Four in Five Ethnic Minority NHS Managers Report Experiencing Racism

Nearly four in five ethnic minority NHS managers and staff surveyed say they have experienced racism within the past three years, according to a major new report examining leadership, progression and workplace culture across the health service.

The NHS Alliance BME Leadership Network surveyed 950 ethnic minority NHS staff and leaders and conducted interviews with senior board members. It found that racism, exclusion and unequal opportunities continue to affect the careers of many people working within the NHS.

Covert discrimination was the most commonly reported form of racism, while respondents also described difficulties accessing career opportunities and influential professional networks. Among staff at Bands 1 to 8, 86% said they wanted to progress to a higher role, but just 33% believed they had a realistic chance of doing so.

The findings also raise concerns about retention. Around one in five respondents said they were planning to leave the NHS within the next three years, with experiences of racism and inequality influencing some people’s decisions about whether they wanted to continue their careers within the health service.

There has been progress in increasing ethnic minority representation at senior levels. NHS England figures previously showed that the number of very senior managers from black and minority ethnic backgrounds increased by 85% between 2018 and 2024. However, significant inequalities remained, including white applicants being more likely to be appointed from shortlisting at 80% of NHS trusts.

The new findings come as NHS organisations face greater scrutiny over the experiences of their workforce. New national staff standards introduced this year will make NHS employers formally accountable for performance in areas including racism, violence and sexual safety, with workforce measures incorporated into NHS oversight arrangements.

For NHS leaders, the findings highlight that increasing diversity at board and senior management level is only one part of the challenge. Creating workplaces where people believe they have equal opportunities to progress, feel able to challenge discrimination and want to remain for the long term will be equally important if the NHS is to retain experienced leaders from every background.

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