Does Appraiser Diversity Reflect Those They Serve?

AUTHOR and Collaborators: DR NKOLIKA ANYABOLU, Dr Susi Caesar, Jools Mumford, Gill Watson.

Presentation Video:  https://www.youtube.com/watch?v=8JtT4ysKnYk

ABSTRACT:

This is research addressing questions about protected characteristics with honesty and transparency. The aim was to produce an equality and diversity factsheet that would help to inform Wessex Appraisal Services. We know that the healthcare profession tends to attract diversity, and the findings from this research show doctors in Dorset and Hampshire are more ethnically diverse (23%) compared to the population (4.4%) as well as Nationally (13%). We hope that through these results, doctors would be able to recognise they have shared characteristics, thus they are not alone.

BACKGROUND:

The Health Education England Wessex Appraisal Service (WAS) provides appraisals to c.3000 appraisees, through c.200 appraisers.

• The service provides appraisal to GPs in Dorset and Hampshire.¹
• Dorset has much lower levels (4.4%) of ethnically diverse residents than the country as a whole (13%).²
• Though Hampshire is largely white British county with 89.0% of its inhabitants described as White British, there is a growing diversity of its population.³
• No study has been done to date exploring the diversity of WAS appraisers and appraisees.

METHODS:

Both qualitative and quantitative research methods were used in the form of internet research, and online surveys. This mixed methodology reflects the complexity of understanding diversity and asking about differences in a sensitive and culturally appropriate way.

• A demographic survey was designed using questions modelled on the National Census and GMC Data Explorer.4 This was to help provide a benchmark for result comparison.
• The survey was sent out via email to 2,400 doctors registered with NHS England South East (Hampshire & Isle of Wight) and South West (Dorset).
• Data was collected from 8th June 2021 to 22nd Sept 2021.

RESULTS:

• There were 604 respondents: 
  • 85% Appraisees and 15% Appraisers.
• Characteristics of respondents:
  • Appraisers (68% Female, 32% Male)
  • Appraisees (63% Female, 37% Male)
  • 11% of Appraisers and 8% of Appraisees identified with a different sex from that registered at birth
  • 2% of respondents identified as Gay/Lesbian, and 1% identified as Bisexual
• Ethnicity:
  • 83% of Appraisers are White, and 17% belong to a Black, Asian, Mixed or Other ethnic group.
  • This is in contrast to Appraisees, who were 77% White and 23% of Black, Asian, Mixed or Other ethnicity.
• Primary Medical Qualification:
  • 88% United Kingdom, 4% European Economic Area, and 8% International Medical Graduate.
• Languages spoken:
  • English, Welsh, French, Spanish, German, Urdu, Italian, Hindi, Gujarati, Dutch, Portuguese, Punjabi, Croatian, Greek, Bengali, Bhojpuri, Arabic, Latin, Kannada, Malay, Afrikaans, Polish, Hausa, Yoruba, Igbo, Tongan, Russian, Chinese, Japanese, Cantonese, Sinhalese, Romanian and Shona.
• Disabilities:
  • 5% of respondents had a disability including Hearing loss, Dyslexia, Spastic Paraparesis and Dyspraxia.
• Additional Roles:
  • GP Trainer, Lifeboat Medical Advisor, QI Lead, Clinical Director, Life Coach, Clinical Supervisor, Prescribing lead, Missionary, Medical Director and Judicial Role.

DISCUSSION:

• A very large proportion of doctors in Dorset and Hampshire obtained their Primary Medical Qualification (PMQ) in the UK (88%), compared to the GMC data, which shows 60% of doctors on the register obtained their PMQ in the UK4.
• This research shows an understanding of the importance of recognising and respecting differences while appreciating different perspectives and the valuable benefits a diverse workforce can bring to the organisation, which is fundamental to its growth and success. Thus it will allow the Wessex Appraisal Service to consider how their activities as employers affect their staff with different protected characteristics.

CONCLUSIONS

• Doctors in Dorset and Hampshire are more ethnically diverse (23%) compared to the population (4.4%) and Nationally (13%)
• Not asking about diversity can help perpetuate discrimination
• Through this research, we have identified and would make recommendations aimed at, improving support for doctors of diverse backgrounds in aspiring to leadership, management and teaching roles
• Having an understanding of the diversity of Appraisers and Appraisees will also help to ensure steps are taken to provide an inclusive and supportive programme for doctors receiving appraisal from the Wessex Appraisal Service
• This research shows compliance with the Equality Act 2010, which provides a modern, single legal framework with clear law to protect the rights of individuals and advance equality of opportunity for all.

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