An independent appraisal of the NHS Workforce Race Equality Standard

Think tank: Civitas

Author(s): Dr Richard Norrie

December 14, 2021

This report from UK think tank Civitas examines the NHS Workforce Race Equality Standard and calls for it to be “wound up”.

The NHS seeks to monitor and control diversity and equality through a programme known as the Workforce Race Equality Standard (WRES) – it is based on a series of statistical indicators pertaining to outcomes between white and non-white minority groups. However, as the Director of the Statistics and Policy Research Programme at Civitas, Richard Norrie, argues, closer inspection of those indicators reveals ‘they do not withstand methodological scrutiny’. In its methodological critique, the paper identifies several concerns, leading the author to conclude that the NHS WRES ‘is a failure’:

  • ‘…the current flawed approach leads the focus away from trusts where there are massive gulfs’ while ‘focusing attention on trusts where there are minor differences’.
  • ‘There is a wider objection, one that can be made to all WRES indicators, in that by focusing on “BME” alone, it obscures differences between minority groups.’
  • It finds that some of the data are ‘subjective’ – the problem being ‘Perception is not everything, so it should not be taken as gospel, which, unfortunately, is the approach of WRES.’
  • ‘Judging from the metrics chosen, the WRES designers believe “equality” will have been reached when there is equality of outcome for white and non-white groups.’ There is, however, in Norrie’s view, ‘a compelling argument for why this is an unreasonable expectation…’.
  • ‘It is a categorical error to assume the cause of any given statistical disparity is necessarily to be found in the place where the statistics are collected, yet this is the assumption behind WRES.’
  • ‘This analysis has revealed that WRES indicators are poorly conceived, mathematically flawed, and have little validity in the sense that they do not all measure the same intended thing – “race equality”.’
  • ‘The programme is subsequently lauded publicly, winning an award for excellence. The great and the good wish to be associated with this programme, only it is demonstrably flawed.’

In any case, there is little evidence of improvement on the 9 indicators, despite the NHS’ efforts to put a positive spin on it. It is therefore recommended in the report that government act to ‘Wind up the WRES programme’. Richard Norrie proceeds to argue that government conduct a review into ‘the suitability of existing discrimination complaints procedures, ensuring they are fit for purpose, including the extent to which charges of discrimination are used simply as bargaining tools in litigation’. The implication of the research into the WRES scheme, in Richard Norrie’s view, is that ‘the NHS creates a rod for its own back, while misdirecting resources and talent away from where they are best needed and served.’ ‘WRES is the creation of a cohort of ideologically-minded individuals who benefit from the programme, while the costs are left to patients and the taxpayer. Ultimately, this means money is wasted and not spent on improving health.’ The author also argues for a wider review of the Equality Act 2010, since the NHS feels obliged to enact this programme under the ‘Public Sector Equality Duty’ of the Equality Act. The author is concerned that ‘If this is being fuelled by legislation, notably the Public Sector Equality Duty, then that should be reformed, particularly to remove the sections that necessitate the publication of data.’ Richard Norrie adds, ‘It may require scrapping, since all that is required is a legal commitment to equality of opportunity and the means to enforce it; these exist elsewhere in legislation.’