Race Observatory Explores Cost of Racism to NHS at ConfedExpo

Better care, training and anti-racist policies could significantly increase workforce numbers and productivity in the NHS, improve patient experience, and save millions of pounds spent annually on addressing racism claims brought by staff, clinicians and patients, according to a panel of health and race experts speaking at the Confed Expo conference today, 15 June.

Hosted by the NHS Race and Health Observatory, leading authorities including Board members Dr Chaand Nagpaul, Yvonne Coghill and chair, Marie Gabriel will focus on exploring the emotional, workforce and financial costs with Andrea Sutcliffe, Chief Executive of the Nursing and Midwifery Council, and patient advocate, Shabiha Azam.

Whilst claims resulting in formal proceeding run into millions of pounds for the NHS annually, the emotional impact of racial discrimination is equally devastating to the public purse with increased staff sickness and absence, as well as negatively impacting on workforce retention.

This autumn, the Observatory will publish a new review examining the costs of racism in the NHS.  Despite making up almost a quarter of the NHS workforce, Black, Asian, and minority ethnic staff are more likely to experience bullying, harassment, and discrimination than White staff, and are less likely to be appointed or promoted.

Worse outcomes are also faced by patients across maternity services, where Black, Asian, and minority ethnic women often report experiences of negative interactions, stereotyping, disrespect, discrimination and cultural insensitivity. Black British mothers are up to five times more likely than White mothers to die during pregnancy or within the first six weeks after childbirth. The risk of dying from pregnancy-related causes is three times higher for mothers of mixed ethnicity than for White mothers and twice as high for women of Asian ethnicity.

The impact of racism and discrimination on the nursing and midwifery profession is significant, said Andrea Sutcliffe, Chief Executive Officer and Registrar of the Nursing and Midwifery Council.  “Racism towards nursing and midwifery professionals is utterly unacceptable but persists across health and social care. It destroys people’s confidence, undermines morale, destabilises team working and directly impacts on safety. With more than a quarter of our register coming from black and other minority ethnic communities, it’s more important than ever for employers to create inclusive, anti-racist cultures, free from discrimination and bias.”

Black and minority ethnic people, particularly Black groups, are also over-represented in mental health pathways, where harsher treatment is received, particularly within inpatient wards. Black men are also more likely to be restrained in the prone position or put into seclusion.

 Established in April 2021 to tackle ethnic health inequalities, the NHS Race and Health Observatory brings together evidence and insight around long-standing inequities affecting ethnic minority patients, communities, and the healthcare workforce.

Observatory board member and ex-chair of the British Medical Association (BMA), Dr Chaand Nagpaul says the effects of racism is impacting adversely on workforce numbers at a time of unprecedented NHS pressures and impacting on quality and safety of patient care.

“Racism is not only wrecking the lives of thousands of healthcare practitioners daily, but also threatening patient care and services, with one third of ethnic minority doctors having left or are considering leaving work, and 16% off sick due to racist experiences. Eradicating racism needs to be an urgent national priority to make full use of our diverse healthcare workforce amidst exceptional service pressures as well as to ensure the future sustainability of the NHS.”

Racism and lack of culturally competent care can also result in untold suffering for patients and their loved ones. Shabiha Azam, a lifelong NHS advocate herself, discussed the impact of the loss of her late father, Mohammed Azam, 69, a volunteer and community champion from West Yorkshire, who passed away in 2021 from COVID-19.

After being moved to the high-dependency unit, the family were relieved to hear that Mohammed was sitting up and eating, only to later discover it was another patient also called Mohammed.  Worse to come was the discovery that a DNR (do not resuscitate) notice had been placed on file without any former discussion with the family.

Shabiha said, “The biggest regret was in his last hours, the hospital arranged a 30-minute video call with the wrong family. Although Dad said he didn’t recognise them, there was this assumption made that he was delirious. It was strangers, not his family on that video call, we didn’t get a chance to say goodbye properly.”

Although they are grieving the loss of Mohammed, and the shortcomings in his care, as a family dedicated to improving healthcare and outcomes for others, this has inspired them to help make meaningful change across the NHS.

The family, with the support of NHS England, have since produced a digital story video entitled, Mohammed Azam – A Legacy for Today, a learning resource to help Hospital Trusts across England improve patient care, recognise cultural bias and assumptions around racial profiling.

Yvonne Coghill, former director of the NHS Workforce Race Equality Standard said: “We have so much data and research to learning from. Health leaders now need to simply get on with demonstrably making the necessary changes to ensure equity is embedded throughout the service.”

Chair of the NHS Race and Health Observatory, Marie Gabriel, added:

“Racism is costing the NHS millions and is a high and avoidable price to pay from public funds. This resource could instead be directed towards ensuring better access, outcomes and experience for those who use services and work in the NHS.  The Race and Health Observatory works with communities, global experts and the NHS to enable improvement.  We need to ensure these resources, and those created in honour of Mohmmed Azam ensure that no other family suffers the painful and avoidable human cost of discrimination.”