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This report summarises the findings of the WDES return 2021 covering the reporting period 2020. It outlines the Trust WDES performance across the ten metrics enabling a comparison of workplace and career experiences of disabled staff and non-disabled staff. The report sets out plans to support year on year positive changes in the experiences of disabled staff.

The Trust has been self-reporting on its performance against the WDES standards since 2019 when it was first launched. Over this period it has sought to implement measures to address inequalities in the experiences of disabled and non-disabled staff. Actions have sought to reduce bullying and harassment; improve recruitment of a diverse workforce and improve the retention of disabled colleagues. In understanding our progress, where possible, we compare our performance with the previous reporting years and that of other Trusts in North West London ICS.

The WDES data is drawn from NHS Electronic Staff Record (snap shot date 31 March 2021) and includes data from the annual staff survey 2020. Disability data is routinely gathered at the point of recruitment through a process of ‘voluntary self-reporting’. Staff self-declaration is therefore important in enabling the organisation present a true and accurate picture of employee Disability in the organisation.

As at 31 March 2021, the total number of staff in the London North West Hospitals workforce was 8584. Since 2018, there has been a 7% increase in the Trust workforce whilst the number of staff declaring a disability has remained unchanged (2020 - n=169 representing, 1.9% of the workforce). This is a 1.5% difference against the NHS declarations of 3.5% (2019). Over one in four of the LNWH workforce overall fell into the disability unknown category.

In comparison, approximately 11% of Trust staff survey respondents in 2020 (NHS 20.1%) indicated they have a disability or long term health condition. This equates to a gap of 9 percentage points between Trust ESR and staff survey disability declaration rates. A further breakdown of our data indicates that the highest declaration rates were among non-clinical AfC band 8A (6.6%) and clinical AfC 8D (6.67). Compared to the NHS, 2.3% non-clinical and 2.8% clinical declared a disability compared to 3.6% and 2.9% respectively. For medical and dental, our Trust reported a higher declaration rate of 1.10% when compared to only 0.8%. Additionally, there was a slight increase in declarations from more senior roles, AfC bands 8C-VSM (this includes Executive leaders). The lowest proportions were (0.78) was reported among medical consultants.

An analysis of our WDES findings indicates that in 2020, disabled staff had a poorer experience of the Trust in all areas of the WDES metric when compared with non-disabled staff. Disabled staff were less engaged and less likely to recommend the organisation as a place to work. Over the two years of the WDES, there has been some improvement in the experiences of disabled staff as they tell us they are more likely to be victims of harassment, bullying or abuse and more likely to feel pressured to work when unwell. They also are less likely to say the Trust acts fairly with regards to career progression.

Over the last three years, the relative likelihood of non-disabled staff being appointed from shortlisting has increased (see points below). When the figure is below 1: this indicates that disabled staff are more likely than non-disabled staff to be appointed from shortlisting. Over this period the Trust has implemented a number of initiatives to support recruitment of disabled employees including our Disability Confident Scheme and more recently implementation of BAME panels which provides oversight of equality, diversity and improvement issues during recruitment and selection.

The relative likelihood of non-disabled staff appointment from shortlisting is:

• 2019: 1.25
• 2020: 1.24
• 2021: 0.79

Metric 3 of the ten WDES metrics measures the relative likelihood of disabled staff compared to non-disabled staff entering the formal capability processes. In 2019 to 2020 this was based on 26 employees entering the process over two years. Of this two were disabled with a relative likelihood of 4.02 (2/1). This indicates that disabled staff are more likely to enter the Trust formal capability process

Based on responses from disabled staff in the annual survey more say they are likely to experience bullying, harrasment or abuse (BHA) from patients, colleagues and managers. Between 2018-2020 the numbers of staff saying they had experienced BHA from patients and colleagues increased by 2% and 10% respectively. Over this period, the numbers of staff saying they have experienced BHA from managers have remained unchanged. It is clear that the current initiatives to tackle this issue is not working and a review will be required moving forward.

In terms of reporting, the proportion of disabled and non-disabled staff reporting their experience is broadly similar, ranging from just over 40% - to less than 50% which is comparable with the average over a 3 year period.  However, the extent to which disabled staff has progressively decreased from 49% in 2018 to 43% in 2020. Engagement with disabled staff to understand why this might be the case, would help to inform the approach to improve reporting. The picture for non-disabled staff is more mixed, showing an increase in reporting from the 2018-2019 (45%-48.7%) prior to a reduction in reporting to 47%. The Trust has invested in a number of culture, civility and anti-bullying programmes and it is important that the opportunity is seized to cover these issues in the programme.

Disabled staff are significantly less likely to believe that the Trust provides equal opportunities for career progression or promotion when compared to their non-disabled colleagues and compared to disabled staff nationally. The data below shows a continual decline in this belief in recent years amongst disabled staff/ staff with long term conditions. 

Their belief is significantly lower than the national average for disabled staff. Trust non-disabled staff while having a more favourable belief compared to disabled staff, have a significantly lower belief in the Trust than national average figures would indicate.

Staff group	2018	2019	2020
Disabled staff/ LTC*: LNWH	63.5%	61.1%	59.0%
Non-disabled staff LNWH	73.3%	73.1%	73.9%
Disabled staff / LTC: Average	78.4%	79.3%	79.6%
Non- disabled staff : Average	85.5%	86.1%	86.3%

More of our disabled staff tell us that they feel under pressure from their manager to come to work despite feeling unwell. There has been a progressive increase in this metric for over one third (36%) of disabled staff since 2018 (28%). The national average for responses to this question from non-disabled staff was 23.4%.

There have been marginal improvements (31.5% in 2018 to 33% in 2020) in the metric measuring the number of disabled saying that they were satisfied with the extent to which the organisation valued their work. Across England in 2019, the average was 37% for disabled staff and satisfaction rates for disabled staff ranged from 19% to 60%. London reported a satisfaction rate for disabled staff of 39% (2019).

This metric measures what is commonly known as reasonable adjustments in most Trusts. Again, data for this metric has been drawn from the annual staff survey. The proportion of disabled staff who said that the Trust has made adequate adjustment(s) to enable them to carry out their work, increased by 6%, from 60% in 2018, to 66% in 2020. This shows some progress, however, is significantly below the London average of 75.5% (2019). This highlights improvements that the Trust has made in this metric over a four year period. There is however more work to do in understanding where the barriers are and in making an appropriate and timely response to meet staff needs for reasonable adjustments. This will build staff confidence in the Trust, and convey that every staff member is valued and supported to reach their potential.

Disabled staff are less likely to feel engaged in the organisation than non-disabled staff. In 2020, disabled staff had an engagement score of 6.4 when compared to non-disabled colleagues (7.1). This is below the average for disabled staff in England (7.08). In 2019, London had the highest scores for all regions at 6.68.

Over the last year, the Trust has taken action to facilitate the voices of disabled staff through the establishment of the Disabled Inclusion Network (DIN). It continues to introduce a range of initiatives to better engage disabled staff and elevate their voices.

Over the last year, the Trust has undertaken a range of initiatives across the ten WDES metrics in order to improve the experience of disabled employees. This includes:

• Launch Equality, Diversity and Inclusion Strategy
• Relaunch of the Disability Inclusion Network chaired by the Trust deputy Chief Executive
• Introduce equality representation on panels to oversee EDI considerations in recruitment and selection
• Ongoing work to improve Disability declaration rates through self-service via the Electronic Staff Records
• Continued support of Disabled staff through Trust Occupational Health Services, EAP, health and wellbeing service and reasonable adjustments.
• Support for staff who were shielding due to COVID to ensure they were secure and safe to return to work (where appropriate)
• Become a Disability Confident Employer (Level 2 status) aimed at creating fairer recruitment and selection processes
• Launched workshops to raise awareness of BHA, recommit to Trust HEART values and resources for staff to empower them to challenge BHA
• Launched People pulse survey to continue to gather feedback from staff on their health and wellbeing needs
• Celebrate key events to promote disability issues and awareness
• Introduction of COVID risk assessments to ensure staff health and wellbeing is supported
• Introduction of a mandatory requirement for recruitment training for all those involved in recruitment and selection decisions

Below is an improvement action plan for 2021 and outlines initiatives that will enable the Trust to progress the disability inclusion in the organisation. Actions over the next year include:

• Rolling out the disability components in the EDI strategy
• Increasing membership of the Disability Inclusion Network
• Conduct a deep dive into the cases that result in formal capability proceedings
• Improve incident reporting processes
• Publicise zero tolerance of bullying, harassment and abuse to patients and the public
• Roll out conflict resolution training
• Continue to use HEART to reinforce Equality, Diversity and Inclusion considerations in all aspects of Trust working life
• Work towards achieving Disability Confident Employer Level 3
• Launch a campaign to increase the number of staff updating personal details through ESR self-service portal

The WDES return was submitted to NHS England on 31 August