International Day for the Elimination of Racial Discrimination: Inequity in the Health and Care Workforce

21st March is an awareness day that is founded in remembrance of those participating in a peaceful anti-apartheid protest in South Africa, who faced police brutality in 1960. The battle to eliminate racial discrimination is as relevant as ever, as demonstrated powerfully by the parliamentary debate last week in which comments against MP Diane Abbot were discussed, but Diane herself was denied the right to contribute, 46 times.

It is vital to understand the impact of discrimination. It is not just about someone making an aggressive and shaming comment, then apologising. It is about the attitude and mentality that informs these types of comments, which characterises how people treat and interact with those of diverse ethnicity. One of the outcomes of othering people of ethnicity, is silencing them about their lived experience and denying them the opportunity to share the rich wisdom that they have gained in navigating this.  

To deny other ways of being, thinking and approaching tasks as inferior is a form of racial discrimination which is symptomised by workforce inequality in healthcare. This month, the NHS Workforce Race Equality Standard 2023 data analysis reported that ‘at 76% of NHS trusts, white applicants were significantly more likely than BME applicants to be appointed from shortlisting, higher than the 71% last year’.

This mirrors the findings of the Social Care Workforce Race Equality Report 2023 which draws on data collected from 23 Local Authorities in England and applies a similar model to the NHS version, to compare data for white employees with those of diverse ethnicities. Key statistics show that persons of diverse ethnicity are:

  • half as likely to be appointed from a shortlisting;
  • 40% more likely to enter the formal disciplinary process;
  • more than twice as likely as a regulated professional to enter the fitness-to-practice process;
  • 20% more likely to have experienced harassment, bullying, or abuse from people who use social care, relatives, or the public;
  • 30% more likely as a colleague and 90% more likely as a manager to have experienced harassment, bullying or abuse from colleagues and managers.

These statistics show that employees of diverse ethnicities are being disproportionally denied permission to apply their understanding and skills in a manner that is equitable and fulfilling in the work place. In turn, this denies diverse groups of service users the benefit of informed care practice; members of the workforce who can bridge the gap between service processes and patients needs, are excluded from safely sharing their ideas and skills.

At Social Interest Group, we seek to overcome barriers and stigma that stifle equity in the workforce, through inclusive learning and practice. Inclusivity in practical terms is about creating safety for all team members;

  1. to be accepted and included equally
  2. to learn with proactive support, and be able to ask questions within this process.
  3. to make contributions that are validated and accredited
  4. to challenge without retaliation, for the purpose of innovation and best practice.

Dr Timothy Clarke states that these are the four stages of psychological safety and reaching and maintaining these allows teams to exist in the ‘realm of innovation’. An innovative organisational culture creates a space for broad and forward thinking mentality amongst teams and fosters empathy amongst staff. This enables teams to adopt a person-centred approach to care and support practice as an outworking of their own experience within an organisation.     

Raje Ballagan Evans, Policy and Impact Manager