Institutional racial discrimination is blocking black and ethnic minority NHS staff from senior positions, an independent study has confirmed.

Only 8 per cent of senior managers are from non-white backgrounds compared with 12 per cent of the working-age population, an assessment commissioned by the NHS Institute found.

The problem is caused by “racially biased recruitment” practices, overseas qualifications being undervalued and the “institutional culture” found in the NHS, according to the report, Access of BME Staff to Senior Positions in the NHS.

Despite initiatives such as the institute’s Breaking Through programme, BME staff lack mentors and experience stereotyping, it says.

In addition, NHS organisations have adopted a “piecemeal approach to increasing ethnic diversity” and are failing to realise the benefits of having a more representative senior management team.


The evaluation, by consultants Matrix Knowledge Group, is based on existing evidence, interviews with primary care trust staff, recruitment figures and comparative information from other organisations.

Comments from PCT equality and diversity leads suggested “racial discrimination did exist in some areas - on an individual, group, and at an institutional level”.

The report states that a more representative workforce is needed to implement world class commissioning, competition and community engagement.

Diversity training for managers was not enough, it found. And as well as supporting existing BME staff, more effort is needed to attract staff from outside the NHS to senior positions.

Glass ceiling

The researchers found London to be the least reflective of its population, with a 24.5 per cent difference between the proportion of non-white residents and BME senior managers.

Middle managers were more representative but those from non-white backgrounds still appeared to be hitting a “glass ceiling”.

A long way to go

Kate Lobley, the institute’s head of building leadership capacity, said there was no doubt that progress had been made but “there is still a long way to go”.

She said: “We must work together across the NHS to understand best practice and drive improvement, ensuring genuine integration and advancement for this group of staff.”

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