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by Nosheen Hussain, OHT Fellow
“But what can I do? I am just one person.” said 7 billion people.
That quote summarises my main takeaway from the One HealthTech (OHT) talk and panel discussion at Digital Health Rewired last week. The discussion was centred around the importance of increasing leadership diversity in digital health in the NHS. The talk was a very timely one as - that same morning - there were headlines of a CEO from a major healthtech company who decided it was okay to spew racist remarks at a black female MP. Anyone who has worked in diversity and inclusion will at some point have heard the question ‘Do we still need to be talking about diversity?’. As echoed by our panel of key NHS leaders that day, the resounding answer is ‘Yes. We really do.’
As a new member of the Manchester OHT Hub, this was my first time at Rewired. The event was truly buzzing, filled with interesting ideas and stimulating discussions. Alex, Bernie and Charlotte have all been on the team for a while and were in full swing with preparing for their talk for Rewired when I joined. They have been the most welcoming and encouraging bunch of people and quickly got me up to speed on everything they were up to. It was great to finally meet them in person (Bernie and Charlotte at HETT North the week prior and Alex at Rewired) and to analyse the survey results for the talk.
Back in August 2023, the team first initiated a movement to increase leadership diversity in the NHS. This project stemmed from the insightful roundtable discussions we led at events like the Digital Academy Leadership Summit (2022) and HETT North (2023 & 2024). At Rewired, we wanted to continue to raise awareness of the movement. Our talk was split into four parts:
(1) survey results from people working in Digital, Data and Technology (DDaT) to provide evidence for why this movement is needed;
(2) qualitative interviews with digital health leaders in the NHS;
(3) a panel discussion with key leaders in the NHS;
(4) our policy recommendations.
Alex began the talk by presenting evidence on why this movement is needed. She presented initial results from a survey that she distributed through social media channels and networks to people working in DDaT. The survey explored people’s experiences of their professional journeys, perceptions of role models and support networks, and general advice. We analysed results from the 40 people who responded to the survey. Alex and I summarised the data into five key takeaways:
The prevalence of imposter syndrome and challenges expressed by the survey respondents were in line with what we expected to see. However, only 32% of the respondents were from ethnic minority backgrounds and 18% reported disabilities; a more diverse group of respondents are needed to ensure that these results are representative of the diverse workforce. As most of the respondents described their expertise level as ‘practitioner’ or ‘expert’, aiming future surveys at those in more junior roles may allow us to collate the experiences and opinions of a more diverse and representative group of people.
The full descriptive analysis for the survey can be found here.
Qualitative interviews
Bernie then discussed the qualitative evidence she had gathered through interviews with 150 female leaders in tech in the NHS and digital health space. Understanding that discussions about inclusivity cannot be exclusionary, she also interviewed 20 male digital leaders on the topic of allyship. She shared a video with soundbites of a few of the interviews she had conducted. The conversations covered a wide range of topics; some insights included:
Disparity around female-led start-ups in digital health: Women in healthtech are often disadvantaged due to stereotypes. Only 2% of funding goes to female-founded start-ups. How can we work together to change the infrastructure that causes this to happen?
Importance of women’s networks and support around key life events: Establishing networks is crucial to empowering women, facilitating discussions as to why women don’t put themselves forward for leadership roles, self-confidence, imposter syndrome, and female-related subjects such as menopause and having a baby.
Defining allyship: Allyship means providing opportunities to others, stepping aside to provide space for them, and providing mentorship to allow them to move into those spaces with confidence.
Diverse representation in organisations: Achieving diverse representation requires organisations to recognise individuals’ talents, even when they don’t fit stereotypical profiles of candidates.
Panel discussion
Charlotte then led the panel discussion with the following key leaders in the NHS:
Rizwan Malik Consultant Radiologist at Royal Bolton NHS Foundation Trust; Managing Director at South Manchester Radiology
Abigail Harrison Chief Digital and Infrastructure Officer at Lancashire & South Cumbria NHS Foundation Trust; Vice chair CIO Advisory Panel
Rafiah Ansari Chief Digital Ethics and Assurance Officer at Surrey and Borders Partnership NHS Foundation Trust; NIHR Clinical Doctoral Research Fellow; Shuri Network Steering Group member
Paul Rice Chief Digital and Information Officer at Bradford Teaching Hospitals NHS Foundation Trust and Airedale NHS Foundation Trust
The panel all shared their experiences, frustrations and hopes for the future of healthcare:
Inclusivity at a conference taking place during Ramadhan: Several healthtech events coincide with Ramadhan, posing challenges for Muslims who are fasting. At Rewired, an inclusive iftaar event was organised, welcoming attendees of all faiths and showcasing the significance of diversity in advisory boards. Hassan Chaudhary, a Rewired advisor, organised the iftaar, emphasising the value of representation and understanding diverse cultural needs.
Unconscious bias is never an excuse: Unconscious bias is often used to rationalise discriminatory behaviour. Given the widespread accessibility of the internet and our capability to educate ourselves, there is no justification for harbouring unconscious bias.
Importance of creating an inclusive environment: Failure to grasp the diverse needs of individuals can foster a sense of exclusion, leading them to believe that certain opportunities or resources are beyond their reach (for example, mothers who may not be able to attend meetings at 3pm as they need to pick their children up from school or Muslims who may not be able to attend meetings at Friday lunch times due to Friday prayers).
Why is there a lack of diversity in the workforce? It is important to identify barriers that stop people from applying to senior positions. One issue is mandatory prerequisites that can deter candidates from diverse backgrounds from applying to senior roles. Organisations should instead nurture talent. Any specific qualifications can be achieved as part of a personal development plan while working in the role.
Whose responsibility is to address structural barriers? Entrusting organisations alone with the task of diversity and inclusion can sometimes result in insufficient action. Instead, individuals should all take responsibility and implement change incrementally.
On the importance of outrage: Expression of healthy outrage is necessary to propel a movement.
‘Oh, she’s not technical’: Women are often perceived as being less technical than men. Abigail recalled a time when a woman with 20+ years of experience in IT was described as being ‘not technical’; a term that would not be used to describe a man with equivalent experience.
Ethnic diversity in junior teams but not in leadership teams: There is often ethnic diversity within junior teams in the NHS but this is not represented in leadership teams. Unconscious bias could be a potential factor in this disparity.
On the importance of active empathy: Instead of being complacent, active empathy is about understanding people’s experiences and actively looking for ways to improve diversity and inclusion based on those experiences.
The Shuri Network: Launched in 2019, The Shuri Network focuses on active, tangible change in diversity in digital health in the NHS. This includes shadowing programmes, mentorship programmes, and networking opportunities for people from all backgrounds.
Do we still need to talk about diversity? The biggest risk to diversity and inclusion is complacency. Diversity and inclusion must be a constant effort. The current headlines tell us this is still an important discussion.
On the importance of curiosity: It is important to ask questions and to continuously learn about people from different walks of life. There is always a fear of asking the wrong questions, but the genuine intent to learn is what matters.
Policy recommendations
Diversity and inclusion do not just happen. It takes work, intention, and cultural competence. Cultural competence is the ability to recognise, engage, and adapt across cultural differences and is foundational when it comes to valuing and supporting teams and colleagues.
Attempting to take an organisation through a culture transformation can feel like a herculean task. It cannot be done in isolation, nor can results expect to be realized overnight. It must be every leader's responsibility to foster an inclusive workplace environment. The problem is that many leaders simply don't know what to do that will be measurable and have tangible outcomes. These are our three main recommendations that can be implemented by you, your teams or your organisations:
1. Reflect on your own activity: Whether recruiting, chairing a meeting, or line managing someone with feedback, reflect on how you are doing so. Think about the language you use and be aware of your biases.
2. Recruitment and retention: Check your processes for both external recruitment and internal promotions. Check your use of language for job descriptions and person specifications. Challenge your HR teams to really think about different audiences and how it will land with people.
3. Education: Don’t stop at the ‘mandatory’ diversity training; make space and time for follow ups and team discussions. By recognising differences, we will increase the cultural competence of individuals and teams, as well as increase the curiosity of people about how others work and learn rather than judging. Continual conversations on diversity and inclusion with leadership teams can really impact the company culture in a positive way.
On behalf of our team, thank you to everyone who has supported us so far. Many colleagues and friends have championed our cause and are keen to support in our future plans. Many thanks also to the CIO, CCIO and CNIO Advisory Panels in their active support in this initiative, as well as our colleagues in Digital Health, our One Health Tech family and all our allies.
If you are interested to learning more about how to be an inclusive leader, please let us know! We have compiled a list of resources to help you here.
Feel free to also reach out to anyone in the OHT Manchester Hub (our LinkedIn accounts are linked below).
Join the movement. #BeDDaTChange
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