The bleak plight of black and minority ethnic staff across the NHS has been exposed in an exclusive HSJ analysis of recruitment rates, employment relations and workforce figures.

The survey of every NHS trust and primary care trust in England proves BME workers are grossly under-represented among senior management but disproportionately involved in disciplinaries, grievances, bullying and harassment cases and capability reviews.

Responses from the 231 organisations that provided figures show BME staff make up around 16 per cent of the workforce but are involved in more than twice as many bullying and harassment cases and capability reviews.

In addition, nearly a third of grievances are taken out by BME staff. Unison BME lead Dave Godson said: “These statistics are strikingly high and show that unfortunately racism is alive in the NHS. People should be encouraged to report and confront racist and bullying behaviour.”

He said the findings backed up a Unison survey last year in which two thirds of black members reported they had experienced racism and racist abuse in their job.

University College London Hospitals foundation trust workforce director David Amos said many human resources procedures involved staff in Agenda for Change bands three to five, in which the largest proportion of BME staff were concentrated.

He said more research was needed into whether the figures revealed a problem with staff working in those types of roles, or were related to people’s ethnicity.

Legal duty

“Everyone has a legal duty to be monitoring this data. There’s no doubt that everyone could do better,” Mr Amos said.

He pointed out that race legislation was designed to protect people with diverse backgrounds and therefore provided more opportunities for non-white staff to take out grievances with employers.

“It’s clearly the case that some staff… use the legislation to defend themselves when they’re being performance managed,” he said.

Trusts also need to invest in professional development for staff around diversity issues, he said. At his trust, staff induction programmes contain a section on equality.

Many BME staff also appear to face barriers when it comes to applying for jobs. On average, BME people make up 39 per cent of job applicants, 24 per cent of those who are shortlisted, but only 17 per cent of appointed candidates.

At some organisations the figures are particularly stark: at Havering PCT, 37 per cent of people interviewed for jobs were BME but this translated into only 15 per cent of offers made.

A spokeswoman said: “All candidates who apply for interviews are selected against the person specification for the particular post for which they have applied.

“As with all organisations, the person who is offered the job is the person who best meets the person specification and who best performed at the interview on the day.”

At Lancashire Care foundation trust, 21 per cent of shortlisted candidates were BME but only 13 per cent of successful applicants.

Managers’ role

NHS Employers head of equality and diversity Carol Baxter said: “Managers need to develop their interviewing skills regarding diversity. It’s a legal obligation to train staff in equal opportunities.”

Impact assessments also reduced the risk of discrimination, she said, but trusts did not always carry them out.

NHS Employers is working with 11 trusts that have identified patterns of BME under-representation among managers and over-representation in disciplinaries.

It is also carrying out research with Bradford University into why BME staff account for such a large proportion of disciplinaries and capability reviews.

HSJ’s figures, collated using the Freedom of Information Act, show the national picture reflects a report published by the South East Coast BME network in August. This caused a stir in the region but led to the strategic health authority committing itself to addressing the problems and trusts offering to fund local BME forums.

The report’s author, Vivienne Lyfar-Cisse, said HSJ’s analysis showed managers needed to be held more accountable for the experiences faced by their BME staff.


  • Average % BME applicants - 39

  • Average % BME shortlisted - 24

  • Average % BME appointed - 17


At the 231 organisations that responded to HSJ’s information request, BME staff make up:

  • 16% of the workforce

  • 8% of non-executive directors

  • 5% of executive directors

  • 34% of capability reviews

  • 44% of bullying and harassment cases

  • 31% of grievances

  • 29% of disciplinaries