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What can we learn from hospitals with staff that reflect the communities they serve?

Mike West, Professor of Organisational Psychology, Lancaster University Management School

17 July 2013

As our joint event with Kick It Out and 7 Bedford Row approaches next week, I’ve been reflecting on a piece of research ( see footnote) I conducted two years ago on how ethnic representatation across teams, boards and organisations affects organisational performance. I was part of a team examining this issue using data from the UK Census and from all NHS hospitals in England.

Our work showed that the ethnic diversity of hospitals did not explain better performance; in fact it tended to be negatively related to performance (in terms of quality of care and use of resources). We probed deeper by examining the extent to which the ethnic diversity of frontline staff matched the ethnic diversity of the communities the hospitals served, using census data. This revealed powerful relationships.

The extent to which frontline staff were representative of their local communities, in terms of ethnic diversity, was related to the performance of the hospitals as evaluated independently by the Care Quality Commission. Representativeness not only predicted quality of patient care but even financial performance of NHS hospitals .

We were able to show also that this was partly due to the fact that patients were treated with higher civility, respect and dignity in contexts where representativeness was high. They were listened to, treated with greater compassion and involved in decisions about their care to a greater extent in hospitals where the ethnicity of frontline staff matched that of the local population or community.

So there is a strong case for promoting representativeness at all levels of organisations. Equally importantly, the research showed we need to encourage all to practise behaving with conscious civility towards all those we encounter in our work, whether from our own ethnic background or not. Civility and respect cost nothing but they make a big difference to the service provided. And that also applies to our interactions with colleagues within our own organisations.

That internal climate for civility has a powerful knock-on effect upon civility towards customers, patients and whoever else our organisations serve. Diversity management is important if we are to create inclusive organisations where people feel their identities are enhanced, their sense of belongingness is deepened and their efficacy is strengthened. Our research provides some powerful insights into ways this can be achieved . Examples include training staff to be civil to all groups andencouraging positive attitudes towards diversity amongst staff. Developing a culture of inclusion, particularly within teams, that values the contribution of all team members was also seen to make a significant difference. I will be expanding on these issues at the 'Embrace Diversity' event next week.

1] King, E., Dawson, J. F., West, M. A., Penny, C., Gilrane, V., & Bastin, L. (2011). Why organizational and community diversity matter: The emergence of incivility and organizational performance. Academy of Management Journal, 54, 1103-1118. 

The event 'Embrace Diversity: Have you recognised the benefits of diversifying your workforce?' will be on 25 July 2013.