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Exclusive: Concern over race bias on nurse leadership course

Just 4% of recruits to a nursing leadership course set up at the request of the prime minister are from a non-white background, Nursing Times has learnt.

Last year David Cameron announced £46m to help 10,000 nurses and midwives develop their leadership skills in a bid to address care quality concerns. About 1,200 nurses and midwives will go through a bespoke course designed by the NHS Leadership Academy, while thousands of others will go through the academy’s existing courses.

However, academy data shows 94% of the first 315 recruits to the bespoke course were white with a British or Irish background. A further 2% were white but from other backgrounds.

Of the 4% from black and minority ethnic backgrounds, just over 2% were black, around 1% were Asian and fewer than 1% were from a mixed background. This is despite Nursing and Midwifery Council data suggesting about 20% of registrants are from a non-white background.

Lynette Phillips, a member of the chief nursing officer’s BME forum, told Nursing Times she was “disappointed” but not surprised by the figures. She said it was “very important” because nurses and midwives who had been through these programmes would have an advantage when applying for leadership positions.

“If BME nurses do not get onto these programmes then the likelihood of changing the status quo and making leadership at all levels more diverse is less,” she said.

Places are allocated through the academy’s 10 regional delivery partners that work with local providers to nominate staff for the courses. Carol Baxter, head of equality, diversity and human rights at NHS Employers, said it was “absolutely clear that bias, unconscious or otherwise” still occurs in the NHS.

Unconscious bias is a phenomenon identified by psychologists where individuals tend to favour people who look more like them.

For example, a study published in the International Journal of Nursing Studies last year looked at the prospects of more than 1,000 newly qualified nurses from eight London universities. It found the odds of receiving an offer of employment by the time of qualification were lower for all the minority ethnic groups studied than for white British nurses.

Professor Baxter added: “The NHS must have zero tolerance for discrimination when tackling these problems.”

The academy, which shared the data with Nursing Times on request, acknowledged there had been a “hiccup” with the first recruits to the course.

The organisation was created as part of the government’s NHS reforms and took over responsibility for a number of existing leadership courses when it formally started work in April.

Yvonne Coghill, the academy’s senior programme lead for inclusion, told Nursing Times she had been working hard to raise awareness of training opportunities and was confident future cohorts would be more representative.

“Bearing in mind we only started in April we are really getting our act together. There was a hiccup in BME recruits… It’s across the board that there’s this issue. This is an NHS issue,” she said.

Dave Ashton, head of practice at the academy, told Nursing Times under-representation on the new nursing and midwifery programme was, in part, due to the time pressure of getting the first cohorts onto the course as soon as possible following the prime minister’s announcement last October.

He said he was personally “determined” to address issues of under-representation and said established courses were far more

representative: 22% of recruits to the Edward Jenner course were from a non-white background, as were 20% on the Elizabeth Garratt Anderson programme and 26% on the Mary Seacole course.

Dr Ashton said ensuring staff from diverse backgrounds were put forward for courses was part of the academy’s service level agreements with local delivery partners.

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Readers' comments (38)

  • Nursing Times is obsessed with BME nurses: yet another non-story!

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  • Bias is bias which ever way it is couched, just because there were a low number of applicants from certain racial groups does not mean there was a bias. Certainly positive discrimination is not the answer as it is an open bias which is equally wrong. If one were to take this logic to the extreme, would this group deem the white heterosexual male as the most under-represented group in all NHS promotional photographs. In a nutshell that's were this type of logic could lead us. Instead of bleating why not ask why so few BME applied or were accepted

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  • Anonymous | 29-Oct-2013 12:04 pm

    Nursing Times is obsessed with BME nurses: yet another non-story!

    I'd be more impressed if you declared who you were. You are completely wrong

    Far from being "obsessed" Nursing times and health service journal should be congratulated on taking the issue seriously

    This sort of apparent discrimination risks denying patients the best care and nurse leadership, demoralises BME nurses and undermines patient care

    This is not the fault of any one individual. It is a system failure. The Leadership Academy is only one small part of the problem and at least they acknowledge the issue and are openly trying to address it.

    It is time for the Trusts who employ these nurses to get their act together and encourage BME nurses to apply, provide the secondments, acting up, CPD and other encouragement and support that some nurses get and others don't.

    Keepup the good work Nursing Times. Carol Baxter is right in what she says and for their part Yvonne Coghill and Dave Ashton have acknowledged the challenge. Ifonly other NHS bodies and individual Trusts were as open we might move forward more quickly.

    That would be to the benefit of all staff and all patients. It's time to stop wasting the talent of almost 1 in 5 of our nursing workforce

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  • Surely the question should be "who were the best qualified to attend the course" not "how many BME nurses did we give a place to"? If we start saying with positive discrimination then you could discriminate against someone who is better suited to the course but does not get in because they are not BME. Please remove colour from the criteria and dispense the course on merit, if its 70/30 in fvour of BME or non BME does it maatter. I thought it was meritocrosy we were in.

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  • Sorry for the typos but really !!!!!!

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  • Whilst 4% of applicants may have come from BME backgrounds, 100% of BME applicants who applied were accepted onto the course, this wasn't the case of non-BME applicants.

    Why these 'academic' types feel the need to constantly do-down the NHS, to constantly assert that there is racial division - in what is a very ethnically-diverse workforce - where none exists, is beyond me. I genuinely do not understand people's motives, one must presume these to be entirely commercial.

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  • Jobs & training places should be decided on ability not age, sex or race. That is true equality. That's what patients want - capable people in charge of their care regardless of these factors

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  • I agree with most above. I have been a nurse for a very long period and have never known racial bias-did Middy 40 yrs ago with an Asian Tutor! Most of the population are white-that's our history and, as many have said, it's a thing not everyone is suitable for and may not apply for. Positive discrimination IS discrimination i.e accepting someone to balance up race intake instead of seeking the best candidate from whatever background.

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  • Colleagus

    I find the responses from the previous four posters astonishing

    Are you really suggesting that there is no race discrimination in the NHS? Is the suggestion that the well documented differences in recruitment, promotion, discipline etc. are just down to merit?

    I wonder how you deal the well documented differences based on ethnicity in treatment eg mental health?

    Not all differences may be down to ethnicity but are you really suggesting that none of them are?

    This discussion reminds me of those thirty years ago when men said they were not aware of any discrimination based on gender.

    Anonymous | 29-Oct-2013 1:15 pm says

    Whilst 4% of applicants may have come from BME backgrounds, 100% of BME applicants who applied were accepted onto the course, this wasn't the case of non-BME applicants.

    Would you like to say how you came about this and say who you are so we can have an open discussion about it?

    If it's true, of course, (and I have no idea if it is) it begs another question - what is it that discourages so few applicants to these nurse leadership courses when other leadership courses have five times higher the proportion of BME staff on them? Any thoughts?

    Racism is alive and well in the NHS. We cant tackle it if nurses deny it exists

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  • Unfortunately, some of the sandal-wearing, Guardian-reading, liberal-voting ultras who post on this site do not realise that their brand of discrimination - however well meaning - is as ugly as that of any hate-preaching EDL member.

    To constantly refer to people as BME, to treat them as some form of imbecilic subset that need special treatment and be kept apart does as much damage as preaching hate at some right-wing rally. To constantly draw attention and make comparison of different races is wrong. Most minority ethnic people I know would be mortified to think that their race has any bearing on any decision regarding recruitment or in this case, access to education. Most people just want to get on with their lives!

    There are idiots in all walks of life and the NHS is no different, but to constantly assert that the NHS is inherently racist is just plain wrong, indeed it is probably the most culturally-rich and diverse employer in the country.

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  • Roger kline- you are talking a lot sense.

    Pretty much the only one on here who is in fact.

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  • I am a senior nurse of African origin and have made 4 requests to get on this course . All were declined .Our views are not listened to and when we raise concerns we are seen as obstructionist .
    Racism is rife in the NHS. How many Directors of Nursing in the NHS are from BME backgrounds ??? . Another research for the Nursing Times could be how many BME nurses have had Masters Degree courses supported by NHS funding ?

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  • roger kline | 29-Oct-2013 6:30 pm

    Couldn't agree more, Roger. From other comments, it would appear that the wilful blindness continues apace. Sadly, a lot of work still required.

    Anonymous | 30-Oct-2013 12:13 pm

    From your experience, it would appear that the person who posted that 100% of BME applicants were accepted was misleading or misled.

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  • Unfortunately, the Torygraph, right wing extremists are sitting around with their heads in the sand again.

    To the individual who makes comparisons about concern around the evidence-based and widespread racism within the NHS with the EDL, do everyone a favour and educate yourself. Look at the extensive research and perhaps it will prevent you from making such offensive and ignorant comments in future.

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  • Anonymous | 30-Oct-2013 2:39 am

    "There are idiots in all walks of life and the NHS is no different"

    Yes and some them deny the existence of rasicm in the NHS.

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  • nhsleadership

    Hello Anon, who posted on 30 Oct at 12:13pm - can you please email us some more details and we can discuss, either over email or we can call you.

    If you can please email to:

    Thank you, and look forward to hearing from you.

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  • I have to say I think this is all just nonsense, I am really fed up with identifying healthcare workers into special groups. I say let's stop discriminating against nurses who are left-handed everything is set up for right-handed nurses!! we left handed nurses need our own conference and dedicated month.

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  • Anonymous | 1-Nov-2013 3:09 pm

    Then you should be ashamed of yourself. There is no excuse for you, and the others who seek to completely deny the existence of a very real issue, to be living in such a state of ignorance and intolerance!

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  • Good grief, why one particular person feels the need to multiple-post under various aliases is beyond me - why stifle debate by constantly attacking those who believe the NHS to be a mindful employer and a non-racist organisation?

    One wonders whether the senior nurse (of black origin) actually contacted the NHS Leadership Academy or was this person the product of one mans over-active imagination?

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  • Anonymous | 2-Nov-2013 3:20 am

    Why so defensive? You are probably just one person multiple posting. It is puzzling, but not unexpected that you should accuse someone who holds a different viewpoint of stifling debate. If true, then you are guilty of the same thing by 'constantly attacking' those who believe that the NHS is not a mindful employer and is a racist organisation. Why not do some reading on the subject and take the blinkers off?
    Racism aside, I actually can't believe that someone has used the words 'NHS' and 'mindful employer' in the same sentence. Truly deluded!

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