What gets measured gets done – how can the NHS make the most of the workforce race equality standard?

Leanora Volpe profile picture

17 April 2019

Leanora Volpe
Policy Officer


The recent 2018 workforce race equality standard (WRES) update shows that while improvement has been made, there is still much work to do before the NHS can consider itself a global exemplar in equality and diversity standards.

The data shows that trusts have made progress on race equality in some areas. Black and minority ethnic (BME) staff now make up 19.1% of the NHS workforce, with over 10,000 more BME people working in the service than in 2017. The proportion of BME staff in very senior manager roles has increased from 2017 from 5.7% to 6.9%, and there have been year on year improvements in the likelihood of staff from black and minority ethnic backgrounds being appointed from shortlists relative to white applicants. The number of BME board members is increasing gradually. This all represents a step in the right direction and providers will continue to take equality and diversity seriously to sustain this progress.

A worthy ambition

In spite of improvements, the figures shed light on how far the NHS has to go to fulfil its potential to become a global exemplar of diversity and race equality which - as the 5th largest employer in the world – is surely a worthy ambition. Senior BME representation, for example, is slightly lower than the 8% of directors on private sector FTSE 100 boards: a troubling realisation for the NHS. Additionally, the proportion of BME staff experiencing harassment, bullying or abuse from staff in the last 12 months has increased from 26% to 28% in the past year, and the percentage of BME staff believing that their trust provides equal opportunities for career progression or promotion has decreased from 76% in 2017 to 72% in 2018.

In spite of improvements, the figures shed light on how far the NHS has to go to fulfil its potential to become a global exemplar of diversity and race equality which - as the 5th largest employer in the world – is surely a worthy ambition.

Leanora Volpe    Policy Officer

White applicants are 1.45 times more likely to be appointed from a shortlist than their BME counterparts, and people from BME backgrounds are radically underrepresented at senior manager levels. The latest NHS staff survey results show that of those working in the NHS, 15% have experienced discrimination – compared to just 6.4% of white staff. Just 69% of BME staff say that their organisation acts fairly with regard to career progression regardless of ethnicity, compared to 86% of white staff.

Supporting diversity

If the NHS is to meet the needs of its population, diversity needs to run through its workforce like a stick of rock, from the most senior members of the NHS all the way to porters and healthcare assistants. This includes within NHS arms-length bodies, where BME representation on boards is the same, if not worse, than in the provider sector.

If the NHS is to meet the needs of its population, diversity needs to run through its workforce like a stick of rock, from the most senior members of the NHS all the way to porters and healthcare assistants.

Leanora Volpe    Policy Officer

The case for improving board diversity extends beyond it simply being the right thing to do. Organisations with more BME representation at senior level tend to benefit from a greater variety of perspectives, helping to avoid ‘group think’ and supporting effective decision-making. At the front line it ensures that – in a population where 8 million people have a BME background – patients are more likely to receive care that suits their health, social and cultural needs and preferences. There is evidence that increasing representation of BME staff has a positive effect on staff engagement, and there is a link between diversity and quality of care.

There is evidence that increasing representation of BME staff has a positive effect on staff engagement, and there is a link between diversity and quality of care.

Leanora Volpe    Policy Officer

Not only do we all need to recognise why diversity is important, we must take greater steps towards supporting diversity well. The experience of BME staff is just as important as their presence in the workforce. Unfortunately the NHS staff survey results echo the WRES findings that BME staff still experience more harassment and bullying than white staff, and feel they benefit from fewer opportunities to progress. Trusts are working hard to improve the experience of BME staff, with many implementing robust staff engagement programmes and forums to ensure their voices are heard and changes are made where needed, and ‘reverse mentoring’ schemes to improve senior managers’ understanding of staff experiences on the front line.

We welcome the national WRES team’s work with NHS Improvement focusing on tools and interventions to improve workplace culture across the NHS. This should help build on local efforts in this area, and provide the additional support trusts need in the context of severe staff shortages and threats to the provider leadership pipeline.

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Leanora Volpe profile picture

Leanora Volpe
Policy Officer

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