Racial bias in healthcare: how to create safe spaces for conversations on racial equity
The last few years have been the most challenging in NHS history. To ensure the NHS is positioned to recover post-pandemic, it’s vital that inclusion and diversity are placed at the heart of the organisation. Not only will this help to overcome the challenges in recruitment, retention, and planning, it will also directly improve clinical outcomes and the experience of care for patients.
The 2021 NHS Workforce Race Equality Standard report, which highlights the experiences of NHS staff across the organisation, showed that whilst there have been positive changes in diverse representation, there’s still much more that needs to be done at a cultural level to tackle inequities and build inclusive cultures.
The state of the stats: racial equity in the NHS
The 2021 WRES report found that racial inequity still clearly exists in healthcare. Not only can this lead to employees underperforming in their roles, but in many cases, this also results in employees opting to leave the NHS.
Key statistics from the 2021 WRES report include:
White applicants were 1.61 X more likely to be appointed from shortlisting compared to BIPOC applicants BIPOC staff were 1.14 times more likely to enter the formal disciplinary process compared to white staff.
36.2% of staff from an “other” Asian background (i.e., other than Bangladeshi, Chinese, Indian, or Pakistani) experienced harassment, bullying or abuse from patients, relatives or the public in the last 12 months.
35.3% of staff from an “other” Black background (i.e., other than African or Caribbean) experienced harassment, bullying or abuse from other staff in the last 12 months. This has increased from 32.8% in 2016.
16.7% of Black or ethnically marginalised staff had personally experienced discrimination at work from a manager, team leader or other colleagues; the highest level since 2015 (14%).
28.8% of all Black, Asian and ethnically marginalised staff had experienced harassment, bullying or abuse from staff in the last 12 months.
Identifying types of racism experienced in the workplace
Before we discuss how to implement a simple process, let’s clarify the four common types of racism experienced in the workplace:
Microaggressions: Comments and behaviours, whether intentional or not, that undermine, belittle, stereotype, or insult those in ethnically marginalised groups.
Racial harassment: Unwanted conduct based on skin colour, religion, culture or country of origin, which violates dignity or creates an intimidating, hostile, degrading, humiliating or offensive environment.
Racial discrimination: Decisions made based on skin colour, religion, culture or country of origin. These decisions may relate to hiring, termination, punishment, scrutinisation, promotion, compensation, job training, or other aspects of work-life.
Racist jokes: Racist jokes as remarks that are intended to be funny, based on skin colour, religion, culture or country of origin.
How can you create safe spaces for conversations on racial equity?
The first important step to tackling racist behaviours at work is implementing a simple and transparent policy and process to report racist incidents to protect and support employees. Health workers may experience racism from colleagues, managers, and patients, as well as outside of work.
1. Make sure that there’s a method for all employees to report racism at work that is:
Simple: remove any barriers to reporting racist incidents by making the process easily accessible and a quick process.
Safe: it’s critical that Black, Asian and ethnically marginalised workers feel confident that complaints will be taken seriously, acted on and dealt with satisfactorily.
Closely monitored by multiple workforce leaders, to reduce unconscious bias and ensure no reports go unaddressed.
Regularly promoted across internal communications so employees know where to find it and understand tackling racial inequity is your priority.
2. Appoint a senior figure from an ethnically marginalised group within the organisation to represent more junior employees
Appoint a senior figure from an ethnically marginalised group within the organisation to represent more junior employees who experience or witness harassment. Having a clear point of contact who is a champion for racial equity and a senior figure within the organisation can help junior employees feel represented and understood.
3. Develop an active safe space for having conversations about race
Forming safe spaces can be an effective way of giving people the confidence to have conversations about racism. Consider setting up a digital platform dedicated to conversations about racism, using a platform such as Slack. To help maintain engagement levels and monitor conversations, ensure that your organisation appoints a leader to oversee the channel.
When this system is in place you can then move on to deciding how best to support staff who are experiencing racial abuse from patients, relatives, or the public, which we’ll discuss in our next post.
Do you have a system in place for reporting racist incidents within your organisation?