Report into NHS recruitment and retention warns inequality among staff is getting worse

Inequality among NHS staff members of different races and religions is “getting worse”, according to a report by the Nuffield Trust.

Commissioned by NHS Employers, part of the NHS Confederation, the research says that Muslim staff are more than twice as likely to experience discrimination than staff of no religion, and male nurses are twice as likely to progress up two pay bands than female nurses.

The report, called Attracting, Supporting and Retaining a Diverse NHS Workforce, gives data based on interviews with frontline workers.

It says that 13% of Muslim staff have felt they have been discriminated against by a manager or colleague within the last 12 months, compared with 6% of workers with no religion.

After nine years’ service, 41% of male nurses progressed up two pay bands, compared with 20% of female nurses, according to the report.

Those who prefer to self-describe their gender are twice as likely to experience discrimination as male or female staff, the report found.

The research adds that ethnic minority staff are 27% less likely than white staff to be “very senior managers”, the highest executive grades, though there are large disparities between trusts.

White staff were at least twice as likely to be appointed from a shortlist than those from ethnic minority groups in 36 trusts, but in another 32 the likelihood was the same.

The report also found that only two in five deaf NHS workers said they had the reasonable adjustments they needed at work during the pandemic.

Its authors conclude: “Despite considerable effort and countless initiatives, inequality between NHS staff groups is persisting or even getting worse – and the health service does not have the tools to address this.

“Crucial data is lacking, less high-profile groups are being overlooked, and the understanding of what actually works to improve diversity and equity is poor.

“It also stands in the way of the health service’s ability to find and retain staff at a time when more capacity is desperately needed and targets require an additional 50,000 nurses.”

Nuffield Trust senior policy fellow, Dr William Palmer, said: “On paper the NHS has recognised for years that disparities and discrimination among staff are morally unacceptable and disruptive to good quality care.

“Yet progress in actually reducing disparities has been painfully slow – and we even saw signs that bias may be getting worse.”

Danny Mortimer, chief executive of NHS Employers, added: “There is an absolute commitment from our members to finally address the inequities in our workplaces.

“This report highlights action that is being taken but rightly reminds us that far more urgency and impact is needed in every part of the NHS.”

Royal College of Nursing chief executive Pat Cullen said the NHS leadership has “no alternative but to act on the findings” of the report.

She said: “This report spells out clearly that a lack of inclusion and diversity can’t be pushed down the list of priorities any longer.

“It’s not just a barrier to recruiting and retaining more nurses; it puts patients at risk.”

The report recommends the NHS includes nationality in its staff survey and that each trust ensures its diversity leads have access to continuous training.

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