A survey reveals that while guidelines for employers outline thorough risk assessment of BAME staff, only 38% of respondents had undergone any kind of risk stratification by their employers. Though trade unions representing healthcare workers are engaging in various services to support BAME staff, 61% of respondents had not received any support ….write Radhika Kaimal and Dr. Manoj Rajagopal
With the easing of lockdown measures around the UK, the fear of a second wave of Covid-19 looms upon the population and health authorities alike. Mitigating such a situation relies heavily on an already pressured health service.
One of the observations of the pandemic thus far, is the increased susceptibility of ethnic minority population and Covid-19 outcomes. Of the NHS staff who have sadly died from Covid-19, 63% where from BAME background. Of this number, 71% of the nurses and midwives, 94% of doctors and dentists, 56% of the healthcare support staff and 29% of other healthcare personnel were from a BAME background. Addressing and mitigating the vulnerability of all healthcare staff, especially those of BAME background, is of paramount importance. This will be vital in ensuring the healthcare system can cope with a second wave of Covid-19 infections
Public Health England have highlighted some of the possible reasons for increased susceptibility to COVID-19 in ethnic minority groups. These disparities are set against a higher prevalence of numerous health conditions, including diabetes, cardiovascular disease, and mental ill health in ethnic minority populations across the UK. However, firm evidence to confirm this is awaited.
Research has also shown differential attainment by ethnicity in the medical workforce across all measures of career progression. Ethnic minority healthcare workers also have more difficulty in having their concerns and grievances heard.
An online survey was initiated to report on current attitudes of BAME healthcare staff towards working on the frontline. The survey was sent across UK to different health staff in various posts to get their opinions and concerns, as well as their views on what support would give them confidence in continuing to work on the frontline.
221 responses were collected on 1st June. 64% of respondents were doctors, 29% were nurses and the remaining were healthcare assistants and other ancillary staff. 86% of the nurses and 90% of the doctors felt very much concerned about working on the frontline and that this was related in part or entirely to their ethnicity.
The results of the survey highlighted the fact that while guidelines for employers outline thorough risk assessment of BAME staff, only 38% of respondents had undergone any kind of risk stratification by their employers. Though trade unions representing healthcare workers are engaging in various services to support BAME staff, 61% of respondents had not received any support.
In spite of this, only 19% of respondents were in favour of being withdrawn from frontline work. They felt that provision of adequate PPE and effective risk stratification would provide them with adequate support and protection to continue their work.
In addition to the above responses, an overwhelming number of respondents reported a feeling of institutional apathy among the NHS and management. “It would be great if frontline BAME staff are not coerced into front line positions by colleagues who then are not participating equitably in frontline tasks.”
Issues included a lack of representation among decision making teams, with many feeling excluded by the management. “Very few BAME staff are part of the management boards of the trust, more representation of BAME staff in management boards an absolute must”.
Another point reiterated by many was the culture of coercion towards ethnic minority staff, preventing equitable delegation of frontline tasks and in high risk areas. “Auditing work pattern of BAME staff. Not making them work more than their fair share in the red areas”. “Frontline duties should be equally distributed”
It seems that these issues are not exclusive to the Covid-19 period and exist as systemic flaws within the healthcare system. The survey has also raised questions on institutional bullying and racism. “The main issue is that BAME staff are going through mental bullying from those in charge or co workers who are of white background.” There were calls and suggestions to request various organisations to raise voice against these indifferences to BAME staff. “Investigate vigorously institutional racism in NHS trusts Also push back against culture of complaints against BAME staff which are in part due in part to cultural differences in approach” BAME healthcare workers continue to be insufficiently supported, with their concerns systematically dismissed. “The trust is not proactive in recognizing the risk to staff.” Even after BAME staff been disappointed and concerned on the treatment they receive from their employers and managers, they still find it difficult to raise their concerns. “[BAME staff] fear that if they say no to such unreasonable requests, they will lose their jobs and face uncertainty in this country.”
Research confirms that the extent to which an organisation values its minority staff is a good barometer of how well patients are likely to feel cared for. Tackling the above issues will be vital to ensuring that BAME staff are not only properly equipped and supported to work in the event of a second wave of infection, but also that they are valued and respected for their service to our healthcare system.
(Radhika Kaimal is a student at Clitheroe Royal Grammar School and Dr. Manoj Rajagopal is working with the NHS as a Consultant Psychiatrist)