Ten years on: The Snowy White Peaks of the NHS

Over one-quarter of English National Health Service (NHS) staff are from black and minority ethnic (BME) backgrounds. Peer-reviewed research, grey literature and staff surveys consistently show that the NHS treats such staff less favourably than white staff in recruitment, career progression, bullying, discipline, referrals to professional regulators and the response when BME staff raise concerns.1 Such disadvantage may be compounded for the growing number of overseas trained staff and through intersectional disadvantage, notably for BME female staff. BME staff report exposure to ‘microaggressions’, racist stereotyping, prejudice and overt unfair treatment, and such experiences are associated with low employee satisfaction and greater staff turnover.2 These experiences are associated with emotional problems, somatic symptoms, low job satisfaction and long periods of sickness absence among this workforce.3 Race discrimination adversely impacts access to and the provision of healthcare.4 The NHS response to race discrimination within the NHS has been late, glacial and often performative. In the wake of the Macpherson Inquiry (1998),5 Ministers launched the Race Equality Action Plan (REAP)6 to address the striking absence of BME staff from senior positions. However, when The Snowy White Peaks of the NHS (TSWP) (2014)7 reviewed progress a decade later, there was almost none to be found. A decade further on this commentary considers the impact of that 2014 report. This surveyed London’s NHS Trust leadership. 41% of London’s NHS staff and 45% of the population were of BME heritage, but we found: