Published: 16 May 2025 | by Shelagh Prosser
Key points
- Start with where people are at right now.
- Engage in a positive way.
- Build strong relationships and recognise contributions.
- Identify the organisational enablers.
- Get executive sponsorship.
- Empower leaders by supporting and coaching them to make the connections between EDI and the strategic priorities they need to deliver.
- As with any other key business function, establish robust and transparent governance for EDI.
- Learn from others and avoid “reinventing the wheel”.
Organisation profile
North London NHS Foundation Trust (NLFT) was launched in November 2024 following the merger of two separate London mental health trusts. NLFT provides a wide range of mental health services to the London boroughs of Barnet, Camden, Enfield, Haringey and Islington, a diverse population of over 1.5 million people. Most NLFT services are community-based but there is also hospital inpatient provision and specialist services such as the Eating Disorder Service and support for people with learning disabilities. NLFT employs around 6,000 staff (excluding agency staff). In its five-year strategy, it sets out its purpose: “Working with our communities to improve mental health”; its vision is “Better Mental Health. Better Lives. Better Communities”. Over the last 16 months staff have experienced considerable change due to the merger and the need to scale up services. As Samina Arfan says, “It’s about doing things differently.”
Commitment to advancing EDI
“At North London NHS Foundation Trust, we take a strategic approach to equality, diversity and inclusion (EDI), with both clinical and non-clinical leaders fully committed to achieving sustainable progress in inclusive employment and service delivery,” says Samina. “The view is that while much has been achieved there is still more to do.”
The EDI function is situated within the People, Organisational Development and Equalities (PODE) Directorate, and the associate director is a key member of the directorate leadership team.
Up to this point, the primary focus for Samina and team has been on ensuring legal compliance and meeting the requirements of various NHS equality frameworks, such as the Workforce Race Equality Standard (WRES) and the Workforce Disability Equality Standard (WDES). However, the Trust leadership team and Board fully acknowledge that excellence in EDI is essential for providing excellent patient care and experience. This commitment is further illustrated by the Trust’s dedication to implementing the Patient and Carer Race Equality Framework (PCREF), which is NHS England’s first-ever anti-racism framework for all NHS mental health trusts and mental health service providers.
“Our aim is to better understand how health inequalities impact within and across our different communities so that we can shape and deliver services sensitively and appropriately.”
Samina Arfan, Director of EDI
EDI governance
A recent key achievement has been the review of the EDI governance structure. Previously, progress on advancing EDI was reported to two sub-committees of the Trust Board: the People & Culture Committee and the Quality & Safety Committee. However, the demands on the agendas of both committees limited the time available for discussing EDI issues and reviewing progress.
As a result of a governance review, an EDI Programme Board was established in March 2024, initially chaired by the chief executive and the chief people officer. This board oversees three workstreams:
- Service User and Health Inequalities, co-chaired by two divisional operational managers.
- Workforce, co-chaired by Samina and an HR deputy director.
- Staff Network Alliance, chaired by the deputy CEO.
This structure allows for comprehensive oversight of EDI initiatives and promotes a more integrated approach, enhancing EDI capacity, capability and ownership across the trust. It also positions Samina and her team as sources of expertise who facilitate action, rather than as the sole custodians of the EDI agenda. For instance, Samina uses a coaching approach with the workstream co-chairs to empower them to take ownership of EDI efforts relevant to their areas of responsibility.
The revised governance structure cements the understanding that EDI is a Trust-wide responsibility. Having the right individuals in the right roles within the governance structure is crucial to ensuring that accountability is effective and that forums focus on overseeing delivery, rather than become merely a “talking shop”.
“We have developed an EDI matrix action plan, bringing together local EDI plans to identify shared challenges and synergies while also tracking progress against NHS contractual equality frameworks, such as the EDI Improvement Plan, WRES and WDES,” says Samina. “This enables the Programme Board to operate strategically and prioritise resources effectively.”
Samina believes that establishing a clear governance structure with board-level and committed executive leadership has enabled NLFT to understand where it is on its EDI journey and what more needs to be done if there is to be transformational and sustainable change.
Brightmine has a wealth of resources to help you with your EDI policies and pay gap reporting.
EDI priorities for the next six to 12 months
“We will continue to focus on enabling the Trust’s staff networks to operate strategically and effectively,” says Samina. There were originally 10 different staff networks across the two Trusts, so when they merged there was inevitably some duplication. These were reviewed and amalgamated into five networks, with an additional four new networks with a broadened scope, new co-chairs and a strong visual identity and branding for what the networks champion.
Engaging with the diverse communities of the five boroughs served by NLFT, and with the voluntary sector, will remain a priority. As Samina says: “Our aim is to better understand how health inequalities impact within and across our different communities so that we can shape and deliver services sensitively and appropriately.”
Improving diversity data to build a stronger evidence base is an ongoing priority, particularly data that will build understanding of who is using NLFT services and who is not, and what their experiences are. To help with this aim, the Trust has developed, with others, a set of divisional (directorate) standards. As Samina says, “This is not rocket science and there’s nothing in there that we shouldn’t be doing, but the standards pull it all together so that we can start benchmarking each division and understanding where there are opportunities to improve consistency.”
“It is essential to constantly learn as we progress. I don’t believe anything is ever a failure; it’s about assessing your starting point and considering how you can continuously improve and adapt.”
Samina Arfan, Director of EDI
The standards include a requirement for each division to undertake an equality impact assessment of its services to help identify where there is overrepresentation or underrepresentation of certain community groups and any evidence of differential impact. These standards will provide consistency across the divisions and ensure that each unit of the Trust is delivering on key EDI requirements such as the NHS Accessible Information Standard. These standards will also provide a review framework for the Trust’s various user groups such as the Patient and Carers Race Equality Framework advisory group.
NLFT is also making good progress on collecting and using workforce diversity data. For example, as well as gender pay gaps, the Trust now monitors for ethnicity, disability and sexual orientation pay gaps, and the findings are helping to inform appropriate target interventions. In respect of the gender pay gap, the largest disparity relates to female consultants, in particular in Clinical Excellence Awards, and to ethnicity, where the biggest disparity is within clerical and admin grades. As Samina says, “It’s about increasing transparency to start having the conversation.”
Given the multifaceted EDI agenda for NLFT, it was important to review existing resources and the skills mix within the EDI team to ensure that the capacity exists to support delivery of the EDI priorities. The team of five now takes a project management approach to key areas of work rather than having subject leads. External specialist support may be brought in if there is a specific need that requires a particular push.
Positioning NLFT as an anti-racist organisation
In 2024 the Trust Board signed off an anti-racism statement. This was an important step forward for the Trust, and presented a real opportunity to look at the scope and breadth of the work that needed to be done to advance race equality in respect of the experiences of service users and staff. The statement was prompted by the feedback from the NHS Staff Survey which revealed a marked difference and disparity between how the Trust’s Black, Asian and Minority Ethnic staff were feeling compared to other staff, and also by the indicator disparities in the NHS Race Equality Standard, for example relating to bullying and harassment and career progression.
“To support our commitment to being an anti-racist organisation and address disparities for career progression, we launched Proudly Positively Diverse, a positive action programme. A total of 27 NLFT ethnic minority staff took part in the ‘Maximising Your Leadership’ six-month programme,” says Samina. “This focuses on building leadership skills in a supportive way rather than starting with the deficit model, which assumes that the individual is not progressing because there is something wrong with them. We are also currently delivering the ‘Calibre leadership programme’ for disabled staff.” Samina believes that the Trust’s investment in this programme demonstrates its commitment to inclusion. She says of the first session of the programme: “There was such energy in the room and positivity and people really want to focus on their development and get ready for that next move. The programme will be evaluated at key stages to find out how people are feeling and how it’s benefiting them.”
The positive action programme sits with the Learning and Development/Organisational Development function of the PODE Directorate and Samina believes it is an example of how to build organisational ownership of EDI. She says that it had been the EDI team’s role to identify and flag the progression disparity between ethnic minority and white staff, collaborate on a solution and support functional areas to embed inclusive practice.
Advancing disability inclusion
Experiential feedback from the disability network and the NHS National Staff Survey has highlighted the need to improve the provision of reasonable adjustments, particularly in terms of the consistency of the process across the Trust. With the expertise of the Business Disability Forum, changes have been made to the existing Workplace Passport, and disability inclusion training has been provided to a cohort of managers. A member of the EDI team continues to roll out this training to all divisions and teams while also raising awareness of the Access to Work scheme.
Additionally, a working group with representatives from IT, Finance, Estates, Procurement, and Health and Safety has been established to ensure that the reasonable adjustments process operates smoothly, effectively and efficiently. A set of key performance indicators (KPIs) is being developed to measure the impact of this process. Samina emphasises that “ensuring an effective approach to reasonable adjustments is about creating the right environment for a conversation between the individual and their manager. Provision is not a given, and managers often need support in understanding what is reasonable and what their role is in the process.”
Operating strategically
Samina believes that being part of the PODE leadership team is crucial for aligning the EDI agenda with strategic priorities, ensuring it does not become viewed as merely a “nice to have”. The Trust’s Chief People Officer has been key to ensuring this happens. The bi-weekly meetings facilitate discussion and collaboration within the context of the broader challenges and available resources. She states, “We aim to not overpromise and underdeliver, but to ensure that whatever we ‘propose or do’ supports the delivery of the Trust’s objectives and priorities. I connect the dots in a way that is helpful and helps others understand their roles.”
There is always room for improvement
NLFT is a learning organisation. As Samina explains, “The speed and pace at which we worked as we transitioned into a new organisation often demanded quick actions, which can mean that the entire organisation may not always have the chance to fully buy in. Therefore, it is essential to constantly learn as we progress. I don’t believe anything is ever a failure; it’s about assessing your starting point and considering how you can continuously improve and adapt.”
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About the author
Shelagh Prosser
Shelagh is an independent consultant with a successful track record of working with public, private and not-for-profit businesses to enhance their performance on diversity and inclusion.
Prior to setting up her company, she held senior diversity posts in the civil service, the BBC and the transport industry.
Her expertise includes strategy and policy development, diversity diagnostics, equality analysis, research and evaluation, and writing best practice guidance.
Shelagh has worked with Brightmine since 2010 and is the author of our leading practice guides on transgender employees, religion and belief, gender and sexual orientation.