Racism is an overlooked challenge to UK healthcare services

As of 2021, even it was not fully acknowledged; for example, the Commission on Race and Ethnic Disparities report concluded that institutional and structural racism is no longer an issue for Britain. Yet, the Covid-19 pandemic has exposed and further exacerbated racial inequities at all levels. Amid the pandemic, adding injury to insult has been the killing of George Floyd, magnified racism further by social unrest in response to the murder.

The Workforce Race Equality Standard (WRES) report (2022) shows that 22.4% of staff working in NHS trusts in England are from black and ethnic minority backgrounds. However, racism, discrimination, harassment, exclusion, bullying, and other incivilities remain pervasive challenges for the staff from black and ethnic minorities. Since 2015, NHS trusts have been required to report activity and progress around key indicators in standards on race and disability. The WRES report shows some progress, for instance, in appointing senior managers from black and minority ethnic groups. On the other hand, bullying, harassment, exclusion, and unfair scrutiny experienced by staff from ethnic minority backgrounds have increased.

The WRES report confirms the findings of our study, “nursing narratives: racism and the pandemic”, where hundreds of ethnic minority participants working in frontline health and social care roles shared shocking stories of racism at work. The project aimed to explore and understand the stories and experiences of healthcare staff from ethnic minority backgrounds during the pandemic and in their working lives.

We conducted a questionnaire survey and qualitative interviews with nurses, midwives, and other healthcare staff. Three hundred-eight respondents completed an online survey, and 45 people participated in the narrative interviews.

Our findings report that racism is prevalent in the health and social care sector and is usually unreported. It impacts ethnic minorities and migrant staff working in NHS at all levels. In the case of reporting to the author that 77.3% of respondents who complained about racism said they were not treated fairly. Incidents of racism were not individual and isolated; it was a culture that permeated daily practice. Our survey findings revealed that 59% of the survey respondents had experienced racism during their working lives, making it difficult to do their job; thus, 36% had left a job.

The study highlighted the greater risks and exposure to the harm of staff from ethnic minority groups during the pandemic, i.e., 52.6% of the participants experienced unfair treatment in the pandemic concerning either Covid deployment, PPE, or risk assessment provision.

Our research underscores that the endemic culture of racism is a persistent challenge to the UK’s health and social care sectors; thus, it must be recognised and called out. It is time for critical scrutiny of the status quo concerning inclusion, diversity, and equity measures in the NHS workforce.