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BME nurses 'seriously under-represented' in senior NHS posts despite some progress

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Black and minority ethnic nursing and midwifery staff remain “seriously under-represented” at a senior level within the NHS, although some progress has been made recently, according to a report on the treatment of BME employees within England’s health service.

It also found that, across NHS staff groups, BME candidates were generally less likely to be appointed than white applicants, while the proportion of BME staff on boards failed to reflect the size of the workforce as a whole.

The number of BME nurses and midwives in band 5 posts remained about the same between 2015 and 2016, according to the second annual report from the NHS team analysing data on the recently introduced requirements for the Workforce Race Equality Standard (WRES).

But over the same period, there was a 6% increase in the number of band 6 BME nurses and midwives in the NHS, a 7% increase at band 7 level, a 13% increase at band 8a and a 12% increase at band 8b, according to official headcount data from NHS Digital.

At band 9 level the numbers doubled – from three senior BME nursing and midwifery staff in 2015 to six in 2016.

“The data here suggest that some progress is underway”

WRES 2016 report

Those behind the report said the data showed improvements in career progression for BME nurses and midwives across the NHS were “entirely possible”, but noted more needed to be done by employers.

“Whilst BME nurses and midwives remain seriously under-represented at bands 6 and above, the data here suggest that some progress, though limited, is underway,” they said.

The WRES team was set up in 2014 to analyse NHS data across nine indicators comparing the treatment of BME staff with white workers. Since April 2015, all NHS trusts were required to submit data and show how they were improving equal opportunities.

Other new findings from this year’s report included the fact that white job applicants were 1.57 times more likely to be appointed by the NHS than BME applicants at the shortlisting stage.

“The evidence points to BME staff suffering in silence”

Joan Saddler

Meanwhile, there was a greater chance that BME staff would be put forward for disciplinary processes than white employees at around three quarters of all types of NHS trusts in England (164).

In particular, at 65 of these trusts, the chance of this happening was more than twice as likely for BME workers.

It reflects findings from a recent analysis commissioned by the Nursing and Midwifery Council, which found black nurses and midwives were more likely to be referred to the regulator than their white counterparts.

The new WRES report also concluded that “the current proportion of BME board members is neither reflective of the workforce nor of the population served in England as a whole”.

NHS Digital data from 2016 showed that 81% of England’s NHS trust workforce was white and 19% from BME backgrounds.

But among the 193 NHS trusts that provided suitable data, 43% had zero BME board members, 37% had one, and 11% had two. The remaining 9% had between three and five.

“This is racism and it’s time that the health and social care sector took the challenge of tackling it seriously”

Tom Sandford

Yvonne Coghill, NHS England’s director for WRES implementation, said: “We fully realise there is a long way to go, however celebrating the achievements and progress that has been made in some sectors and regions is important.

“We will continue to work closely with the frontrunners on this agenda to identify what’s working and support those organisations that need additional input,” she told Nursing Times.

Joan Saddler, co-chair of the NHS’s equality and diversity council, added: “The report gives detailed baseline data about workforce race equality in specific organisations and we want to thank those organisations that are progressing well.

Yvonne Coghill

Yvonne Coghill

Yvonne Coghill

“The evidence also points to BME staff suffering in silence as they are absent at leadership levels or bullied disproportionately to the rest of the workforce,” she said. ”This is not acceptable and providers of NHS services and system partners need to improve in a planned and sustained way.”

The Royal College of Nursing’s director for England, Tom Sandford, said: “These figures show once again the evidence that black and minority ethnic staff in the NHS are significantly more likely to experience discrimination and are less likely to be appointed than their similarly qualified white colleagues.

“This is racism, and it’s time that the health and social care sector took the challenge of tackling it seriously and systematically,” he said.

“We will continue to work closely with the frontrunners on this agenda to identify what’s working”

Yvonne Coghill

Amy Leversidge, employment relations advisor at the Royal College of Midwives, added: “Whilst this report is welcome and some progress has been made, it paints a worrying and disappointing picture of the levels of discrimination in our NHS.

“All the evidence shows that BME midwives, maternity support workers and other NHS staff in the NHS are being treated less fairly than their white colleagues,” she said.

“There is clearly discrimination in the NHS towards BME staff and action is needed to tackle this,” she said. “This report shows that employers in particular have a lot of work to do to ensure that BME staff are treated fairly in the workplace.”

Danny Mortimer, chief executive of NHS Employers, said the report showed some progress but that there was “much more work to do”.

“It is important to acknowledge the progress the nursing profession has made in improving the representation of BME colleagues in senior posts,” he said. “It is also important to learn lessons from those organisations who have taken action to improve.

“Nonetheless, the fact remains that BME staff have a poorer experience than their white colleagues, and our patients receive poorer care as a result,” said Mr Mortimer.

He added: “Equality remains at the heart of the health service, and reports like this are a timely reminder of the need for us to keep focused and maintain momentum as we continue to work towards the eradication of discrimination and harassment against our BME staff.”

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