This page is dedicated to supporting staff in addition to free psychological services, resources for workplace support and self-help.
- The NHS is the fifth largest employer in the world, with one in five workers of BME heritage.
- Black people make up 6.5 per cent of NHS staff. The proportion has increased but currently, only 10 per cent of NHS board members are from BME backgrounds.
- White staff are still 1.5 times more likely to be appointed for a job than BME staff.
- 5.2 per cent of the medical workforce and 6.6 per cent of the non-medical workforce in the NHS are from a black background
- 1.3 per cent of very senior managers working in the NHS are black
- 2.5 per cent of Band 9 managers identify as black
- 3.6 per cent of senior doctors, 7.1 per cent of junior doctors and 3 per cent of other doctors are from black backgrounds
Figures taken from the NHS Workforce Statistics (March 2020 data).
Learn about the NHS Workforce Race Equality Standard (WRES) and how NHS organisations can address race equality issues.
Trigger warning: Reading about racism can evoke negative, uncomfortable feelings and trauma. If you've been affected by the contents of this page, remember you can always have a chat with our Keeping Well practitioners.
Experiences of racism can be traumatic
The impact racism can have on your mind and body is sometimes described as racial trauma. There's no universal definition of racial trauma. Racism can exist in many forms, in many levels in society – including in the healthcare system. Some professionals use it to mean all the effects that encountering racism can have on how we think, feel and behave. Others, like those using the race-based traumatic stress injury model, use it to describe a specific group of symptoms. (Carter, 2007).
- Feeling depressed or angry about specific events or situations affecting you, family members or people you identify with.
- Feeling very anxious, on edge and unable to relax (called hypervigilance or hyper arousal). For example, you might always be looking out for threats or danger or might have previous experiences with colleagues or patients that have been distressing or targeted.
- Intrusive thoughts or flashbacks related to specific events or memories
- Avoidance. For example, you might find it difficult to remember or talk about your experiences. It might feel hard to believe they really happened. You may also avoid people or places that remind you of your experiences.
- Low self-esteem
- Finding news articles or events in the press triggering
- Physical symptoms. For example, sweating, trembling or a racing heart.
- Blaming yourself. There are many reasons for this. Sometimes it can be the way your brain tries to make sense of what has happened.
Racism may also have a traumatic impact on you even when you didn't encounter it personally. For example:
- Vicarious trauma. This is when seeing or hearing about racism towards someone else feels traumatic to you. It may also bring back painful memories of your own experiences.
- Historical trauma (or historical loss). This is when you're affected by the realisation of how your racial group has been oppressed over time.
- Intergenerational trauma. There is still much to be researched and learned by the impact of this following trauma. Knowing that when our elders have been harmed by racism, this can affect us in turn. It can impact our self-esteem, sense of safety, and views of the world around us.
But however you choose to define your experiences, it is always okay to ask for help with your mental health. You shouldn't need to say specific things or use specific words to get support. What you find traumatic is personal to you. You might go through something similar to someone else, but be affected differently by it. You might find it much harder or easier to cope. It is important to remember, that every reaction to something difficult is valid.
What's it like being a member of staff from an ethnic minority background in the NHS?
Watch this short video by The Kings Fund who spoke with 12 members of staff from ethnic minority backgrounds about their experience working in the NHS. It outlines staff experiences, from being bypassed for career development opportunities to the impact of micro-aggressions in the workplace.
If you feel you may have experienced a traumatic experience or event related to racism, and would like further support visit our coping with traumatic experiences page.
This section includes some advice which may be helpful when talking to a colleague who is dealing with racism at work. It is not intended to offer a failsafe formula.
There are no easy solutions, and the range of potential experiences that may trigger this kind of conversation is almost infinite. But the hope is that these ideas will help you approach the situation in supportive, sensitive way and with some confidence that you are helping.
Please note the below scenarios assume that the supporter in the conversation is white and a colleague, friend or manager to a BAME employee who has experienced racism. It should be noted that that the supporter may not be white and may also feel discomfort about engaging in this kind of conversation.
Be a helpful listener and ally in the conversation
- Dont let your frustration get in the way – e.g. your sense of powerlessness at not being able to resolve all the issues raised.
- Don't shy away from parts of the discussion you cannot immediately relate or respond to
- Don't let your fear of saying the “wrong” thing, get in the way of your curiosity about what has happened and what should be done
Remember that your own discomfort is minimal compared to what your colleague is experiencing, and that where you experience that discomfort or lack of understanding, it is a strong signal that you would benefit from educating yourself about racism, its manifestations and impact.
Create space for safe conversations
- Always maintain confidentiality. While the content and themes may be helpfully shared to inform organisational action to combat racist discrimination, it is critical to agree that the detail of discussions will remain confidential with nothing that is said attributed to individuals.
- Acknowledge different perspectives. Recognise that individual worldviews are shaped by the experiences of the individual, many of which are determined by culture, race, gender, sexuality, country of birth, among other things.
- Acknowledge fear. It’s likely that people will worry about reactions, responses or reprisals.
- Acknowledge the likely discomfort felt by those involved, but communicate the importance of pushing through in pursuit of greater mutual understanding, learning and agreed actions.
- Exercise humility. Admit mistakes and accept that positive intent may not always be enough.
- Accept that you have learning to do. There is always learning from listening to new perspectives; acknowledge that this is a journey for you.
Keys to an effective, supportive conversation
- Active, empathic listening is essential. As your colleague gives vent to their feelings and shares what happened, it is enough just to listen to them. Don’t interrupt, don’t put words in to their mouth, and don’t feel the need to rescue them - let them speak. Active, empathic listening helps establish a space that is non-judgmental, compassionate, and safe. It says “I am here for you.”
Validate. Very often when people encounter racism, they can experience self-doubt – not least because of the social narrative that BAME employees are “oversensitive”, “too ready to take offence” or “blow things out of proportion.” It is important to validate and not question your colleague’s experience, so make sure they hear from you a clear acknowledgement that that what happened to them was wrong, unfair and not their fault. To be sure, not everyone will need this kind of validation, but even then there is value in your acknowledgement and support.
Seek to empower, not rescue. The great majority of us, when we hear someone describing a personal problem, will naturally have a strong desire to help. This often leads to well-intentioned advice and offers of intervention, which can be disempowering. It could well be that what your colleague wants and needs is your active support, but it is usually best to start from the principles that:
- They know best how they want to handle the situation
- They have the ability and access to the resources they may need
- Your role is to help them think through their options, and decide on the best course of action for them.
Be an ally and be prepared to be an active advocate. An ally is any person that actively promotes and aspires to advance genuine inclusion through intentional, positive and conscious efforts. As an ally, you want to understand how you can help to redress inequalities, working alongside those who experience unfairness.
In practical terms there are many ways in which you can be an effective ally, and in this instance – when responding to a report of a racist experience – you may be most effective if you take an active role and advocate for your colleague. This may mean:
Helping to document and report the incident
Accompanying them to interviews or meetings
Signposting or helping them research resources that may be helpful
Being a continuous source of support through what may be a drawn-out and draining process
Stay in touch. It is rare for situations like this to have a quick fix. So one supportive conversation is unlikely to be the extent of what your colleague needs from you. As a genuine ally, you should:
- Check in to see how your colleague is coping
- Follow up on actions and communications to ensure that headway is being made – this is particularly important as it is very common for reports of racism to be assigned to the “too difficult” pile
- Maintain an interest in the welfare and maybe even the career progression of your colleague.
Looking After You Too: Coaching for NHS staff from ethnic minority backgrounds
- Looking After You Too (LAYT) coaching is a one to one wellbeing support offer for staff from ethnic minority backgrounds working in the NHS (clinical and non-clinical).
- The coaching service is provided by trained coaches from ethnic minority backgrounds who will help you develop practical strategies to manage and maintain your health and wellbeing.
- LAYT coaching is confidential and free. No details are shared with employers and the coaches are external to the NHS. It can provide you with a safe and judgement-free space to deal with difficult conversations and build resilience.
Our Strengths Coaching programme aims to support BAME NHS colleagues across the health and social care system by building confidence and empowerment in individuals, and working to improve inclusivity, engagement and productivity within teams. Coaching builds a partnership between coach and coachee. The role as the coach is to help the coachee to achieve their personal best and to produce the results they want in their personal and professional lives.
Black Minds Matter UK
The aim of Black Minds Matter is to ensure that black people in the UK can access mental health support. The organisation does this by helping black people and families across the nation to find professional mental health services, in addition to raising money to help cover the cost of such services.
Mind for Young Black Men
The Young Black Men programme through which works specifically with young black men aged between 11 and 30 years old.
BAATN - The Black, African and Asian Therapy Network
Home of the largest community of Counsellors and Psychotherapists of Black, African, Asian and Caribbean heritage in the UK.
Resources and support networks for young Black people on our Bayo website.
- Workforce Race Equality Standard (WRES) - Since 2015 all NHS organisations have been required to demonstrate how they are addressing race equality issues in a range of staffing areas.
- Shattered hopes - The NHS Confederation's report into black and minority ethnic leaders’ experiences of breaking the glass ceiling in the NHS. It shares reflections on the lived experience of senior black and minority ethnic leaders in the NHS.
- Addressing shattered hopes blog - Rob Webster and Fatima Khan-Shah share their aspirations for addressing race inequality in the NHS, and the steps that are being taken in the West Yorkshire Health and Care Partnership.
- Health on the Line: To be more representative means doing things differently - A podcast featuring Matthew Taylor, chief executive of the NHS Confederation and Ifti Majid, chief executive of Derbyshire Healthcare NHS Foundation Trust and co-chair of the NHS Confederation’s BME Leadership Network.
- The NHS Race and Health Observatory (RHO), which is hosted by the NHS Confederation and supported by NHS England and NHS Improvement, has been set up to investigate the impact of race and ethnicity on people’s health. The RHO has published an infographic highlighting ethnic health inequalities in the UK, to coincide with Black History Month.
- Ethnic health inequalities and the NHS – This report published by NHS Race Health Observatory argues that the NHS has not made significant progress in reducing ethnic health and more needs to be done.
- Strengthening NHS board diversity - This report overview published by the NHS Confederation explores the steps needed to strengthen the diversity of NHS boards in England.
Current evidence throughout the Covid-19 pandemic shows that those from a Black and Asian minority ethnic background have been disproportionately impacted, with age and specific underlying conditions also associated with more severe illness. NHS Providers published a report here to improve understanding of the factors.
- Protection of staff: NHS Employers published guidance for NHS organisations to take appropriate measures to protect staff and mitigate the risk of Covid-19, including taking ethnicity and age into account alongside other factors.
- WRES and Covid-19: Some examples from NHS organisations, highlighting practical ways in which diversity can be achieved.
- Supporting loved ones overseas: There are many colleagues working in the NHS, health and social care sector who come from or have loved ones overseas. Here is some advice on how you can be supported, click here.
- Leaflets and translated resources: The South Asian Health Foundation created translated guidance resources about transmission, mortality, prevention and protection can be found in: Hindi, Punjabi, Urdu, Bengali and Gujarati
- Unequal impact of COVID-19 report: A report published by the NHS Confederation on research into the impact of COVID-19 on people with protected characteristics, with recommendations for health and care systems.
- How NHS organisations are supporting black and minority ethnic staff through Covid-19 and beyond: This report published by the NHS Confederation includes examples of how NHS organisations and integrated care systems have supported BME staff, following COVID-19 risk assessments.
- Perspective from the Frontline: The Disproportionate Impact of Covid-19 on BME Communities: A short piece published by the NHS Confederations' BME Leadership Network.
Coping well during Covid: BAME wellbeing webinar
This webinar created by Thrive LDN considers the challenges Black, Asian and minority ethnic communities face and some techniques and strategies to support wellbeing now and as lockdown restrictions ease.
Emily Gardner is joined by David Truswell, chair of the Dementia Alliance for Culture and Ethnicity. David has worked in community based mental health services in the UK for over thirty years and has been a great advocate for people from Black, Asian and minority ethnic backgrounds. He has a rich history and understanding of how mental health has and does impact different minority communities.
BAME Mental Health Webinar
The below webinar from a collaboration with MIND discusses the barriers to access for BAME individuals and how we can address unmet needs. In addition, there's a discussion on how people with mental illnesses that have a similar prevalence in all races are treated differently due to their background.
BAME Seminar: 'No one can see me cry'
The Centre for Global Higher Education have run a seminar called: 'No one can see me cry - understanding mental health issues for BAME academics, staff and those in higher education'.
To report a crime that isn't an emergency, call 101 or you can report a hate crime online here.
- Resources to tackle racism and discrimination - NHS Employers has collated a range of useful resources which can be used to help aid conversations and to implement change.
- Tackling racism in the workplace (recruiting and retaining our mental health workforce) - The Royal College of Psychiatrists (RCPsych) has published new guidance and resources to help mental health employers tackle racism in the workplace. It includes 15 actions designed to help employers implement meaningful change at a strategic and systemic level.
- Mind website has useful information about terms and concepts surrounding racism, such as racial gaslighting.
- Citizens Advice Bureau can help with issues such as employment claims or taking legal action against perpetrators
- Stop Hate UK can help with reporting hate crimes in boroughs.
- Stand Against Racism and Inequality (SARI) can help with reporting, and offer free and confidential support for anyone who is a victim of hate crime.