Minority ethnic health leaders express disappointment over inequalities in NHS

Minority ethnic health leaders have told the head of the NHS they feel a “deep sense of disappointment” over inequalities within the health service.

The Chairs and Chief Executives Ethnic Minority Network has urged NHS England chief executive Sir Simon Stevens to ensure leaders of integrated care systems (ICSs) are representative of the communities they lead and serve.

In a letter, reported by the Health Service Journal (HSJ), they welcome measures such as the Government’s recently published white paper, which includes proposals to bring the NHS and local government together legally through ICSs and tackle health inequalities.

But they write that they also feel a “deep sense of disappointment”, adding: “If the NHS is going to deliver its newly stated aim, there will need to be recognition of and focus on all root causes of inequality, not simply the ones we feel comfortable to address.

“How can the NHS possibly deliver its ambition to reduce health inequalities across ethnic minority communities if the organisation itself fails to deliver equality internally for the people it employs?

“If NHS staff are to truly understand the communities they serve, understand their lived experience and how this in turn affects their life chances and health outcomes, they must first work within organisations that are not only diverse, but where diversity is welcomed, the benefits understood and there is strong evidence of equality, belonging and psychological safety.”

The letter, signed by co-chairs Raj Jain and Patricia Miller, chief executives of Salford Royal Foundation Trust and Dorset County Hospital Foundation Trust respectively, notes inequalities in the general population and NHS workforce.

They cite a report from the Joint Committee on Human Rights, which found that more than 60% of black people in the UK do not believe their health is as equally protected by the NHS compared to white people.

They also note that just eight out of 231 NHS Trusts and Foundation Trusts in the NHS in England are led by ethnic minority chief executives.

The 2020 NHS staff survey found that black and minority ethnic staff in England reported experiencing discrimination and were less likely to feel their organisation provides equal opportunities compared with white employees.

This survey, and a recent Workforce Race Equality Standard report, provide evidence that “very little progress” has been made to create positive inclusive cultures over the past two decades, the group writes.

They recommend that executive officers as well as non-executive leaders of ICSs must be representative of their communities, noting the benefits of diversity of leadership.

They also say every ICS must develop a 10-year strategy with annual milestones for reducing inequalities, and that directors should demonstrate their actions in tackling racism.

The deputy chief executive of NHS Providers, Saffron Cordery, said “there is still a long way to go” on race equality within the NHS.

She said the membership organisation for NHS services “fully” supports the proposals raised, adding: “Covid-19 has only reinforced the need to understand better the structural inequalities at play in the NHS and to make action on equality, diversity and inclusion a top priority.

“Leaders in every part of the system must be held fully to account for how they are tackling racism and other inequalities in their organisations and in the services they deliver across their communities.”

An NHS spokesperson said: “Chairs and chief executives of trusts such as Dorset and Salford are right to want further steps towards closing the gaps in the experience, opportunities, and outcomes between their minority ethnic and white staff, and since the introduction of the workforce race equality standard in 2015, more staff from minority ethnic background are in senior roles than ever before.

“We will also continue to support and challenge trusts and ICSs to take positive action to reduce health inequalities in the communities they serve.”