New figures show NHS workforce most diverse it has ever been
The NHS workforce is more diverse than at any other point in its history, according to an annual report into race equality across the health service. Published today, the NHS Workforce Race Equality Standard shows Black and minority ethnic (BME) staff make up almost a quarter of the workforce overall (24.2% or 383,706 staff) – an increase of 27,500 people since 2021 (22.4% of staff). The analysis shows more than two fifths (42%) of doctors, dentists, and consultants, and almost a third (29.2%) of our nurses, midwives, and health visitors are from Black and minority ethnic backgrounds.
BME staff still under-represented in senior positions
While the figures also show an increase in representation at board level – including executive board roles – BME staff still remain proportionally under-represented in senior positions, which is why the Long Term Plan has called on every NHS trust to set its own target for senior BME representation reflective of their overall workforce.
The number of Black and minority ethnic board members across all NHS trusts has increased to 13.2% in 2022, up from 12.6% the year before, and almost double what it was in 2017 (7%).
In the past 12 months, BME very senior managers have increased from 9.2% to 10.3% (an increase of 51 – up from 290 in 2021 to 341 in 2022).
The Messenger review of NHS leadership, published in June 2022, highlighted within its recommendations the importance of equality, diversity and inclusive leadership.
Amanda Pritchard, chief executive of NHS England, said: “Figures from today’s Workforce Race Equality Standard report show the number of BME staff in very senior roles and on NHS boards continuing to go in the right direction, which evidence shows is not only better for staff, but for patients too.
“But we know there is still significant room for improvement to change the experience of BME staff, which is why we are continuing to support local NHS organisations to help them tackle race inequality – including setting local targets to ensure their senior leadership is fully representative.”
Dr Navina Evans, NHS England Chief Workforce Officer, said: “It is encouraging to see improvements in today’s report but it is also clear that there is still more work to do to improve the experience for our BME colleagues.
“As we create the new NHS England and redesign our approach to delivery, it will be essential to work alongside our system partners to maximise impact and create the change we all want to see.”
Professor Anton Emmanuel, head of Workforce Race Equality Standard (WRES), said: “There has been a notable and sustained increase in the number of BME colleagues in the NHS, along with improved board and very senior management representation.
“Unfortunately, some colleagues are subject to inequitable processes; less likely to be promoted, more likely to face formal disciplinary and more likely to be bullied or harassed. We must use the data in this report to drive evidence-based actions to reverse these trends, by replicating pockets of improvement by some trusts across a number of indicators.”
The figures have been published alongside a new medical WRES action plan, which has been jointly developed by royal medical colleges and regulators.
Based on data and evidence gathered through the WRES report, the plan sets out the “first five” practical actions to tackle existing inequalities in the medical workforce. This includes steps to reduce disproportionate representation of international medical graduates in General Medical Council referrals, improve diversity in senior medical leadership appointments, and increase BME representation in the councils of royal medical colleges to better reflect the workforce.
The country’s top doctor welcomed the publication of the medical WRES action plan.
Professor Sir Stephen Powis, NHS England medical director, said: “The NHS’ medical workforce is one of the most diverse in the country, and continues to attract talent from around the world.
“While I am pleased that ever increasing numbers of people from a BME background are choosing to become doctors and join our health service, there is much more NHS employing organisations, royal medical colleges and regulators can do to improve representation and experiences.
“This report will be vital in ensuring the NHS and other health bodies continue to tackle inequality and take practical steps to break down the barriers that prevent people from reaching their potential, and ensure all staff and patients are treated in a fair and equitable way.”
The WRES report also shows:
- 29.2% of ethnic minority and 27.0% of white staff reported harassment, bullying or abuse from patients; an increase from 28.9% and 25.9% respectively.
- There was a modest reduction in staff bullying reported for both ethnic minority and white staff. A drop from 28.8% to 27.6% for ethnic minority staff and 23.2% to 22.5% for white staff.
- The percentage of staff believing their trust provides equal opportunities for career progression and opportunities has fallen for white staff from 59.6% to 58.7%. There was a modest improvement for ethnic minority staff, to 44.4% from 44% in 2021.
- White shortlisted job applicants were 1.54 times more likely to be appointed from shortlisting than BME shortlisted applicants – an improvement from 1.61 in 2021. While data for BME staff entering formal disciplinary process remains unchanged from 2021 at 1.14 times, a vast improvement from its peak in 2016 at 1.56.
There's still much to do to improve the experience of BME staff in the NHS
Responding to the publication of the NHS Workforce Race Equality Standard (WRES) 2022 report, Joan Saddler OBE, Director of Partnerships and Equality at the NHS Confederation, said:
“Today’s analysis highlights that whilst important progress is being made, there’s still much to do to improve the experience of Black and Minority Ethnic (BME) staff working in the NHS and to eradicate the scourge of racism from across the service.
“With an additional 27,500 BME staff now in the service compared to last year, health leaders will be spurned on to increase their efforts and reject complacency in their work to build a truly inclusive service for the NHS workforce and patients alike.
“Of particular concern for NHS leaders will be the increase in the percentage of BME staff experiencing harassment, bullying and abuse from patients, relatives and the public following an encouraging decrease the year before.
“Whilst an increase on last year’s data, just 44.4% of BME NHS staff believe their trust provides equal opportunities for career progression or promotion; it shows there is still a long way to go for NHS employers to facilitate true workplace equality for BME staff.
“NHS leaders are committed to ensuring tackling racism is intrinsic to all their work and the NHS Confederation is supporting them in making this commitment a reality through our EDI programme published in June 2022 and recently enhancing this support through our anti-racism strategy published in November 2022, which aims to commit, understand and act to support our members, and the Confederation as a whole, to drive structural change.
“The anti-racism strategy will be constantly evaluated in partnership with our BME Leadership Network that exists to strengthen the voice of NHS BME leaders and to support NHS organisations to meet the needs of all communities."
Read the Workforce Race Equality Standard report.
Read the Medical Workforce Race Equality Standard report.
Read about the NHS Confederation's EDI programme (June 2022).
Read about the NHS Confederation's Anti-Racism Strategy (November 2022).
