Nursing and Midwifery professions are attracting increasingly more people of Black and Asian Minority Ethnic (BAME) heritage. There are however significantly fewer BAME staff in senior leadership roles, increased attrition during training, and a high number about to retire from the profession.

NHS Horizons was commissioned to co-design and facilitate a one day Accelerated Design Event to identify the issues and solutions focusing on transforming perceptions of nursing and midwifery.

A Horizons Accelerated Design Event (ADE) is a workshop-style activity designed at achieving three months’ worth of work in just one day. Utilising a range of evidence-based adult developmental learning and Liberating Structures techniques, participants are encouraged to investigate the issues at hand, and co-create solutions and action plans that are meaningful for the individual participants and the organisations in which they work. 

Every ADE is bespoke: the structure and activities for this event were co-produced with a design team of over 30 people, working virtually, including key people recommended by stakeholders and some critical friends. 

This was our agenda for the day:

We started by using transformation cards to recognised and share everyone's individual and collective contribution. Attendees were invited to choose two cards:

1. Looking Back: A card that captured their personal experiences of the past that they were bringing into the room

2. Looking Forward: A card that describes the potential changes for the future.

A key part of an ADE includes understanding the evidence base. For this event we had fantastic speakers who captivated and inspired the audience, influencing their contributions throughout the day:

Paul Vaughan, Head of Nursing Now England, NHS England and Improvement

Click on image below for the full slidedeck


Yvonne Coghill CBE OBE FRCN Director WRES Implementation Team, NHS England and Improvement

Click on image below for the full slidedeck

Graham Woodham, Head of Regulated Workforce, Skills for Care 

Click on image below for the full slidedeck

Kaushika Patel, Project Director: Freedom to Achieve, Interim Pro Vice Chancellor/Dean, De Montfort University

Click on image below for the full slidedeck

Ying Butt, Associate Director of Nursing, Royal College of Nursing & member of Chief Nursing Officer BME Forum

Click on image below for the full slidedeck


After the presentations, attendees were offered time for reflection and an opportunity to build on what they had heard, or have to contribute through table conversations:

A World Cafe

A World Cafe is a fabulous approach for creating a living network of collaborative conversations. The instructions are very straightforward: 

Participants were invited to pick a topic that interested them, visit the designated table and share their views, hopes and ambition with colleagues. After 15 minutes everyone chose a second topic and contributed in the same way, building on the previous groups conversations. Each table has a host (a topic expert) and a writer. The host was responsible for setting out the context for the first group, stimulating conversations and contributions from everyone and offering clarification if needed. In subsequent rounds, the host summarised the previous conversations and encouraged additional contributions too. The writer's role was to capture the conversation, highlighting frequently heard phrases or words

The following topics were explored:

An Unconference

The next activity is an unconference, which is where participants choose a topic they'd like to explore in more detail. There are different methods for choosing the final topics for the unconference; at the BAME event we used 25/10 crowdsourcing. Every participant wrote an idea on a card. While music is played, the cards are passed around - when the music stops, you give a score to the idea on the card you have in your hand. 

The topics with the highest scores were chosen to be taken forward to the Unconference. Participants were able to discuss the issues: why it was important; what the challenges are; what the opportunities are; how progress will be made; and identify one big idea to be taken forward.

There are the big ideas that came out of this Unconference:

Making a commitment:

We use lots of different approaches at the end of our ADEs. At the BAME event Helen Bevanused a new approach called Consequences, based on the traditional parlour game.

Attendees were asked to:

  1. Fold a piece of A4 portrait paper into four different sections
  2. Draw a head on the top section and adding their thoughts on the day.
  3. Pass their paper onto the next person who drew the body and added their thoughts, the third drew the trousers and added their thoughts, and finally the last person drew the feet and added their next steps
  4. By the end of the activity each piece of paper contained three sets of reflections and the next steps from the day’s activities.

The full report is now available and includes Yvonne's Top 10 Tips for Success:

❖ Know who you are and understand the impact you have on others, this is essential for being able to influence people from all backgrounds

❖ Treat people as you would expect to be treated yourself, respect, dignity and civility cost nothing and the rewards for this behaviour to others are great

❖ Have fun and be fun, life is short and needs to be enjoyable as well as hard work, laughing a lot keeps you looking and feeling young.

❖ Have your family and friends around you as much as possible, they sustain and nurture you and enable you to be of your best in the workplace

❖ Be forgiving and do not hold onto old grudges or try to get revenge on your perceived enemies, this takes energy that can best be used delivering on your objectives or your goals

❖ Look after your body you only have one, do not abuse it with too much of anything, food, drink, drugs. Keep it clean and healthy, appreciate and value it

❖ Find ways of really relaxing, walking, music, baking, whatever it takes

❖ Seek to find a role that you absolutely love. If you are passionate about your work, you don’t have to work a day in your life

❖ Be humble and remember those that are less fortunate than you, in the workplace these might be people that are in lower positions than you and in life generally give gratitude and thanks for what you have and acknowledge that some people have less

❖ Share your wisdom and your experiences, help others learn from your experience so they too can be the best that they can be