The 2023 NHS Workforce Race Equality Standard: here we go again?

Spring is in the air and there have been three recent temperature checks of staff satisfaction and inclusion: the NHS Staff Survey, the Workforce Disability Equality Standard (WDES) and the Workforce Race Equality Standard (WRES). As ever, this year’s WRES data shows a mixed picture on race equality and inclusion for NHS staff. On the more positive side, there has been: 

• growth in the ethnic diversity of workforce (from 17.7% in 2016 when data collection started, to 26.4% in 2023) 

• a continued decline in the relative likelihood of ethnic minority employees entering the formal disciplinary process (1.56 relative likelihood in 2016 to 1.03 in 2023) 

• an increase in the ethnic diversity of NHS trust board members (7.1% in 2016 and 15.6% in 2023).  

However, for two WRES indicators, the picture in 2023 is pretty much the same as it was in 2016. White staff are still more likely to be appointed from shortlisting across all job posts and they are more likely to access non-mandatory training and continuous professional development. Also, the percentage of staff from ethnic minority groups reporting experiencing discrimination from colleagues has always been more than double the percentage of white staff reporting the same. The NHS Staff Survey shows the percentage of staff who experienced discrimination reporting that it was on the grounds of their ethnicity has risen from 46% in 2019 to 51% in 2023.  

Of course, being an employee from an ethnic minority group and having a disability are not mutually exclusive (a person can have more than one characteristic protected by the Equality Act 2010), so it’s important to point out the WDES isn’t telling an encouraging story of inclusion either. WDES data shows the staff engagement score for disabled staff has fallen for the third year running, NHS trusts are not making (legally required) reasonable adjustments for 26.6% of disabled staff – and they are more likely than non-disabled staff to report harassment, bullying or abuse by a manager. 

Navina Evans spoke with pride about the increasing ethnic diversity of NHS workforce at The King’s Fund’s recent leadership and workforce summit, but the fact is the ‘high-impact’ actions of NHS England’s national equality, diversity and inclusion (EDI) improvement plan are yet to live up to their name if the WRES and WDES are anything to go by. More staff from minority ethnic groups may be joining the workforce, but their experiences in the workplace are not always equitable or fair.   

There are many layers and aspects of racism in health care that need to be addressed, and it is therefore unsurprising that taking action is not straightforward. As an NHS director of human resources once told me, a trust’s improvements in one or two WRES indicators is often simultaneous with a decline in others. Tackling racism takes considerable time, focus and resources. Paradoxically, there is currently political pressure on the NHS and civil service to prove EDI initiatives are value for money. Undoubtedly it is very challenging for the NHS to move forward when there is political downplaying of the issue. 

The publication of WRES data tends to give me a sense of déjà vu every year. The King’s Fund and others call out discrimination within the workforce every year. So it was interesting when a colleague pointed out the NHS Staff Survey dataset shows a few areas where there was little to no difference between what white staff and staff from ethnic minority groups reported. For example, there is barely a difference between the percentage of ethnic minority and white staff survey respondents who reported being satisfied about recognition for good work and that their line manager encourages them. There are also some areas where experiences reported by staff from ethnic minority groups are better than those reported by white staff, such as looking forward to going to work (63% and 53% respectively).  

So, as important as it is to know where the inequalities are showing up and to confront them, it would be helpful to understand what’s happening for those staff from ethnic minority groups who feel a greater sense of being valued and having purpose.