Major NHS review reports ‘stark ethnic inequalities’ across health services and levels of pay

A new review of 10 years of healthcare research has found “stark ethnic inequalities” affecting parts of the health system including mental health services and the pay levels of ethnic minority staff.

The review, first reported in The Guardian and seen by the PA news agency, recorded inequalities in every field it studied: mental healthcare, maternal and neonatal healthcare, digital access to healthcare, genetic testing and genomic medicine and the NHS workforce.

The Observatory director Dr Habib Naqvi said the review made a “clear and overwhelming case for radical action on race inequity in our healthcare system”.

“It is clear that existing evidence on the stark health inequalities faced by ethnic minority communities has not led to significant change.

“This is why the Observatory has been established: to synthesise what already exists, translate it into actionable policy recommendations, and to challenge leaders to act.”

The report said the impact of racism within the NHS workforce included evidence of a pay gap affecting “black, Asian, mixed and other groups”, and that during the pandemic Covid-19 infections were higher in ethnic minority staff.

Some of the the largest inequalities were recorded in mental healthcare.

It found GPs were less likely to refer ethnic minority patients to the Improving Access to Psychological Therapies programme compared to white patients.

Black children were 10 times more likely to be referred to mental health services via social services than a GP compared to white children.

The review of maternal healthcare found evidence of negative interactions, stereotyping, disrespect, discrimination and cultural insensitivity, leading to some ethnic minority women feeling ‘othered’, unwelcome, and poorly cared-for.

Lead investigator Dr Dharmi Kapadia from the University of Manchester said “the time for critical action” was now.

She said: “For too many years, the health of ethnic minority people has been negatively impacted by a lack of high-quality ethnic monitoring data recorded in NHS systems; lack of appropriate interpreting services for people who do not speak English confidently and delays in, or avoidance of, seeking help for health problems due to fear of racist treatment from NHS healthcare professionals.

“Our review confirmed that all of these issues are still to be tackled by the NHS. The evidence on the poor healthcare outcomes for many ethnic minority groups across a range of services is overwhelming, and convincing.”

The research was conducted by the University of Manchester in conjunction with the University of Sheffield and the University of Sussex.

Over 13,000 research papers were screened and 178 studies were included in the final review. But one problem encountered by the researchers was a lack of research into ethnic experiences in a number of specific areas.

An NHS spokesperson told The Guardian: “The pandemic has shone a stark light on health inequalities across the country and the NHS is already taking action to improve the experiences of patients and access to services.

“The NHS has set out what local health services should be focusing on over the next year so they can make these improvements in their local communities and is already working closely with the Race and Health Observatory to drive forward the recommendations set out in this report.”

The report. which is expected to be published in full later this week, urges further ‘critical action’ to be undertaken by organisations including NHS England, NHS Improvement and NHS Digital.

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