Ethnic minority staff are being ‘disproportionately’ impacted by the major reconfiguration of integrated care boards (ICB), NHS England and trusts, a health union has warned.
In a letter to health secretary Wes Streeting, ministers and senior health officials, Managers in Partnership’s (MiP) Black Members Network said that the impact of organisational restructuring included psychological harm, loss of employment opportunities, and reduced representation.
The network also warned that the ‘patterns of inequity, racism and discrimination’ experienced by ethnic minority staff undermines the NHS’s ability to deliver the key ambitions of the 10-Year Health Plan to improve population health, reduce inequalities and strengthen continuity of care.
The letter said that the NHS is entering its largest reorganisation in a decade but the staff ‘most exposed to risk are being kept in the dark, left without support and taking the biggest hit’.
The network, which represents managers from diverse ethnic backgrounds and senior leaders across the NHS who are members of MiP, said that across multiple restructures members have reported:
- Staff from diverse ethnic backgrounds losing roles at a higher rate during organisational change;
- Senior leadership teams becoming progressively less diverse with each restructure; and
- Significant anxiety following the removal of representational standards, eliminating the only baseline data showing who is being pushed out.
It also cited NHS England figures showing that only 6.8% of very senior managers are from ethnic minority backgrounds, within a workforce that is 25% ethnic minority.
MiP national organiser Rosie Kirk said: ‘As the NHS is being reorganised, Black staff are losing jobs, losing representation and facing growing uncertainty. Skills are being lost and protections are weakening while racism goes unchallenged.
‘Our members are telling us they feel anxious, unsupported, and shut out of decisions that directly affect their livelihoods, with serious implications for mental health and safety at work.
‘This directly undermines the NHS’s ability to deliver the ambitions of the 10-Year Health Plan, which cannot be achieved without a supported, diverse and protected workforce.’
The letter said that the MiP Black Members Network was using the term ‘Black’ in its ‘broad, political and inclusive sense to describe people who share lived experience of racism and structural inequality in the UK’.
Last year the government told ICBs that they had to cut their running costs by 50%, equating to reducing staff by about 12,500 across the health system. As of 1 April, the number of ICBs has reduced from 42 to 36.
The government also announced in March last year that NHS England is to be abolished, with functions brought back into the Department of Health and Social Care (DHSC). This is expected to result in a 50% cut in headcount.
MiP also said that many NHS trusts are going through cuts to corporate staffing and merging leadership models.
The union’s letter to Mr Streeting, health minister Karin Smyth, NHS England chief executive Sir Jim Mackey and DHSC permanent secretary Samantha Jones called for them to:
- Reinstate representational standards immediately;
- Publish equality impact assessments for all restructuring proposals;
- Issue national guidance protecting staff from discriminatory disciplinary threats;
- Mandate and enforce patient racism policies; and
- Protect the mental health and well-being of Black staff.
The network also stressed that islamophobia and hostility are rising, leaving staff feeling unprotected and unable to work confidently.
The facilitator of The NHS Alliance’s BME Leadership Network, Joan Saddler, said: ‘The disproportionate impact on BME staff affected by the restructures needs to be understood through their equality impact assessments and the resulting data used to improve processes system-wide.
‘This is something that our members are actively monitoring, managing and attempting to mitigate.’
Healthcare Leader has contacted DHSC and NHS England for comment.
