This report by NHS Confederation looks at the lived experience of senior black and minority ethnic leaders in the NHS. It is based on the findings of a survey and series of roundtables conducted by the BME Leadership Network in spring 2022, which focused on the challenges BME leaders face in relation to racism and discrimination as they move through their careers.
The report highlights that:
- More than half of surveyed BME NHS leaders considered leaving the health service in the last three years because of their experience of racist treatment while performing their role as an NHS leader. Colleagues, leaders and managers seemed to be a particular source of racist treatment, more so than members of the public. This is concerning, given that the NHS has been prioritising equality, diversity and inclusion activities in recent years. This suggests that more focused efforts are required at every level to reduce the incidence of racist behaviour and to improve awareness among all staff of the impact of this type of discrimination.
- Only 10 per cent of leaders surveyed were confident that the NHS is delivering its commitment to combat institutional racism and reduce health inequalities.
- Senior BME staff reported low levels of confidence in their own organisations’ abilities to manage and support a pipeline of diverse talent and in the ability of the system to achieve this at a national level. Only a minority were confident they could rely on the support of colleagues to challenge racial discrimination, and a smaller minority believed they would be supported by NHS England and NHS Improvement if challenging prejudice or discrimination locally.
- Leaders described how structural and cultural issues within the NHS led to a situation where BME leaders were not present in sufficient numbers to generate a climate of inclusivity and were sometimes siloed in particular types of role. This helped to create a situation where career progression was felt to be unduly challenging and where neither succession planning nor talent development were occurring at sufficient scale to support the next generation of diverse leaders.
- Some leaders reported policing their own behaviour in the workplace and compromising their values in order to fit in. Being able to represent their own cultures and be themselves at work was a critically important goal for many.
The report outlines that it is essential that BME leaders are able to see effective development programmes to support diverse talent, and that they are provided with the right support to feel secure in calling out unacceptable behaviour.
It highlights that the NHS needs to do more to tackle cultures of discriminatory behaviour, provide personal support to current and aspiring leaders, and develop succession planning and talent development schemes.