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Nearly 100 trusts have no ‘very senior managers’ (VSM) who are declared to be from a black, Asian or minority ethnic background, HSJ analysis has revealed. According to data obtained from every NHS provider in England, 96 out of 214 (45%) did not have any VSMs declared as being from a BAME background. This includes several large providers, such as The Newcastle upon Tyne Hospitals Foundation Trust — where around 9 per cent of the workforce and 15 per cent of the city’s population are BAME — and Liverpool University Hospitals FT. Jon Restell, chief executive of the Managers in Partnership trade union, said the underrepresentation of BAME staff in leadership positions has “dangerously damaged” the NHS’ response to coronavirus, labelling it the “ultimate wake-up call”. Read full story (paywalled) Source: HSJ, 30 November 2020

Minority ethnic people in UK were ‘overexposed, under protected, stigmatised and overlooked’, new review finds. Structural racism led to the disproportionate impact of the coronavirus pandemic on black, Asian and minority ethnic (BAME) communities, a review by Doreen Lawrence has concluded. The report, commissioned by Labour, contradicts the government’s adviser on ethnicity, Dr Raghib Ali, who last week dismissed claims that inequalities within government, health, employment and the education system help to explain why COVID-19 killed disproportionately more people from minority ethnic communities. Lady Lawrence’s review found BAME people are over-represented in public-facing industries where they cannot work from home, are more likely to live in overcrowded housing and have been put at risk by the government’s alleged failure to facilitate Covid-secure workplaces. She demanded that the government set out an urgent winter plan to tackle the disproportionate impact of Covid on BAME people and ensure comprehensive ethnicity data is collected across the NHS and social care. The report, entitled An Avoidable Crisis, also criticises politicians for demonising minorities, such as when Donald Trump used the phrase “the Chinese virus”. The report, which is based on submissions and conversations over Zoom featuring “heart-wrenching stories” as well as quantitative data, issued the following 20 recommendations: Set out an urgent plan for tackling the disproportionate impact of Covid on ethnic minorities Implement a national strategy to tackle health inequalities Suspend ‘no recourse to public funds’ during Covid Conduct a review of the impact of NRPF on public health and health inequalities Ensure Covid-19 cases from the workplace are properly recorded Strengthen Covid-19 risk assessments Improve access to PPE in all high-risk workplaces Give targeted support to people who are struggling to self-isolate Ensure protection and an end to discrimination for renters Raise the local housing allowance and address the root causes of homelessness Urgently conduct equality impact assessments on the government’s Covid support schemes Plan to prevent the stigmatisation of communities during Covid-19 Urgently legislate to tackle online harms Collect and publish better ethnicity data Implement a race equality strategy Ensure all policies and programmes help tackle structural inequality Introduce mandatory ethnicity pay gap reporting End the ‘hostile environment’ Reform the curriculum Take action to close the attainment gap Read full story Source: The Guardian, 28 October 2020

One of the earliest signs that black, Asian and minority ethnic (BAME) people were being disproportionately harmed by the coronavirus pandemic came when the Intensive Care National Audit and Research Centre (ICNAR) published research in early April showing that 35% of almost 2,000 Covid patients in intensive care units in England, Wales and Northern Ireland were non-white. A lot has happened in the intervening six months with numerous reports, including by the Office for National Statistics and Public Health England (PHE), confirming the increased risk to ethnic minorities and recommendations published on how to mitigate that risk. However, as the second wave intensifies, the demographics of those most seriously affected remain remarkably similar. ICNARC figures show that the non-white proportion of the 10,877 Covid patients admitted to intensive care up to 31 August was 33.9% in England, Wales and Northern Ireland. This rises to 38.3% of patients admitted since 1 September, albeit of a much smaller cohort (527 intensive care admissions). The government mantra “we’re all in this together” proved to be little more than an empty rallying cry early in the pandemic and the ICNARC figures show it remains the case that people in the most deprived socioeconomic groups make up a greater proportion of patients in critical care. Read full story Source: The Guardian, 9 October 2020

NHS leaders are being encouraged to have ‘difficult discussions’ about inequalities, after a trust found its BAME staff reported being ‘systematically… bullied and harassed’, along with other signs of discrimination. A report published by Newcastle Hospitals Foundation Trust found the trust’s black, Asian and minority ethnic staff are more likely than white staff to be bullied or harassed by colleagues, less likely to reach top jobs, and experience higher rates of discrimination from managers. It claims to be the first in-depth review into pay gaps and career progression among BAME workforce at a single trust. The new report revealed that, in a trust survey carried out last year, some BAME staff described being subjected to verbal abuse and racial slurs by colleagues; had left departments after being given no chance of progression; and been “systematically… bullied and harassed”. Read full story (paywalled) Source: HSJ, 22 September 2020

A third of coronavirus patients in intensive care are from black, Asian and minority ethnic backgrounds, prompting the head of the British Medical Association to warn that government inaction will be responsible for further disproportionate deaths. Chaand Nagpaul, the BMA Council chair, was the first public figure to call for an inquiry into whether and why there was a disparity between BAME and white people in Britain in terms of how they were being affected by the pandemic, in April. Subsequent studies, including a Public Health England (PHE) analysis in early June, confirmed people of certain ethnicities were at greater risk but Nagpaul said no remedial action had been taken by the government. Nagpaul told the Guardian: “We are continuing to see BAME people suffering disproportionately in terms of intensive care admissions so not acting means that we’re not protecting our vulnerable communities. Action was needed back in July and it’s certainly needed now more than ever. “As the infection rate rises, there’s no reason to believe that the BAME population will not suffer again because no action has been taken to protect them. They are still at higher risk of serious ill health and dying.” Read full story Source: The Guardian, 20 September 2020

A clinical commissioning group (CCG) has ordered an independent review of its culture which it said was prompted by the “injustices experienced by black Asian and minority ethic colleagues” during the pandemic, HSJ has learned. The review at Surrey Heartlands CCG, due to report in the autumn, is being led by Duncan Lewis, emeritus professor of management at Plymouth University. He has led several major reviews into culture at NHS organisations, including one into bullying and harassment at South East Coast Ambulance Service Foundation Trust in 2017 and one into workplace culture at Whittington Health Trust in 2018. HSJ asked the CCG for the terms of reference of the review and the reasons why it felt it necessary to commission such an inquiry. It said the review’s scope would be determined by what staff felt was important regarding “our organisational culture, policy and practice – things we do well and things we need to improve”. It added in a statement: “We will listen to the findings of the review and we will make any changes that are necessary.” It is not yet clear if specific events within the organisation itself prompted the CCG to take the unusual step of commissioning the work. But the commissioner’s interim chief did say “feedback from staff” had been a driver. Read full story (paywalled) Source: HSJ, 26 August 2020

A healthy population is one of any nation’s most important assets. We have known for a long time that not everyone has the same opportunity to access the things they need to lead a healthy life, such as good quality work and safe secure stable housing. Now we can see that the COVID-19 pandemic is replicating and exacerbating deep-rooted health inequalities. Without concerted action, this health crisis will also become a health inequalities crisis. The COVID-19 pandemic has brought health inequalities into sharp focus. While every part of the population has been affected by the current crisis, some communities have been hit much harder both by the virus itself and by the measures taken to control its spread. Evidence is starting to emerge, for example, of the unequal impact of the shutdown of the economy. For example a recent survey of UK households found that the lowest earners have been worst hit by loss of earnings, with the most severe losses for single parents. The uneven impact of COVID-19 has also highlighted the inequalities faced by Black, Asian and minority ethnic communities. Recent data shows that some ethnic groups are at much higher risk of dying from COVID-19 than the rest of the population (e.g. Black men are four times more likely to have died of COVID-19 than their White peers). Read full article here.

More than one in five GP partners said they removed practice staff away from face-to-face care due to ethnicity during the pandemic, a Pulse survey has revealed. The survey in June revealed that 84 of the 378 respondents said that ‘ethnicity was a crucial factor in removing anyone in your practice away from face-to-face assessments’. Around 70% of respondents said they had been counting ethnicity as a factor when risk assessing staff. See full article here