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White NHS nurses twice as likely as black and Asian colleagues to be promoted – study | NHS



White nurses are twice as likely as black and Asian colleagues to be promoted in the NHS, with minority ethnic staff overlooked due to structural racism, according to research.

The Royal College of Nursing (RCN) said its study suggests racism is “endemic” in health and care. A survey of almost 10,000 nursing staff found that those who are white or of a mixed ethnic background are more likely than black and Asian colleagues to have received at least one promotion since the start of their career.

The difference is most stark among those aged between 35 and 44, according to the RCN, which published the report at its annual congress in Glasgow. While 65.9% of white and 64% of mixed ethnic respondents in this age group said they had been promoted, this dropped to just 38.3% of Asian and 35.2% of black respondents.


The college called on the government to take action to tackle racism, including a legal requirement to eliminate disparities in recruitment, retention and career progression, or a greater responsibility for employers to protect minority ethnic groups.

The RCN said structural racism is having a “devastating” impact on minority ethnic staff, highlighting survey findings that black respondents working in hospitals and community care are more likely to report experiencing physical abuse than respondents of other ethnic backgrounds.

Bruno Daniel, the RCN’s diversity and equalities coordinator, said: “Examples of racism experienced by nursing staff in the workplace are deeply shocking. The pandemic has shone a spotlight on structural racism in health and care services and we must seize this opportunity to stamp out this vile behaviour once and for all.

“The UK government and devolved administrations must properly acknowledge and address this problem and the devastating impact it has on black and ethnic minority staff and patients.”


Speaking at the conference about being sent to high-risk areas during the pandemic, agency nurse Roseline Sanni-Ajose said: “Covid-19 was a terrible situation for black and ethnic minority nurses in the country. Due to the shortage of PPE, we were not given adequate masks and were told to reuse our protective clothing and wear a gown all day, even if we’d been exposed to Covid-19 patients.”

Saffron Cordery, the interim chief executive of NHS Providers, said the findings represented fresh evidence of “the unacceptable presence of structural racism within our health and care system”.

“As the largest employer of black, Asian and minority ethnic people in the country, the NHS must recognise and confront the structural racism and discrimination that still exists within its ranks,” she added.

“There is also clear evidence that patients from ethnic minority backgrounds have worse experiences of healthcare than their white counterparts. This must be addressed as we bear down on waiting lists by having a particular focus on correcting inequalities of access to healthcare linked to ethnicity or deprivation.”


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Earlier this year, the Guardian revealed that a damning review commissioned by the NHS Race and Health Observatory had found that “vast” and “widespread” inequity in every aspect of healthcare it reviewed was harming the health of millions of patients.


Racism, racial discrimination, barriers to accessing healthcare and woeful data collection on ethnicity had “negatively impacted” the health of black, Asian and minority ethnic people for years, according to the study, which revealed the true scale of health inequalities faced by ethnic minorities for the first time.

“It is only by recognising these facts and having an honest conversation about racism, its structural roots and its impact, that change can be achieved,” said Cordery. “Every leader across the NHS and government has a duty to actively work to eliminate inequality based on race. NHS boards and senior leaders must demonstrate the behaviours expected and needed – collectively and individually – to dispel prejudices.”

An NHS England spokesperson said: “Having a workforce that best reflects the people we care for is good for our staff and good for our patients, so although it’s important that there are more BAME nurses in senior roles than ever before, the NHS recognises that more needs to be done.”

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