NHS doctor
(Photo by Christopher Furlong/Getty Images)

By Drew McLachlan

NHS staff from a black or minority ethnic (BME) background are more likely to face bullying, disciplinary action and be treated less favourably than their white counterparts, a new report has found.

The Workforce Race Equality Standard (WRES) report paints a damning picture of current NHS practices involving BME employees, revealing that they are more likely to be bullied by colleagues and less likely to be shortlisted for senior roles.

Published last Wednesday (19), the findings show that managers are more likely to discipline BME staff over insignificant matters and incorrectly use disciplinary policy to address performance issues. Across England, BME staff were found to be 1.6 times as likely to experience disciplinary action than their white counterparts.

Within London, the likelihood rose to two times.

A leading contributor to this phenomenon, it notes, is the “lack of confidence” some managers feel in conducting informal conversations with BME staff regarding their performance, which it found to be critical in resolving minor issues and avoiding the formal disciplinary process.

Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin (BAPIO), which supports doctors arriving from India to work in the NHS, pointed out to Eastern Eye that despite outright racism becoming less common in the workplace, inequalities persist.

“Between colleagues and managers, outright racism is probably rare,” he said. “More commonly it is unconscious bias, in which they are taken as inferior doctors compared to the white doctors. Fortunately, direct racism has gone down over the years, slowly but surely, yet unconscious bias is still a major problem.”

“direct racism has gone down over the years… yet unconscious bias is still a major problem.”

The number of BME staff reporting bullying and harassment by patients, relatives and other members of the public was found to have fallen slightly, from 30 per cent to 29 per cent, bringing it much closer in line with the 28 per cent of white staff who reported the same.

However, the report warned that bullying and harassment from colleagues remains significantly higher for BME than white staff, at 27 per cent to 24 per cent. Over the past year, the gap has narrowed slightly due to more white staff reporting instances of bullying.

Dr Mehta said doctors trained in India and other countries outside the UK often take a different approach to bedside manner and other communication with patients. While he said that white doctors often take umbrage with this gap in communication skills, the consistent treatment of staff of all ethnicities by members of the public shows that patients don’t take issue with it.

“There is a gap in communication and bedside manner, but patients do not mind. Patients realise these doctors are very competent; they care more about competency of doctors than mannerisms, though both are important.

“Patients have no problem with that, while the colleagues have a problem,” Dr Mehta said.

NHS trusts with a high prevalence of high levels of bullying experienced significant instances of turnover, absenteeism and lower morale, which have led to negative impacts on the quality of patient care and safety, the authors found.

Their findings also showed that across England, white staff, on average, were 1.6 times more likely to be appointed from shortlisting. At 38 of the 238 trusts surveyed, white staff were found to be twice as likely to be appointed from shortlists, while just 15 trusts reported a greater likelihood for BME staff.

Danny Mortimer, chief executive of NHS Employers, noted the progress in the nursing sector when it comes to BME representation in senior posts, urging trusts to “learn lessons from those who have taken action to improve”.

He said: “The latest report from NHS England on workforce race equality shows some progress – but there is much work to do. BME staff have a poorer experience than their white colleagues, and our patients receive poorer care as a result.”

“our patients receive poorer care as a result.”

The authors suggested a number of solutions for trusts to close the gap for BME staff, including better tracking of data, communicating the adverse effects of the gap to middle managers and providing BME staff with easier access to board members.

Joan Saddler, co-chair of the NHS Equality and Diversity Council and associate director at the NHS Confederation, said: “It is crucial to the success of the NHS that we listen to people using services and enable diverse teams to deliver services efficiently and compassionately.

“That’s what this report is ultimately about… The evidence points to BME staff suffering in silence as they are absent at leadership levels or bullied disproportionately to the rest of the workforce. This is not acceptable and providers of NHS services and system partners need to improve in a planned and sustained way.”

Dr Mehta added: “Because all these trusts and hospitals have to now provide data on these standards, they are beginning to look at it very seriously. We are hoping this will help in improving the situation over the next few years.

“Cultural change will take time; it can’t be done very quickly.”

“Cultural change will take time; it can’t be done very quickly. However, we have to give credit to the Department of Health that they are trying to do something about it.”

Rose Obianwu, media relations advisor for NHS England, said that while some progress has already been achieved, she suspects it will be some time before current gaps are closed.

She said: “There are a number of NHS trusts across the country making progress on tackling the workforce race equality challenge. Evidence and research methodology tells us that positive shifts on this agenda will take a number of years of proactive and sustained intervention. Trusts are taking the challenge seriously and good replicable practices from these organisations will be shared widely over the coming period.”

Click here to read the full report.

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