I feel very strongly that we are not providing an inclusive environment for our black and minority ethnic (BME) colleagues. For too long employees from BME backgrounds have been experiencing difficulties in career progression, despite having the right qualifications and experience, and have been denied opportunities as a result of discrimination from either colleagues or service users. This has been recognised by the NHS Equality and Diversity Council. The Workforce Race Equality Standard (WRES) was introduced in 2015 and NHS trusts have to report on this ever year. The first WRES report came out in June 2016 (NHS Equality and Diversity Council, 2016). This has been an important step, as research has shown that a motivated, included and valued workforce helps to deliver high quality patient care, increased patient satisfaction and better safety.
The UK has a diverse population and the NHS workforce should mirror this diversity at all levels—healthcare assistants (HCA), practice nurses, advanced nurse practitioners, GPs and managers. Having read the WRES report for our local trusts, it seemed logical to look at general practice. Patients from diverse ethnic backgrounds respond better to advice when given by a health professional they can relate to and feel will understand their situation. The report is not suggesting that all clinicians should reflect their population, but they should have access to training and development that has been co-designed with their community. WRES data have not been collected from general practice nationally, as it would need a different set of indicators. Career structures, especially bands 1–9, do not translate well to the general practice workforce and the career ladder is less obvious. Trusts are much bigger organisations, and it is easier to get data from HR departments than from individual practices where HR is less formal.
One of our GPs, Sebastian Kalwij, who is also a CCG clinical director, invited all staff to complete a WRES survey. In total, 151 responses were received and equally divided between clinical and non-clinical staff and across BME and non-BME employees. This reflects the patient population, as 54% of residents are of BME origin. Of BME employees, 54% have experienced harassment, bullying or abuse from patients, their relatives or the public in the last 12 months. This is higher than the 2018 All Trusts average and higher than among non-BME employees. We also found 25% of BME employees experienced harassment or bullying from a colleague or staff member at work in the previous 12 months, compared to 10% of non-BME staff. When asked about equal opportunities being provided at work, 28% of BME staff versus 19% of non-BME staff answered no. And when asked if they experienced discrimination personally, 17% of BME staff members responded with yes. When asked if racial abuse made people change jobs, 22% of BME staff had done so in the past. At a time when most GP practices in the country are struggling to recruit or retain staff, this is a very worrying figure and steps need to be taken to improve this.
I hope this information will encourage you to start a conversation with your work colleagues, your primary care networks (PCNs) and your CCGs. Let's work together, having honest conversations and make general practice a welcoming, inclusive and safe place to work and thrive.
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