Widespread ethnic inequalities exist across the NHS, warns report

Health & NHS

Widespread ethnic inequalities exist across the NHS, warns report

A study of ethnic inequalities in healthcare published this month by the NHS Health and Race Observatory has found widespread inconsistencies in the ability of people from different racial backgrounds to access services and the way staff are treated across the workforce.

Researchers looked at inequalities in five areas including access to mental health services, maternal and neonatal healthcare, digital and health services, genetic testing and genomic medicines studies and inequalities in the NHS workforce.

A report based on the study was damning, with many people of ethnic minority background reluctant to seek help for mental health problems because of “a distrust of both primary care and mental health care providers” and “a fear of being discriminated against in healthcare.”

It found that ethnic minority women, those who were unable to speak English and migrants who could speak the language suffered from “a lack of trust, insensitive behaviour, lack of active listening by providers and failure to bridge cultural differences".

When it came to digital health, ethnic minority and white people were “generally equally comfortable” using health apps although older people from BAME backgrounds did not have good access to digital services and suffered from a lack of digital literacy because applications were only available in English.

People from BAME backgrounds were not well represented in large genomic wide association studies and the report noted that younger black people may be apprehensive about participating in the 100,000 Genomes Project.

During their investigation into the NHS workforce, researchers found inequalities across a variety of professions, with international nurses working in the UK feeling “distressed and confused and humiliated because of the covert and overt discrimination.”

Some patients demonstrated racist behaviour and refused care from international or black nurses while staff undermined their work or drew “unfair conclusions about work ethic, motivation or character” and managers scrutinised black international nurses more than other nurses.   

BAME workers suffered from an ethnic pay gap in most NHS sectors but this was “less so for Chinese groups.” BAME nurses and midwives in England spent longer at the entry-grade level over a 10-year period and less time at more senior levels and they were “significantly less likely to have received professional training” than their white counterparts.

When it came to career progression, researchers noted that a study of female pharmacists’ choices which looked at 28 women found “most ethnic minority pharmacists in the sample did not report barriers to their career progression.” However, those who did said their progression “was based on personal connections with senior management.”

The report called for a systematic review of racist experiences in the workforce to understand which professions and settings abuse takes place and an improvement in the way data is collected. The Royal Pharmaceutical Society Director for England Ravi Sharma urged the NHS to produce an “urgent action plan…to improve patient care and tackle workforce issues without delay.”

“This evidence in this report is truly shocking. It’s totally unacceptable that ethnic minorities continue to experience poor access and outcomes across a wide range of health conditions, and that the NHS workforce is disadvantaged,” he said.

Insisting he wanted to see “more ethnic minority colleagues” in local and national leadership positions, he added: “Without this, our perspective is bypassed, our skills and contributions are missed and inequalities are perpetuated for patients and the workforce.

“The pharmacy profession has a high representation of black, Asian and minority ethnic colleagues, comprising over 45 per cent of the workforce. We urge the NHS and governments to include pharmacy in national plans to improve inclusive pharmacy practice to benefit patients, to ensure the workforce is represented at all levels and to protect the safety and wellbeing of pharmacists, their teams and the communities they serve.”

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