No shortcuts to tackling racism

The NHS Confederation has not traditionally been known for being at the forefront of tackling racism. But that’s changing. Tackling racism is just as much a part of great leadership as all the other ‘isms’ that it is necessary to eliminate, and with our new anti-racism strategy we are supporting our members to do so.

In a time of increasing inequality, particularly after the unequal impact of COVID-19 on black and minority ethnic communities along with the global Black Lives Matter protests, it is imperative that the NHS Confederation supports members to tackle inequality and racism in particular; a timely intervention where evidence of the impact of racism shortening life also points to anti-racist practice improving conditions for all communities.

Why we are tackling racism

Evidence that that ill-health and death are unequally distributed among the population of Britain because of social inequality has been regularly reported ¹  since the 1980s. The evidence that racism produces inequity and reduces racialised communities’ access to, experiences of, and outcomes from, NHS care is overwhelming. Similarly legal, ethical and commercial cases as to why the NHS must address its role in promoting racialised inequalities have been repeated too many times.   

Specific quantitative data revealing the impact of racism within the NHS is also well documented.

However, the gulf between NHS leaders’ commitment to tackling racism, the reality of services in racialised communities, and the lived experiences of our staff from those communities, is fuelling ever greater disillusionment among those staff and communities.  

At a time of crippling vacancy numbers right across the service, and an exhausted and demoralised workforce, the potential benefits of tackling racism in the NHS are plain to see

At a time of crippling vacancy numbers right across the service, and an exhausted and demoralised workforce, the potential benefits of tackling racism in the NHS are plain to see. Moreover, given the demographic structures of the communities it discriminates against, it risks alienating itself from the skills and resources that will be essential to its long-term sustainability.

We also know that tackling racism, including institutional and systemic racism, is key to better governance, service transformation, workforce retention and delivering our Public Sector Equality Duty.

Most importantly for the NHS, the Centre for Disease Control (CDC) describes racism as a ‘serious public health threat’ both to patients and the workforce. Recognising that racism is also a fundamental driver of ill health, the CDC locates racism as ‘the root cause of many health disparities’; a position aligned to findings from the Race and Health Observatory Health Inequalities Rapid Evidence Review 2022, analysing ‘the overwhelming evidence of ethnic health inequality through the lens of racism.’

Walking the talk

NHS leaders have struggled to deliver the step change required to improve experiences of racialised communities either working within the NHS or those using NHS services.

However, we can only realistically seek to advise members on their approach to delivering racial equality by demonstrating that our own policy and practice ‘walks the talk.’

It will not be an easy process, but we can do no less if we are serious about healthcare leaders being actively anti-racist

Our anti-racism strategy has been developed with our members, our staff at all levels, and our Black and Asian Minority Ethnic (BAME) staff network. It will be actioned across the NHS Confederation group, targeted and evaluated. It will not be an easy process, but we can do no less if we are serious about healthcare leaders being actively anti-racist.

Anti-racism is a key strand of our equality, diversity and inclusion programme tackling inequality. Being an anti-racist organisation means that we actively target, challenge and remove systemic barriers that enable racism, recognising that this is a corporate responsibility where commitment, understanding and action to eliminate racism and reduce health inequalities really matters:

• Commitment - because for years we have not had the concerted action that drives successful outcomes in diversifying non-executive and executive leadership to assist in creating anti-racist organisations.
• Understanding – means we use the evidence base to inform the personal and organisational leadership and accountability required to eliminate racism.
• Action – because commitment and understanding are meaningless if we do not act.

Our anti-racism strategy can support leaders and organisations to be anti-racist through commitment, understanding and sustained action. But there is no quick guide to tackling racism, we must be in it for the long haul.

It’s time to tackle racism that facilitates health equity, through a diverse and committed body of healthcare leaders.

Joan Saddler is director of partnerships and equality at the NHS Confederation.