Yvonne Coghill takes a look at where the NHS stands in the treatment of its black and minority ethnic staff and patients 

Yvonne coghill

Yvonne coghill

Yvonne Coghill

Three years ago, an American colleague sent me a link to a video and insisted I watch it immediately, the video was entitled Racism and Health. It featured David R. Williams giving a talk to postgraduate students at the University of Massachusetts, not someone I had ever heard of but I was assured that both the video and the professor would be of interest.

My colleague was right, I was fascinated both by the health and race aspect of the video and the black Harvard professor who I’d been told would be brilliant. 

That video left me speechless, I learned more about myself and about the race equality agenda in the hour I spent watching that video than I had in the 10 years before that. Put simply, Dr Williams blew me away. The evidence base for what he was saying was irrefutable, being black in white dominated countries is not good for your health.

About that time, the Workforce Race Equality Standard was being developed; in my opinion, it was developed as a consequence of three things happening simultaneously.

Low numbers

Acknowledgement of the disproportionately low number of black and minority ethnic people in the most senior positions in the NHS, an understanding of the importance of an engaged and motivated workforce to deliver high quality patient care and patient satisfaction and senior leaders in NHS England who wanted to make a difference to the race agenda.

Whether it is work done in America, Australia or the UK, it is clear that globally there is an issue with race

The WRES was launched in April 2015; it was mandated and built into the standard NHS contract. It was designed to measure the differences in the experiences between BME and white staff using nine specific indicators and for organisations to develop plans of action to close the gap. 

Later this month, the second WRES data report will be published and unsurprisingly, there remains a gap in the experience of black and white staff in the NHS. Many people are expecting immediate change and improvement in equality in the system.

Expectations need to be managed, it has taken many years, indeed centuries for the system we have in place in society to be developed and it will take time, effort and determination to dismantle the processes and systems we have in place that disadvantage people from diverse backgrounds.

The wonderful thing about the work that Dr Williams has done and continues to do is that it is irrefutable, the evidence is overwhelming. Whether it is work done in America, Australia or the UK, it is clear that globally there is an issue with race.

People that have more melanin in their skins are treated differently than people with little or no melanin in their skins and this treatment contributes to making people die earlier than their white counterparts or suffer from many chronic illnesses. 

Health inequalities

Last week, Dr Williams forwarded me the link to a TEDMED talk that he had recently delivered (total respect for anyone that can do one of those). The content of the talk reiterated for me why race equality is so important and why in the NHS it isn’t an optional extra.

The connection between race equality, motivation and engagement leads to better health for our staff and higher quality and safer healthcare for our patients, communities and wider society

Dr Williams says that in the US every seven minutes a black person dies prematurely, that is 200,000 people that die every day wouldn’t die if the health of blacks and whites were equal. 

This issue is not unique to America and we know that in the UK you are more likely to have a perinatal death as a consequence of being from a BME background; in 2013, the Office for National Statistics showed there were more deaths per 1,000 live births if you came from a BME background. You are nearly three times as likely to lose your baby if you come from a Bangladeshi background as opposed to a white British background.

Dr Williams’ work has shown us that socioeconomic status is not the only factor to consider when looking at health inequalities. His work shows that how people are treated by society, how much they are valued and engaged has a direct effect on their health and wellbeing.

This is true for all human beings.

When Dr Williams’ work is taken together with Making the Difference, the brilliant work of Professors Michael West and Jeremy Dawson that clearly shows the difference in the experience of BME staff in the NHS, it becomes clear why the NHS as a caring organisation has made race equality a priority.

Equality and fairness are an integral part of the NHS constitution and we know it’s important to motivate the workforce, we also know the link between higher levels of motivation and engagement in saving money as well as saving lives. 

The first two years of the WRES have been successful in raising awareness about the inequalities and different experiences of members of staff based on their ethnicity and that there is more work to be done. Going forward, the priority for the WRES team will be supporting the system to make the necessary changes to reduce the gaps in experience between BME and white staff.

The connection between race equality, motivation and engagement leads to better health for our staff and higher quality and safer healthcare for our patients, communities and wider society.

Yvonne Coghill OBE is NHS England’s Director, Workforce Race Equality Standard Implementation