Shattered hopes: black and minority ethnic leaders’ experiences of breaking the glass ceiling in the NHS
17 June 2022
Reflections on the lived experience of senior black and minority ethnic leaders in the NHS.
Race equality
Workforce
Leadership
Key points
- Racism and inclusion have become key areas of focus for the NHS in the wake of the Black Lives Matter movement and the disproportionate impact of COVID-19 on black and minority ethnic staff and patients. With diverse leadership a key plank of the NHS’s strategy to achieve equality, improving the working life for senior black and minority ethnic staff should be a critical priority for the health service.
- We were encouraged that the Messenger Review into health and social care leadership advanced this cause, placing the need for more diverse senior leadership at the top of the NHS agenda. But we remain convinced that a greater commitment to act is needed. In spring 2022, the BME Leadership Network conducted an online survey and hosted a series of roundtables to understand the experiences of BME leaders, and to explore the challenges they faced in relation to racism and discrimination as they moved through their careers. This report captures what we found and puts forward recommendations to improve the working conditions of BME leaders.
- More than half of surveyed BME NHS leaders considered leaving the health service in the last three years because of their experience of racist treatment while performing their role as an NHS leader. A majority said they had experienced verbal abuse or abusive behaviour targeting racial, national or cultural heritage at least once in the past three years, with more than 20 per cent saying this had happened five times or more.
- Colleagues, leaders and managers seemed to be a particular source of racist treatment, more so than members of the public. This is concerning, given that the NHS has been prioritising equality, diversity and inclusion activities in recent years. This suggests that more focused efforts are required at every level to reduce the incidence of racist behaviour and to improve awareness among all staff of the impact of this type of discrimination.
- Only 10 per cent were confident that the NHS is delivering its commitment to combat institutional racism and reduce health inequalities and fewer than one in four were confident that their organisation has a robust talent management process that is enabling the development of a pipeline of diverse talent.
- Senior BME staff reported low levels of confidence in their own organisations’ abilities to manage and support a pipeline of diverse talent and in the ability of the system to achieve this at a national level. Moreover, only a minority were confident they could rely on the support of colleagues to challenge racial discrimination, and a smaller minority believed they would be supported by NHS England and NHS Improvement if challenging prejudice or discrimination locally.
- Leaders described how structural and cultural issues within the NHS led to a situation where BME leaders were not present in sufficient numbers to generate a climate of inclusivity and were sometimes siloed in particular types of role. This helped to create a situation where career progression was felt to be unduly challenging and where neither succession planning nor talent development were occurring at sufficient scale to support the next generation of diverse leaders.
- Being able to be authentic in the workplace was an issue that emerged powerfully. Some leaders reported policing their own behaviour in the workplace and compromising their values in order to fit in. Being able to represent their own cultures and be themselves at work was a critically important goal for many. For BME leaders, feeling secure that they will be treated equally, regardless of background, was seen to be the ultimate success measure of equality.
- It is essential that BME leaders are able to see effective development programmes to support diverse talent, and that they are provided with sufficient support, both locally and nationally, to feel secure in calling out unacceptable behaviour when this occurs.
- At such a critical juncture for the NHS, action must be taken to end cultures of discriminatory behaviour, to provide personal support to current and aspiring leaders, and to develop succession planning and talent development schemes.