Study shows ethnicity plays role in NHS staff decisions to speak up

30 SEPTEMBER, 2021 BY EMMA BAINES
NURSING TIMES



NHS staff from Black and minority ethnic groups continue to face barriers speaking up about workplace issues, according to research reported by the National Guardian’s Office (NGO) today.

Research commissioned by the NGO found that minority ethnic staff were less likely than White staff members to voice concerns to a Freedom to Speak Up Guardian of a different ethnicity from themselves, because they feared their concern would not be understood or taken seriously.


“All staff should feel confident that their workplace processes are fair and should not fear reprisals"
Habib Naqvi

This presents a barrier to minority ethnic staff flagging discrimination or other workplace issues through the Guardian network at all, because Freedom to Speak Up Guardians are predominantly White.

The research report, Difference Matters, includes data from an online survey of 1,074 workers from eight NHS trusts, 69% of whom were White and 31% Black or minority ethnic.

Over 55% of the survey respondents reported experiencing an issue within the previous four years that they felt could have been raised with a Freedom to Speak Up Guardian. Of these, more minority ethnic (62%) than White (57%) people chose not to raise their concern with a Guardian.

A large difference between the groups was that a much higher proportion of minority ethnic respondents reported that their issues were relating to discrimination (55%) compared to White respondents (8%).

Because of this, 41% of minority ethnic staff reported that they would like to be able to speak to a Guardian of the same ethnicity as themselves. They feared someone else would not understand their concern, or take it seriously. In comparison, only 7% of White respondents said they wanted a Guardian of the same ethnicity.

However, the network of Freedom to Speak Up Guardians is disproportionately White compared to the NHS workforce, with only 10% of Guardians having a minority ethnic background in 2020, down by a third from 2019, according to the most recent NGO’s Freedom to Speak Up Survey.

The research found that Black and minority ethnic workers who did speak up had comparable experiences to White workers.

The report stated: “Based on the responses to the survey and feedback from Freedom to Speak Up Guardians, we conclude that the ethnicity of a Freedom to Speak Up Guardian can impact on a person’s decision to speak up. Specifically, BME workers are more likely to raise a concern with a BME Freedom to Speak Up Guardian.”

“It is clear that more work needs to be done to explore the many factors that can influence whether, when, and to whom a worker will speak up"
Russell Parkinson

Dr Habib Naqvi, director of the NHS Race and Health Observatory, said: “It is important that Black and minority ethnic health and care staff feel confident about speaking up and disclosing information that can prevent avoidable incidents, and lead to better care and outcomes for patients.

“All staff should feel confident that their workplace processes are fair and should not fear reprisals, or the prospect of being discriminated against, for voicing concerns through official channels.

“The healthcare system needs to take targeted action, ensuring opportunities to learn important lessons regarding patient care are not missed.”

Russell Parkinson, head of office and strategy at the NGO, said the research was a “starting place for further discussion”.

“It is clear that more work needs to be done to explore the many factors that can influence whether, when, and to whom a worker will speak up,” he added.

The Freedom to Speak Up Guardians were established so that NHS staff would have an alternative route for raising concerns if they feel unable to do so through the usual channels, such as telling a line manager.

There are now more than 700 Guardians supporting workers in primary and secondary care as well as other NHS organisations.

The NHS People Plan includes commitments to recruit more staff from Black and minority ethnic backgrounds to Guardian roles and to improve training for Guardians on workplace race equality.