As part of the London Mayor’s Design Lab on Workforce Integration we have collaborated with leaders and innovators in HR and policy. It has been inspirational, meeting pioneers such as Andrea Williams-McKenzie, Deputy Chief People Officer at Guy’s and St. Thomas’s Hospital Trust (GSTT) and Design Lab member. Andrea is at the heart of transforming workforce and community integration at GSTT, the very same hospital where her mother worked as a cleaner three decades ago. Read on to find out more about her remarkable journey and insights on redressing inequalities in the health sector and beyond.
“If EDI and 'race' isn't at the heart of what we do, then we miss the creativity, the intelligence, the insights to create new solutions and deliver great care."
The journey so far
Where you start, is not where you have to finish. For anyone of Jamaican heritage in 1960's Britain, life wasn't easy. But Andrea Williams-McKenzie had something invaluable on her side: the love and support of her family. Growing up in Brixton, she was the middle of three children born to parents from the 1st generation Windrush. Andrea's parents instilled self-belief in her and her siblings, that they could be anything they wanted to be. Circumstances did not define who they were. At the same time, her parents gave their children a strong sense of their history, and to be proud of where they came from.
After leaving school, Andrea took a gap year - an unusual choice for a young person to make at that time and an indication of that she had her own mind. She took a junior personnel role at the London Fire Brigade, as part of a Positive Action Programme for young Black African and Minority Ethnic employees to build a career in HR. Enjoying it so much, she decided not to go to university, in favour of working for the Fire Brigade while studying for CIPD qualifications. Her path as a reformer was about to begin.
Seize the opportunity
Being ambitious and wanting to make an impact, Andrea took voluntary redundancy in order to pursue a new role at Ujima Housing Association where she saw a chance to redress the balance in housing for marginalised communities, particularly black, single homeless people. During her 12 years there, she oversaw a total culture change and developed a robust strategy for delivering housing to the mostly Black and Asian community.
Other pioneering roles followed, including building relationships between the prisons and trade unions at Highdown Prison; creating a new Human Resources operation across schools in Kingston; delivering a first-of-its-kind people agenda at the Home Office; changing how the Courts and Tribunal Services worked operationally from being an entirely paper-based organisation to digitisation; diversifying recruitment into senior management at HMRC, and leading strategy towards inclusive workforce integration at one of London's most celebrated hospitals.
Prioritise family & community
What makes Andrea an inspiring role model is not just her track record in the workplace, but her commitment to family and close community. At a key career moment, when she was being headhunted regularly, her son was finding schoolwork difficult. It is well documented that boys of Black African and Caribbean heritage are not sufficiently nurtured by the UK school system, and that impacts their academic performance. Observing that he studied better when she was home from work early, she took the bold decision to pause her career to support her son through his education. Andrea's journey has now come full circle, in her own words, 'working at Guy's and St.Thomas' Hospital is like coming home, because my mother used to work here as a cleaner when I was growing up.'
What now for the NHS and EDI?
From her experiences at Guys and St Thomas’s Trust, Andrea sees thinking creatively about Equity, Diversity & Inclusion (EDI) as crucial. "It's a really challenging time in healthcare and we need to think creatively about repurposing jobs. We have to influence higher education institutes to provide the training needed for the next generation to deliver society's needs”. We are living in an environment that is constantly changing. And this change is going to accelerate for several reasons: the state of the economy, technical innovation, and global influences. “We've seen that when you decouple EDI from healthcare, it causes health disparities. If EDI and 'race' are not at the heart of what we do, then we miss the creativity, the intelligence, the insights to create new solutions and deliver great care."
Andrea considers good data is key in healthcare and will continue to be. We need to gather it and keep joining the dots to inform decisions and policy. "At GSTT, we are introducing a new electronic patient record system called Epic, which allows all patient information to be held in one place. It can keep track of comprehensive data such as the ethnicity… we will have a wealth of information and clearer insights about health disparities." Distilling the right data can help us focus on areas that can make the most impact, such as diabetes, cholesterol, and childbirth, where for a Black woman the experience can be very different to a white woman's experience.
An equity mindset at the top
"When it comes to equity, the only organisations who have achieved some success did so because their Chief Executive actively initiated a change in representation at senior level” say Andrea. “You have to walk the talk and be open to change the in the workforce”. Andrea is concerned not enough of the NHS’s senior leaders are ambitious in that way. They need an equity mindset, to create a psychologically safe environment for all. “If someone isn't working in a safe enough environment to dare speak up, they will never be the best they can be” believes Andrea. That won’t foster a safe and innovative heath care system. Driving a change in representation from the top would help to get better health outcomes and practices for all. "When people hear positive action, they think of positive discrimination. However, they are two different things; positive action is equity in practice! …you're addressing the disadvantages that certain people in society face."
Andrea also wishes more senior leaders understood the value sponsorship as a change accelerator. “It is different from mentoring…in my case, sponsorship definitely supported my development…..the few positive action programmes out there target the junior roles, but what we really need to do is invest in positive action programmes aimed at the middle and senior management levels. This is where we are missing a trick. You don't accelerate change by continuing doing what you've been doing, you have to do something different."
Advice to my younger self
“Don't think you can do it all’. Realistically, you must understand where you need to compromise, and know where your limits are, advises Andrea. “Make sure you only work for organisations that make you feel passionate about what you're trying to do. Be clear about what drives you and what your authentic values are. For Andrea that is focussing on improving the situation for the disadvantaged which has always driven her career choices and been a golden thread running through them all.
What are you hoping for from the Design Lab Programme?
I'd like to see the Design Lab accelerate the work on integration. And answer key questions, like 'how can we innovate the recruitment process to attract a diverse pool of applications at a senior level?' My aspiration is that our senior leaders don't just buy into this intellectually. I want to see them have an emotional connection to making this happen, and an understanding of the complexities.
And finally, a message from Andrea to anyone considering the Design Lab: “Sign up! It's an opportunity of a lifetime for your organisation to be involved in the Design Lab. The GLA's decision to fund this work shows their commitment to equity and how we need to be impatient with ourselves... We've got to put all our energy behind it if we're going to make a difference. If we do, then I think we will make that difference.”
Live discussion on new ideas for a modern workforce
The Design Lab have a Symposium, on Wednesday 6 March 09:15-12:30. Register here to listen for free and discover how other major employers are innovating to improve diversity and integration in their workplaces.
If you or your organisation wants to find out more about the Design Lab, click here. And to find out more about our Equity by Design work click here.
This article was first published on 20th December 2023, and has been updated on 27th February 2024