NHS England report covers diversity, discrimination and pay-gaps

A new report has been published on diversity within the doctor workforce across the NHS in England.  

A foreword written by NHS People Officer, Prerana Issar, addresses the challenges of representation and diversity and calls for action across the NHS to tackle discrimination. It says: “The starkest evidence of the disadvantages faced by BME doctors in the NHS was laid bare by the tragic deaths of doctors due to COVID-19 infection during this past year.” 

The Medical Workforce Race Equality Standard (MWRES) was introduced in 2015, to record the differences of experience between white doctors and Black and minority ethnic doctors. In September 2020, 11 indicators were outlined that would document the experiences of doctors and draw a conclusion about which areas needed improving.  

Several organisations were involved in contributing to the MWRES including the General Medical Council, the Medical Schools Council and Health Education England. 

A summary of the report says, “the data shows that across almost all indicators, BME doctors reported a worse experience at work compared to white doctors” and that this was evident from doctors still training in medical school through to established professionals, at a consultant level.  

BME doctors make up a sizeable portion of the doctor workforce, with 41.9 per cent (53,157) of the medical and dental workforce in NHS trusts and clinical commissioning groups coming from BME backgrounds. Yet, in the executive summary, the report details that BME doctors have an overall worse experience when it comes to discrimination.

Across trusts and CCGs, the report found that BME doctors are: 

  • Underrepresented in consultant grade roles 
  • Overrepresented in other doctor grades and doctors in postgraduate training 
  • Underrepresented in academic positions.

14 areas of suggested action to address these inequalities are set out for the NHS. A selection of these are below: 

  • Organisations and institutions expressly communicating their intention to address inequality 
  • Stakeholder organisations to aim to have a workforce, in both voluntary and staff roles at all levels, that reflects the diversity of their membership 
  • Enhancing the leadership diversity of the royal colleges and arm’s length bodies. 

The report also covers the annual NHS staff survey, which is the second indicator in the report. In response to the question “do staff believe their trust provides equal opportunities for career progression or promotion,” 91.4 per cent of those who identified as white believed their trust provided good career progression, whereas 79.5 per cent of BME consultants agreed with the same statement.

The representation of BME doctors in clinical director roles features in the report, too. From the 41.9 per cent of BME doctors in the workforce, only 26.4 per cent of clinical directors and 20.3 per cent of medical directors were from a BME background.

There is also significant pay gap when considering BME medical and dental staff pay rates. On average, white doctors earn seven per cent more than their BME colleagues. BME doctors are also less likely to receive an offer to be a consultant, when compared to white doctors. The report says 77 per cent of white doctors were offered a post, after being shortlisted, whereas only 57 per cent of BME doctors were invited to be a consultant.  

Professor Anton Emmanuel, Lead for the NHS Workforce Race Equality Standard (WRES) said: “Medicine has long been an aspirational profession for many people, and I am fortunate to have been able to become a doctor, and even more so to work in the NHS. Nevertheless, it is also clear that other colleagues in the system, especially those trained above, have a different experience. 

“This report will be vital in ensuring the NHS and other health bodies continue to take the steps needed to ensure all staff and patients are treated in the fair and compassionate way.” 

Find the full version of the MWRES, here.