Ethnic diversity in top NHS England jobs is at its highest than any point in history, but staff from diverse backgrounds continue to be underrepresented across all levels and face bullying, harassment and discrimination.
NHS England’s workforce race equality standard (WRES) report shows that the number of black and ethnic minority staff at very senior manager level has almost doubled between 2020 to 2021 – up from 153 to 298 – and record levels of ethnic diversity across the organisation, with more than 300,000 staff from a black or minority ethnic background in 2021 (22.4%, up from 18% in 2017).
However, ethnic minority groups remain underrepresented in board executive positions, where they occupy 12.6% of roles (10% in 2020).
The WRES requires NHS trusts and groups of GP surgeries that carry out NHS services to self-assess against nine
indicators of workplace experience and opportunity. Four indicators relate specifically to workforce data, four are based on data from the NHS staff survey, and one considers ethnic representation on boards.
Equality, diversity and inclusion
White applicants were 1.61 times more likely to be appointed after being shortlisted for a role than ethnic minority applicants, and ethnic minority staff were 1.14 times more likely to enter the formal disciplinary process than white staff. These figures reflect little change from 2020.
Bullying and harassment of ethnic minority staff is also rife, and was experienced by 36.2% of staff from “other” Asian backgrounds (other than Bangladeshi, Chinese, Indian and Pakistani staff), and 35.3% of those from “other” black backgrounds (other than African and Caribbean).
Asked whether they had personally experienced discrimination from a manager, team leader or colleagues, 16.7% of ethnic minority staff say they had – the highest level since 2015.
Professor Anton Emmanuel, head of Workforce Race Equality Standard at NHS England, said: “The last two years have been the most challenging in NHS history and it is fantastic that increasing number of BME people have been inspired to join one of the most rewarding careers and that BME representation in senior positions has never been higher.
“There remains a lot of work to do change the experience of black and ethnic minority staff, but it is clear that when monitoring targets are set and evidence-based actions pursued, it is possible to shift staff experience, and the challenge now is to ensure this happens across the whole of the NHS”.
Em Wilkinson-Brice, acting chief people officer, said the NHS had made progress on ensuring equity at work, but noted, “there is much more work to be done… NHS England is continuing to take action to improve diversity within the health service including through trialling inclusive recruitment programmes and continuing to rollout diverse staff networks”.
The health service said it was working to ensure staff felt they had the freedom to speak up about harassment, bullying and abuse, while leaders were working with regional teams to set targets to improve representation in senior roles.
The gulf between the rhetoric of NHS leaders and the reality of services in racialised communities and the lived experiences of our staff from those communities is fuelling disillusion.” – Joan Saddler, NHS Confederation
Joan Saddler OBE, director of partnerships and equality at the NHS Confederation, said the report showed a disconnect between the commitments made and actions taken to ensuring race equality within the NHS.
“The gulf between the rhetoric of NHS leaders and the reality of services in racialised communities and the lived experiences of our staff from those communities is fuelling disillusion,” she said.
“Sadly, this year’s data again shows BME staff are still underrepresented at all levels, especially on boards, and the levels of bullying and abuse directed at BME staff remains stubbornly high from both patients and other staff. This is totally unacceptable and cannot continue to be the lived experience of NHS staff in the 21st century.
“This report is honest in highlighting the systemic barriers to achieving race equality that still exist across the NHS. Concerted action rather than warm words is needed and if these numbers remain static or worse still decline it is BME staff who will continue to bear the brunt of inaction.”
Saddler added that NHS England and Improvement should publish the race equality strategy for the health service “with more focus on changing the power relationships that determine the distribution of NHS jobs services and resources”.