The proportion of ethnic minority workers in NHS England is rising, but are still severely underrepresented in leadership and are more likely to experience discrimination or abuse from the public.
According to the NHS Workforce Race Equality Standard (WRES) for 2023, more than a quarter (26.4%) of staff in NHS England trusts recorded their ethnicity as black or minority ethnic (BME), but only 15.6% of board members did the same.
In every region there was a lower percentage of board members compared to the overall percentage of BME staff in the workforce, but the disparity was particularly acute in London where around half of the workforce is BME.
NHS England diversity
NHS England staff facing record levels of discrimination
Ethnic minority representation at very senior manager pay bands has risen by more than half (61.7%) since 2018, from 201 to 325 in 2023 – the highest number on record, the NHS said. Ethnic minority representation at executive board level was 11%, up from 9% in 2021.
At 76% of NHS trusts, white applicants were significantly more likely than BME applicants to be appointed from shortlisting, an increase from 71% last year. White shortlisted candidates were 1.59 times more likely to be appointed than ethnic minority applicants.
In 2022, at 81% of NHS trusts, a higher proportion of BME staff compared to white staff experienced harassment, bullying or abuse from patients, relatives or the public, up from 71% in 2021.
The recent NHS staff survey showed employees were experiencing record levels of discrimination.
The health service also published its Workforce Disability Equality Standard (WDES) report, which shows disability declaration rates by NHS staff significantly improved in 2023, up by 19.9% on the previous year. Some 4.9% of the workforce declared a disability, an increase of 0.7 percentage points since 2022.
Disabled representation on NHS boards increased to 5.7% in 2023, up from 1.1% in 2022.
Disabled and non-disabled applicants are equally likely to be recruited to the NHS, however only 52.1% of disabled staff believed they had equal opportunities for career progression or promotion and 73.1% felt their employer made adequate adjustments to allow them to carry out their job.
Dr Navina Evans, NHS England chief workforce officer, said: “There are some positive improvements in this year’s WRES and WDES data, including a higher number of people in senior positions in the NHS being filled by people of ethnic minority backgrounds and disabled colleagues.
“But we know there is more to do, and with the NHS workforce more diverse than at any point in its history progress is particularly critical. That is why the NHS’ equality, diversity and inclusion improvement plan sets out targeted actions to address prejudice and discrimination in the workplace, including making sure every NHS board and chief executive has a measurable objective to improve the experience of staff.”
However, Helga Pile, head of health at the Unison union, said progress has been far too slow, especially when it comes to ensuring black health workers are not held back.
“They are much more likely to be disciplined and face harassment and bullying from patients and colleagues. This has to stop,” she said.
“In addition, a quarter of the NHS workforce either has a disability or a long-term condition that affects them in some way. The NHS is getting better at removing barriers that prevent people from working for it, but the pace of progress has to increase.
“The culture of NHS organisations must change and funding found to make that happen.”
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Health and social care secretary Victoria Atkins, said: “I want to see the NHS recruit and retain brilliant people from all backgrounds. It is important that the NHS at all levels represents the people it cares for, and I welcome progress in appointing more black and minority ethnic staff to senior positions and better representation of disabled people in the NHS workforce.”
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