service, frontline acute nursing,community nursing - and managed inpatientpsychiatric wards, before moving into commissioningin 2014.

Her mother, and the treatment she had received,

were a huge motivation in Linda’s desire to becomea Nurse Leader. She knows that “the only way tomake a positive change is if you are in a positionwhere you have a voice and you can represent thevoiceless. I tell people it’s the patient voice,” shesays, “but actually it’s my mum I see in all of this.”

The support network and the relationships thathave developed as a result of the ADONsprogramme have worked really well, says Linda. Shewould like to see senior NHS leaders coming into thegroup, and making themselves available for thesessions, so that both groups could suggest howthings could be improved. She says there is anervousness around listening to other people’sexperiences, and that they can be upsetting, butthat it is important for these experiences to beacknowledged, if progress is to be made.

Linda has experienced bullying and harassmentwithin the system herself, from a very seniormember of NHS staff. This is a common experience,she says, and one that is not confined to ethnicminority groups staff. “I think it upsets you more asyou become more senior,” she says. “As a junior,you dust if off, it doesn’t really matter, but whenyou are senior yourself, you expect people in seniorroles to behave in a certain way. When they don’t, itcan be upsetting and hurtful, and it can damageyour career.”

“I tell people it’sthe patient voice,but actually it’smy mum I see in

all of this”

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“I felt that RuthMay was

speaking to meas a nurse. And

with thedetermination

I’ve always had, Isaid ‘Yes, I wantto play my part’”

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met, and about the important developments thathave taken place during the pandemic. “Things thatwe’d aspired to do for years, like moving into avirtual way of working… it happened overnight.Where we struggled to get into a meeting roomtogether, it happened on Teams… We were almostspeaking the same language as our tech colleagues.That had never happened in the NHS.”

Being an ethnic minority groups leader wasespecially significant, given the disproportionatenumber of deaths in the ethnic minority groupscommunity and the need to support ethnic minoritygroups members of staff. With many of the staff inher team being redeployed to the frontline, Lindahad one-to-one conversations with everyone, andcompleted thorough, individual risk assessments foreach staff member. “There was a lot of anxiety fromBAME staff,” she says. “I made sure that colleagueswould be redeployed to roles that would not putthem at risk, and which they would be comfortablewith.”

She also signposted and encouraged nurses toaccess psychological and talking therapies forhealthcare staff in hospitals, primary care and carehomes, as well as the CCG. Throughout the timethat staff were redeployed, Linda set up a weeklyTeams meeting with each member of staff, to offerher support and keep them updated on key issues in

Linda now acknowledges that this experiencehad a profound effect on the way she was behavingtowards others. “I became that person who is veryguarded and defensive, and maybe I missed out onopportunities because I was no longerapproachable.” A lot of ethnic minority groups staff,she thinks, have gone into fight mode, and as longas this situation persists “someone who has nevertreated me that way is having to respond to mybehaviour, which is fuelled by my feeling that that’swhat everyone is like.” It is a vicious circle, shethinks.

The people on the programme are very engagedwith it, Linda says, but the network needs to bewidened if this is to be truly effective. She suggestseach participant is accompanied to the first sessionby their Chief Nurse or Director of Nursing. “MostExecutive Nurses will never have attended this kindof programme, so hearing what we’ll be discussing,and how it’s structured, would be useful for them aswell.”

The most significant thing about being an ethnicminority groups Nurse Leader during COVID-19, saysLinda, has been knowing that everyone was in ittogether. “And whilst we have had differentchallenges across the health and care system, therewas this force bringing us together.”

She also talks about how challenges have been

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“The NHS isbeginning to

embrace inclusivepractice, and wecannot embedthat withouthaving BAMEsenior leaders”

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the CCG.Linda says that her response to the COVID-19

crisis has been driven by her love for the NHS. “Bythe age of 15, I had fallen in love with the NHS. Itbecomes quite upsetting when you hear some ofthe negativity around it,” she says, especially whenyou have an appreciation for the organisation,having not grown up with it. Ruth May’s message tonurses at the beginning of the COVID-19 outbreak –that this was the time they were needed, more thanever – had a profound effect on Linda: “I felt thatRuth May was speaking to me as a nurse. And withthe determination I’ve always had, I said ‘Yes, Iwant to play my part’.”

Linda stresses that behind every leader are a lotof other people supporting them – not justcolleagues. Most of her family are in Africa, and shewas touched by the fact that they were soconcerned about her, when they were living in farworse conditions. She also received support fromher neighbours. “One of my neighbours did apamper basket to say ‘Thank you for all you do’.” Itwasn’t even a neighbour she knew very well. “I’vehad a lot of support from an amazing line managerand colleagues, and outside of work people havebeen genuinely kind.”

Linda’s message to the next generation of ethnicminority groups nurses who wish to take on

leadership roles is full of hope. “I am beginning tosee things I didn’t see 20 years ago,” she says. “TheNHS is beginning to embrace inclusive practice, andwe cannot embed that without having BAME seniorleaders.” As one of the world’s biggest employers,for the NHS to be having these conversations is ahuge step forward, says Linda.

But people must be prepared to participate, iftrue change is to be achieved: “We need to besitting around that table to support this work. Whenyou play a positive part in change, you are likely toget the positive outcomes you’re looking for.”

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ANNESHA ARCHYANGELIO

Annesha reflects on her desire to celebrate what the Aspiring Directorsof Nursing (ADONs) programme has achieved for her, and her work onthe National Matron's Handbook as part of her NHSE/I Fellowship.

Director of Infection Prevention and ControlDartford and Gravesham NHS Trust

One thing that I think needs to change going forward, with regard to ethnicminority groups staff, is including ethnic minority groups in all mainstreamawards programmes, rather than having specific ethnic minority groupsawards.

My ask would be that all leaders and sponsors of awards programmes have anindividual and a team or organisation award, and encourage or facilitate theinclusion of ethnic minority groups staff in these mainstream awards,in recognition of the extensive work that has been undertaken to inspire andencourage others.

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Annesha leads at Executive and Director level,embedding strategies for infection control and theHealth and Social Care Act across the organisation,to ensure patients and staff are safe. This has beenparticularly important during COVID-19.

From a very young age, Annesha says, she hadgreat aspirations, and considered working in thehealth or medical field. In Jamaica, nursing andhealth care are greatly valued, she says, and a careerin this field is very much something to aspire to.

Her route into nursing hasn’t always been easy,even from the beginning. Her guardian reacted toher wish to become a nurse with “Oh Annesha, Idon’t think you could manage that”. But Anneshawas determined, and came out top of her class. Atnursing school, she committed herself and did well,gaining the respect of her colleagues.

She came to the UK six months after qualifying,and has studied for various qualifications since then,including in health studies and infection control.More recently, she has worked across CCG,community, mental health and acute trusts, and indifferent specialties.

Working as an NHSE/I Fellow has broadened herexperience to the national level, she says, and givenher a greater vision of how she might contribute tohealth care. Annesha is driven by the desire forexcellence in every project she undertakes. “I’m

always thinking ‘There’s something that can come ofthis’,” she says. “I always have a thirst forprogression and development in whatever I do.”

Her focus is on becoming a Chief Nurse, whetherat Trust, regional or even national level. These arepeople, after all, who are at the top of theorganisation and who can contribute most to thewider decisions that have good impacts on thepopulations they serve. However, she is aware thatshe doesn’t have to get there straightaway, and thatshe can be an effective leader across her organisationand contribute by setting a good example.

As an NHS Fellow, her project was to developand implement the National Matron’s Handbook.She achieved this through a series of consultationswith Ruth May and her team, national colleaguesand stakeholders, the Royal Colleges and theuniversities. She also held engagement events,supported by the project team, to find out justwhat the matrons wanted.

Alongside her role in IPC, Annesha is nowworking with other organisations and regions toimplement the handbook. “The handbook focuseson inclusive and compassionate leadership,” shesays, “and on trying to hold on to that, regardless ofthe challenges that we may face.”

One of the keys to improving health care, saysAnnesha, is greater standardisation across health

“I’m alwaysthinking ‘There’ssomething thatcan come of this’.I always have a

thirst forprogression anddevelopment”


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“For me, it’sabout supportingeveryone withtraining anddevelopment,encouragementand motivation”


practical things like support for CV development andinterviews. Unless you get those things right, you’renot going to get the job.”

The COVID-19 outbreak has brought into sharprelief what the ethnic minority groups populationhas experienced. As a senior leader, Annesha hasseen the crucial need to engage with others, and toturn those discussions into practical actions. Shemakes a point of discussing with senior colleaguestheir role in supporting and assisting, with practicalthings such as stress management, and ensuringthat staff are not over-worked. “We have a longway to go… and everyone has different ways ofdoing things. For me, it’s about supporting everyonewith training and development, encouragement andmotivation.”

Annesha’s role has been dominated by COVID-19, and she says everyone is preparing for a secondwave. “We’re hoping that we’re ready to reactwhen we need to, and that we have escalationpoints in place. I’m told I work very fast, but it’s notabout the speed of getting everything in place, it’sabout getting others to come along with you andnot moving too rapidly for them.”

The ADONs programme has provided a lot ofvaluable peer support, Annesha says. It has alsogiven her a lot of resilience, and helped her to buildresilience within the rest of her team. But it has

systems. Having worked in a variety oforganisations, she can see that each one is different,and believes that greater standardisation would bebetter for everyone.

The ADONs programme has been very useful,says Annesha, and definitely assisted her in securingher current role. The coaching, and the RADAsession, have helped her build better relationships,when meeting her new executive team, which hasbeen very useful. These are skills that she willcontinue to use as she progresses further.

She thinks a clearer structure to the programme -perhaps having sessions divided into modules -would have been useful, along with furtherresources and development materials, tocomplement the face-to-face sessions.

The programme has definitely highlighted thechallenges that staff from ethnic minority groupsbackgrounds face, Annesha says. “The people in thegroup all have similar experiences, such as strugglingto get a post, even though they might be far betterqualified than other candidates. The main point isknowing not to give up.”

Annesha has been thinking about how the EthnicMinority Groups Programme compared with othersin the mainstream, which include elements such asfocus groups and action learning sets, and thinksthose would be useful additions: “They include really

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“I think it wouldbe great to havea celebration,and talk aboutwhat each of ushas achieved”


been hugely challenging: “When I was on thefrontline and we started to see fatalities, I started tothink about what I would do when my staff beganto get sick, and the impact it would have on theirwellbeing. And I worried about what would happenwhen I was off sick, and I wasn’t there for everyone,and I’d sit and worry.”

Annesha would like to make a lastingcontribution to a health system with a greaterdegree of standardisation, and with seamlessprocesses that do not have a catastrophic effect ona particular group of staff, simply because of aparticular shared characteristic.

In terms of the next generation, she hopes thatthe hard work she and her colleagues are doingnow will pave the way, and make it easier for thosewho come after her to progress as they would wishto. It won’t be easy for them, she says, but if theykeep trying hard and remain motivated, it will bepossible.

And she doesn’t want the ADONs programme toend here. “I think it would be great to have acelebration, even a virtual one, to say ‘This group ofstaff have been through this process’, and to talkabout what each of us has achieved.”

Most importantly, perhaps, Annesha wants toask “What’s next for this group of staff?”

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MORIAM ADEKUNLE

Moriam talks about how nursing was a ‘calling’ for her, and about howthe COVID-19 pandemic has both challenged and developed her skills asa nurse leader.

Associate Director of Nursing, Clinical Effectiveness – North East London NHSFoundation Trust (NELFT)

Joint Chair – Trust Ethnic Minority Staff Network

1/4MORIAM ADEKUNLE

One thing that needs to change with regard to ethnic minority groups staff isa more proactive identification of ethnic minority groups talents and nurturingthrough a scheme of works, for example, shadowing opportunities, stretchassignment and acting up positions.

My ask is for nursing leaders to take responsibility for ensuring that equality,diversity and inclusion are embedded in every strand of the processes in theirrespective organisations.


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Moriam has responsibility for the support anddevelopment of colleagues, and her team is the firstpoint of contact for nursing and AHP colleagueswho may have a difficulty or need clarification orsupport in the delivery of care. Her team is involvedwith a number of workstreams, and feeds intoassurance and governance at the Trust. She has alsoset up a skills and simulation lab whereprofessionals can upskill and build their confidence,in a safe environment.

Moriam was appointed Joint Chair of the EthnicMinority NELFT Network in January 2019. Its aim isto work with the organisation’s leaders to ensurethe race agenda is embedded within the differentstrands of its work. It provides support to ethnicminority groups staff, and runs a range of webinarsand meetings, focussed on developing people andraising awareness, to keeping the race agenda live.The Network is also supported by a number ofwhite colleagues, who make a very valuablecontribution.

Nursing was definitely a ‘calling’ for Moriam.Growing up in Nigeria, the second of six children,she tried to support her mother and was alwaysasking what she could do to make a difference. “If Isaw someone sad,” she says, “I would always wantto know why and find out what I could do.” Whenit came to thinking about a career, Moriam was

very clear that she wanted to work with people andto make a difference.

She considered medicine, but the significantfinancial commitment of a medical training,combined with the sudden and tragic death of herfather, made this impossible. So she decided onnursing instead and gained a place at theprestigious University College Hospital in Ibadan. “Ihave not looked back since then,” she says. “It wasan amazing journey.” She represented the school atthe annual Florence Nightingale Speech Contest,coming top and being awarded the FlorenceNightingale Shield.

Moriam relocated to the UK in 2004, and saysthat working in this country is what inspired her tobecome a nurse leader. She speaks of the difficultiesof coming to a new country to work, and having tore-train, despite having worked as a nurse in Nigeriafor eight years. In her Band 5 post, she observedthe nursing environment and contributed to thedevelopment of the nursing strategy for herorganisation. She says “I went to meetings… andthere were times I wouldn’t agree with thedecisions being made.” Moriam realised that, toinfluence change and ensure that the right decisionswere made, she needed to be in a senior position.

Moriam was already a scholar on the FlorenceNightingale Foundation programme for ADONs

“...little did Iknow I would be

part of thisresponse to thepandemic”

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“You start to thinkto yourself, ‘Do

people see me as aperson of colour,or do they seewhat I bring tothe table?’”

3/4MORIAM ADEKUNLE

Opportunities do exist for ethnic minority groupsnurses to progress, but, Moriam says, skills andtalent need to be recognised and nurtured. She waslucky enough to have a manager who did just that;he thought that Moriam didn’t realise what sheherself was capable of, and encouraged herdevelopment.

The death of George Floyd, and the subsequentrise of the Black Lives Matter movement, threwracial inequality into even sharper relief, against abackdrop of COVID-19’s disproportionate effect onthe ethnic minority groups community. Moriam wasredeployed to Silver Command, temporarily actingas Tactical Director. It was a hugely demandingtime. “I was watching what was coming throughthe media and worrying how this would impact onpeople, and wondering about what I’d be walkinginto, back at work the next day,” Moriam says.

People were angry and frustrated, and lookingto her for guidance. With 40% of her Trustcolleagues being from an ethnic minority groupsbackground, and a significant number of themworking on the frontline, Moriam consideredwhether these nurses should be removed fromfrontline service to protect them from danger. Itwas difficult to find a balance, something that was“emotionally, mentally and physically challengingand draining,” she says.

when her Chief Nurse told her about the ethnicminority groups programme. She says that if everthere was a time for co-consulting, it has beenduring the COVID-19 crisis. “Those sessions havegiven me a psychological safe space and anopportunity to discuss key challenges with peopleof a like mind.”

Her colleagues on the sessions have helpedshape her thinking, says Moriam, and suggestedsolutions that hadn’t been apparent before. Shetalks about the ‘light bulb moments’ that haveresulted, and her excitement at being able toimplement new ideas immediately.

The RADA session also gave Moriam aninvaluable insight into how to retain presence andgravitas on virtual platforms, at a time whenphysical meetings have become almost non-existent.

Many themes have recurred during the ADONssessions, and these are not unique to this group ofnurses. At meetings, those at the tableautomatically turn to Moriam only if there areagenda items concerning ethnic minority groupspeople. “You start to think to yourself, ‘Do peoplesee me as a person of colour, or do they see what Ibring to the table?’” she says. However, shebelieves that this behaviour is rooted in unconsciousbias rather than being intentional.

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“It’s one thinghaving the skillsand knowledge,but using themto help othersis what gives

me joy”

4/4MORIAM ADEKUNLE

Moriam also found it challenging to have to bein planning meetings when she really wanted to bevisiting colleagues on the frontline and speaking tothem. Through a network of colleagues,communication channels were kept open. “Some ofthe conversations were uncomfortable,” saysMoriam, “but they were conversations we had tohave.”

There were inevitably times when there weredifferent views around the table and herrelationships with her colleagues were strained,admits Moriam. However, she was determined notto allow COVID-19 to cause long-establishedrelationships to break down. “By shifting focusaway from myself, and investing in thoseindividuals, the underlying problems have to agreat degree been resolved.” Without the ADONsprogramme, Moriam says, this would have been farmore difficult.

Has the challenge of COVID-19 made her abetter nurse, and a better leader? The answer is anemphatic “Yes!” In particular, she has noticed inherself a new determination that however she isfeeling, she will show compassion to her colleagues.It’s about being a role model: if she hasexpectations of others, she says, she needs to be arole model for those expectations.

She is proud of what she’s been able to

contribute during the pandemic. “It’s one thinghaving the skills and knowledge, but using them tohelp others is what gives me joy,” she says. “Itreminds me why I became a nurse.”

Moriam is keen to make a lasting contributionto the development of the next generation ofleaders, “so that there are enough remarkablepractitioners within the profession to keep up withthe agenda”. She thinks back to the seniormanager who recognised and nurtured her talents,and that is what she has been doing withcolleagues – through informal coaching sessions,mentoring and signposting. “That’s my way ofgiving back,” she says.

Moriam has one message for the nextgeneration: they must develop resilience, politicalastuteness and emotional intelligence, if they are tothrive. Role models are key, she says. “There’ssomething about seeing someone who looks likeyou, who speaks like you, at that senior level. Itgives you the confidence and the assurance thatyou can do it.”

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MAX OOSMAN

In 2022, Max Oosman will celebrate 50 years’ service in the NHS. He tellsus about arriving in England from Mauritius, having to adapt to verymuch a ‘white world’, and why he thinks labels might actually beunhelpful.

Community Mental Health Nurse PractitionerEast Lancashire Memory Assessment Services

1/4MAX OOSMAN

One thing I would like to change is that racism exists across the NHS and thereis a lack of understanding as to why we treat those who are different from usin an uncivil and inequitable fashion.

My ask is that decision makers at board level look at their organisations andtake responsibility and accountability, to ensure diversity of thought andresources is part of their workforce, so they will attract the best peopleirrespective of their ethnicity. I’d like all staff to understand and embraceallyship together, to make this a better world to work, live and play.


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Max arrived in England to begin his nursing trainingon 30th August 1972, at the age of 19. But hisperception of nursing had been formed during hischildhood in Mauritius. Nursing is much more highlyvalued in Mauritius, with no gender gap, he says,and very early on he recognised the added valuethat nurses brought to society as a whole, withhome births common and nurses visiting toadminister vaccines.

He was, he admits, ‘a bit of a maverick atschool’, and unwilling to accept the status quo. Buthe also recognises that the roots of his own nursingcareer go back to his early school days. Heremembers feeling compassion for children whowere less fortunate than he was, ‘arriving at schoolwith bare feet and runny noses’. “I would takeDad’s small change and buy them things like CocaCola and crisps,” Max says, “and I’d sit in the yardand entertain them.”

Unemployment levels in Mauritius were high,and Max took the opportunity to come to England,for three years’ training at Mid-WorcestershireSchool of Nursing, based in Bromsgrove, to becomea State Registered Nurse.

His arrival at the school was something of aculture shock. He had come from a large family,living in a big house in tropical Mauritius. Now hewas shown to his small, lonely college room, and

the canteen could offer him only a cheese salad fordinner, because the kitchen was shut for the day.

On his first day at the school, he was luckyenough to meet another student from Mauritius –“someone who looked like me, someone on thesame journey” – and the two young men becameinseparable. Their friendship was, thinks Max, vitalto their psychological wellbeing.

Although they were looked after quite well incollege, Max says he experienced prejudice veryearly on. He was placed on a medical ward wherepatients largely required bed rest. There was lots offetching and carrying, he says, and he “often gotthings wrong”. He was assigned the dirtiest work,but was too terrified to recognise the blatantprejudice. He was always on edge, and wasn’tenjoying himself.

And whereas his friend had a sympathetic WardSister, who realised that they were in a strange newenvironment, Max feels his own Ward Sister bulliedothers to compensate for her own lack of clinicalskills, “especially people like us – we were an easytarget”.

After qualifying, neither Max nor his friendfound they could get the jobs they wanted. Thejobs would be advertised first and they would onlyget them if no-one else applied. This was the firsttime he realised he wasn’t being treated the same

“I would takeDad’s small

change and buythem things likeCoca Cola andcrisps, and I’d sitin the yard andentertain them”

2/4MAX OOSMAN

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“You find yourway through themaze, despite allthe bias and thenegativity around

you”

3/4MAX OOSMAN

Max. “She knew everything that was going on. Ireally identified with her.”

Max admits that he struggled for a long time toadjust to the way nurses are perceived in England,especially in contrast to doctors. But now herecognises their true worth: “Nursing is patient-centred care. Nurses get to know their patients theway nobody else does – you are connecting on ahuman level and there are things you can do tochange people’s lives. It’s intense! Now I’m happyas a nurse. I’m the proudest nurse. And I wanteverybody to understand what nursing is reallyabout.”

Allostatic load can be heavy on ethnic minoritygroups staff, Max says, because of the stresses theydeal with every day. This is what he puts a periodof mid-career demoralisation down to. However,moving to MerseyCare and being introduced todementia care energised him again. Max became aNurse Specialist in Dementia Care. He is now aDementia Champion, and has given a keynotespeech to the Alzheimer’s Society.

After his long and varied career, what wouldMax like to tell his younger self? Looking afteryourself is crucial, he says: “To be able to offersupport and help to others, you’ve got to look afteryourself. You matter.”

Growing up with colonisation – and the feeling

as other people, or being given the sameopportunities. At the age of 22, he was given nightduty on a trauma ward: “It was very intense. Icouldn’t sleep. I couldn’t socialise. But I had nochoice. It was definitely down to prejudice.”

Max and his friend – who had been assigned tothe geriatric ward at the back of the hospital –decided to make the move into Mental HealthNursing. After a spell in Epsom, Max returned toWorcestershire, where his skills were put to gooduse on an acute mental health unit attached to A&E.

Always keen to put himself forward foropportunities, Max now got promoted quitequickly, progressing to Nurse Specialist, QualityManager, Nurse Manager, Deputy Director ofNursing, and Clinical Lead. Whenever he didn’t getthe role he wanted, he determined to do betternext time: “You find your way through the maze,despite all the bias, and the negativity around you,”he says. “You create your own resilience, in a way.”

Role models have been a very importantinfluence throughout Max’s career. For instance, heexperienced one nursing sister who was everythinghis first one hadn’t been: “She was very dynamicand progressive. She would take the water jugsround to the patients first thing in the morning.”But there was more to this simple act than met theeye. “She was actually doing a ward round,” says

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“I’m theproudest nurse.And I wanteverybody to

understand whatnursing is really

about”

4/4MAX OOSMAN

of being inferior in his own country – has had a life-long effect on Max, and he says he used to be in anangry place. But it’s important to park that anger,and use in constructively, he says. “History isimportant. But what really matters is now. Youneed to use history to inform the present and thefuture. Kids need to know that.”

Max is no stranger to rocking the boat, and sayshe sees the need to “create good trouble”. He is achange agent for NHS Horizons, and works withNHS England to promote nursing among ethnicminority groups. “I want to change the world. Iwant to show them what I’ve done. Not to be ‘Maxis great…!’ No. It’s about using my lived andlearned experiences to inspire others, to make themsay ‘If Max can do it, I can do it’.”

Resilience is an important concept to him, andhe works hard with his team to instil this ineveryone, emphasising the importance of kindnessand compassion, and inclusivity and diversity ofthought and behaviour. “I want a world whereeverybody is treated as a human being, as equal,”he says. He actually finds the BAME label unhelpful,and wants to think more broadly: “Many people aremarginalised, and not just because of their race orreligion. We need to ally ourselves with others whofeel marginalised. I don’t want to think in terms of‘them and us’, because there really is only one ‘us’.”

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A CALL TO ACTION

A CALL TO ACTION

NHS Trust leadership teams should beheld to account when there is no year onyear improvement of their WRESindicators, and there are poorexperiences for staff from ethnicminority groups backgrounds.

Marsha Jones

The talent management ‘conversation’ isdeveloped as a 360° view of talent, utilisingdifferent perspectives, to ensure a fairerprocess around suitability for progressionthrough the ‘talent management gateway’.

Angela Knight Jackson

WHAT CAN YOUR ETHNICMINORITIES NETWORK DO?

WHAT ARE YOU GOING TO DO?WHAT CAN YOUR

ORGANISATION DO?WHO CAN HELP YOU?

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My ask is that it is made a requisite that youcannot pass the Well-led domain of the CQCinspection if you are unable to demonstratethat you have an active programme toincrease the percentage of ethnic minoritygroups staff in leadership positions (8a+)and there is evidence of the outcome.

Jabu Chikore


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This is a summary of the calls to action from the leaders we feature. Play your part in this by reflecting on these and alone or with your teams and report youroutcomes to the CNO and CMidO Ethnic Minority Groups Action Plan Future NHS Collaboration workspace. Together we can make the difference.

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A CALLTO ACTION

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For every senior leader of all ethnicitiesto seek high potential ethnic minoritygroups 8a and above staff and todevelop a sponsoring relationship withthem.

Bina Jumnoodoo

NHS Trusts ensure that the panels fordisciplinary hearings, appeals and conductcases always have an ethnic minority groupsrepresentative on them to ensure that thereis fair treatment for ethnic minority groupsstaff and that the panel represents diversityto assist in understanding ‘extenuatingcircumstances’

Linda Chibuzor

For leaders and recruiters always to have anethnic minority groups staff member on anyselection and recruitment panel and in allsteering groups for leadership developmentprogrammes.

Hannah Spencer

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A CALLTO ACTION

A CALL TO ACTION

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Decision makers at board level look at theirorganisations and take responsibility andaccountability to ensure diversity ofthoughts and resources is part of theirworkforce, so they will attract the bestpeople irrespective of ethnicity.

Max Oosman

Nursing leaders to take responsibility forensuring that equality, diversity andinclusion are embedded in every strandof the processes in their respectiveorganisations.

Moriam Adekunle

All leaders and sponsors of awardsprogrammes encourage or facilitate theinclusion of ethnic minority groups staff inthese awards, in recognition of theextensive work that has been undertakento inspire and encourage others.

Annesha Archyangelio

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A CALLTO ACTION

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Hilary Garratt, Deputy Chief Nursing Officer forEngland

Angela Knight Jackson, Head of Nursing andDevelopment Programmes, NHS England and NHSImprovement

Paul Vaughan, Head of Perceptions and GeneralPractice Nursing, NHS England and NHSImprovement

Elizabeth Carter, Transformation Lead, Perceptionsof Nursing, NHS England and NHS Improvement

Ethnic Minority Groups 8c Symposium March 2020

CNO Nursing Directorate Ethnic Minority Groupswork programme 2019/20 and 2020/21

CNO Ethnic Minority Groups Strategic AdvisoryGroup listening events

Filipino nurse concerns of impact COVID-19 toFilipino nurses

CNO and CMidO Ethnic Minority Groups Action Plan


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Thanks and credit references for contribution to and leadership of this publication

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