- The NHS Alliance Report-Ethnic Minority Leadership in the NHS
A report with the above title was published by The NHS Alliance on 15 September 2026 and can be found here
The Foreword to the report written by Dame Donna Kinnair, Chair, the NHS Alliance BME Leadership Network reads as follows:
As chair of the NHS Alliance BME Leadership Network, I am privileged to work alongside a strong and committed executive steering group and a dynamic, rapidly growing membership. Our members bring deep expertise, lived experience and a clear expectation that the NHS must now move beyond acknowledgement to meaningful action. They are leaders in their own right; leaders who understand the realities of discrimination, exclusion and inequity not as abstract concepts, but as experiences that shape careers, wellbeing and the quality of care delivered to our communities.
Yet it cannot fall to those who have endured racism, harassment or structural disadvantage to carry the responsibility for fixing the system. Our network exists not because staff from ethnic minorities should be tasked with solving the market failure in the NHS workforce, nor because they should shoulder the burden of ensuring racism has no place in policy, practice or patient care. Rather, our network exists because leadership – collective, evidence driven, courageous leadership – can convene the dialogue that the NHS has too often avoided.
What our leadership can do is create the conditions for a dialogue of equals, where evidence is centred, lived experience is respected and solutions are co produced with those who understand the system from within. What our leadership can do is act as a catalyst for change, influencing the influential, challenging complacency and ensuring that the voices of BME staff are not only heard, but shape the decisions that determine progression, representation and retention across the NHS.
This report, Ethnic Minority Leadership in the NHS, provides a stark and necessary reminder of why this work matters. The findings are clear:
- Nearly four in five respondents experienced racism in the last three years, with covert discrimination the most common form.
- Experiences of racism and inequity were linked to decisions about whether to remain in the NHS, with some long-serving ethnic minority leaders describing the cumulative impact of these experiences over their careers.
- Seniority offers no protection. Band 9 and very senior manager (VSM) leaders report some of the highest levels of isolation and covert discrimination.
- Concerns about fairness in career progression were raised, a finding supported by national WRES data showing that ethnic minority staff reported lower perceptions of fairness in career progression than white staff.
- Access to sponsorship, advocacy and influential networks continues to shape who progresses and who is overlooked.
These findings echo what many of our members have long known: representation alone is not enough. Progression, belonging and psychological safety remain unevenly experienced. Structural barriers persist. Racism – whether by omission, fear, belief or ‘straight, no chaser’ – continues to shape the leadership landscape of the NHS.
But this report also points to opportunity. With proposed ethnicity pay gap reporting, growing organisational awareness and a renewed focus on equity, the NHS stands at a moment where meaningful change is possible.
Our responsibility as a leadership network is to ensure that this moment is not wasted. We must support our members to advance equity and inclusion, strengthen leadership pathways, and secure the opportunities emerging today to build a better NHS tomorrow.
- HSJ-Managers suffer racism too
An article with the above title and published by the HSJ on 25 October 2026, by Roger Kline reads as follows:
New evidence shows racism is driving ethnic minority NHS managers towards the exit, highlighting the urgent need for accountable, evidence-based action
I have lost count of the number of NHS Black and Minority Ethnic leaders and managers, including board members, who have shared with me their personal experience of being undermined, marginalised, or nudged towards the exit in a restructure or redundancy.
A new, rather good, report from the NHS Alliance places these individual accounts in context.
It found that one in five ethnic minority NHS managers in England plan to quit amid racism and that, of 950 managers interviewed, almost four-fifths have experienced racism, exclusion, and obstacles to progressing in their careers.
The report doesn’t mince its words, arguing this is “further evidence of the corrosive and demoralising impact of racism in the NHS”, resulting in “senior minority ethnic colleagues walking away, discouraged, disheartened, and disillusioned”.
Whether some of these managers decide to stay (marginalised, disheartened, and disillusioned) or not, the NHS will be the loser.
The report rightly emphasises accountability and evidence-based interventions. It may ring the alarm bells others have tried to silence.
It comes soon after the curiously named Mann Review on “Antisemitism and other forms of racism” and the NHS Race Standard, both published in summer 2026.
As I have suggested previously, while these two initiatives have the merit of pushing race discrimination up trust agendas, they will simply not do what is needed at a time of rising racism in society and the enduring failure of the NHS to improve matters.
Reading the report’s findings makes clear the gap between what is needed and what the NHS is now likely to do.
The NHS is built on research and learning from good and poor practice. When there is a serious clinical concern, for example, trust boards expect to ask of proposed interventions, “what confidence do we have that what is proposed has a reasonable likelihood of working – and why?”
That simply doesn’t happen with most interventions on discrimination, especially race discrimination.
Where the NHS fails – and where it needs to improve
I have examined hundreds of NHS trust “Action Plans” on tackling racism, and most have the following characteristics:
- An inadequate understanding of the data
- A list of actions for which there is little or no research evidence
- Little or no questioning of why next year’s Action Plan looks very similar to last year’s, which had failed to move the data
- The Action Plan is neither challenged nor owned by the board but is dumped on the chief people officer, some of whom do their very best and some of whom look the other way
The optimist in me says that this rush of reports might just push the NHS into taking the issue more seriously. The realist in me says that simply will not happen unless:
- Ministers signal publicly to boards that this really is a priority and follow through on that.
- Regulators do the same with consequences for those who refuse to make progress.
- There is serious national support – a Get It Right First Time pool of experts and resources.
- Boards put the issue on their risk register, with the chair and CEO setting a behavioural example to everyone else.
- Boards use data and lived experience to hold themselves and each layer of management below them to account, using a serious dashboard supported with evidenced interventions to drive progress.
- Boards require evidenced interventions and abandon performative tick boxes.
- Boards enable staff and themselves to have honest conversations about a wicked issue.
- Boards build progress on this issue into every aspect of trust employment relations, from appraisals to recruitment.
- Boards act immediately to prevent the victimisation of those staff who have raised concerns about racism or indeed any other form of discrimination and hold those responsible accountable. Silence is collusion.
Denial and avoidance
Though the Mann Review and Race Standard may nudge some of this into happening, I suspect that they will primarily encourage the work of those already trying to make progress, but lead to more denial and avoidance elsewhere, not least because the key regulator, NHS England, has a track record in racism that provides no confidence while the Department of Health and Social Care shows little sustained interest.
The crisis (for that is what it is) that the NHS Alliance report describes has been coming. The data doesn’t lie. Six months ago, I suggested that “The NHS’s racism problem is being deliberately downplayed by the government”
The risk is this will end up rather like Freedom to Speak Up processes where the best trusts actively support speaking up but don’t need it so much, while those trusts (the large majority) who really need it largely go through the motions.
Ministers now even want trusts to mark their own homework on “speaking up”.
There is no shortage of evidence on what works to mitigate race discrimination.
Twelve years after the Workforce Race Equality Standard was established, trusts that still do not have a determination to do what works now cannot possibly be regarded as “well led” by the Care Quality Comission, so that may be another nudge.
Black and Minority Ethnic staff from boards to the front line tell me they are tired of waiting for change or trying to move things along.
The NHS talks a lot about compassion, which should mean that we all step in when anyone – patient or staff – is subject to detriment. The research and the new legislative framework on harassment, which require employers to be proactive and preventive, could be helpful.
Ultimately. White NHS leaders have to stand up and be counted, adopt evidence-based interventions, and show the 30 per cent of NHS staff impacted by racism, they are serious.
If they don’t, we will not only see Black and Minority Ethnic staff drift out of the NHS, but patient care will suffer as talent drains away.
- HSJ-‘Angry’ trust CEO warns staff about racist abuse of director
An article with the above title and published by the HSJ on 24 September 2026, by Mimi Launder reads as follows:
>CEO “angry” over racialised abuse and repeated muting of CPO
>CPO suffered “personal”, “aggressive” and “racist” comments
>Incident occurred during all-staff briefing in build-up to inclusivity conference
The chief people officer of a leading hospital trust has been subjected to “racist” abuse by colleagues, HSJ has learned.
Frimley Health Foundation Trust chief executive Lance McCarthy sent an all-staff email claiming the provider’s CPO Shajeda Ahmed “was subjected to anonymous comments that became personal and aggressive” during an online briefing. She was also “repeatedly muted while trying to speak”, said Mr McCarthy.
The CEO’s email, which was sent on the eve of the trust’s annual inclusion conference and has been seen by HSJ, continued: “Given that Shajeda was the only person from a minority ethnic background speaking on that call, the circumstances raise serious concerns that this was not simply unacceptable behaviour but had a racialised dimension.
“It is not the first time Shajeda, or other colleagues from a minority ethnic background, have faced hostility while trying to lead difficult conversations on behalf of this organisation and, ultimately, for the benefit of our patients.”
The CEO declared: “This makes me angry. Not concerned. Angry.”
In the same email, Mr McCarthy celebrated Frimley Health being ranked the ninth-best acute trust in the country in the latest National Oversight Framework results this month.
He added: “And yet, in the same week, I have seen and heard about behaviour between colleagues that falls well short of the organisation those results describe.
“I am talking about people being rude, dismissive or aggressive towards one another. Disagreements becoming personal. People using anonymity as a shield to be unkind or abusive. And, in some cases, racist. This is completely unacceptable.”
Mr McCarthy continued: “Let me be absolutely clear about what I expect from every person who works here… Our job is to care for people. We do not have to be friends with our colleagues. We do not have to agree with them. We do not even have to like them. But we do have to treat every person we work with with dignity and respect. That is regardless of who they are, where they come from, what they believe, what their profession is, what their role is, or what their pay band is.
“This is not about being precious or overly sensitive. It is about the basic standards required to run a fair, open, equitable, and inclusive organisation and to deliver outstanding care consistently to every patient. You cannot build that culture while colleagues are being belittled, abused, intimidated or targeted anonymously.”
He declared: “This behaviour will not be tolerated at Frimley Health… If you cannot treat your colleagues with basic dignity and respect, then the NHS and Frimley Health specifically, is not the right place for you to hold a public salary.”
He noted: “The vast majority of our people treat one another with respect. But a small number behaving badly is still too many.”
Frimley Health performs slightly better than average across all Workforce Race Equality Standard categories. These measure inclusivity and compassion, recognition and rewards, having a voice, safety, learning, flexibility, teamwork, staff engagement, and morale.
HSJ has approached Frimley Health for comment.
- HSJ-Senior Staff told to improve behaviour after bullying and racism findings
An article with the above title and published by the HSJ on 18 August 2026, by Alison Moore reads as follows:
>East Sussex Healthcare Trust commissioned a review after learning of concerns
>Summary report found women, non-consultant medics, and ethnic minorities reported harm
>Some staff left due to environment within general surgery department
A trust has called for “tangible improvements” in behaviour from some of its senior clinicians, after an external review reported bullying, harassment, and racism.
East Sussex Healthcare Trust commissioned an external review earlier this year following concerns being raised.
The full review has not been released, but a summary found that women, non-consultant doctors, and staff from ethnic minorities reported harm.
Some staff reported “shouting and abuse” of non-white medical consultants in meetings, and that trainees were “manipulated and coerced” to raise complaints about staff with minority ethnic backgrounds. The findings were first reported by the BBC.
In a statement to HSJ on Monday, chief medical officer Simon Merritt said he expected “tangible improvements in psychological safety, fairness, and leadership behaviours”.
“Bullying, harassment, racism, sexism or any other form of discrimination has no place in our trust. Our values of kindness, inclusivity, and integrity are not optional,” he said.
“Our senior clinicians hold significant influence over the culture of their teams and with that influence comes responsibility and accountability. We expect every consultant to model the standards expected of them – they are the foundation of safe, fair, and effective clinical leadership.”
Dr Merritt said the trust had issued guidance and confidential advice to staff in the general surgery team. However, the trust does not appear to have taken disciplinary action against any staff.
The summary of the review leaked to the BBC indicates evidence of harmful behaviours becoming normalised, compromising psychological safety, and staff suffering chronic exhaustion and emotional depletion. It says the level of bullying, harassment, and discrimination is “concerning”.
The review’s authors also spoke to former staff, and found many linked their departure to the department’s environment. Some described leadership as “actively unsafe”.
The 2025 NHS Staff Survey showed that the diagnostics, anaesthetics, and surgery division scored below the trust’s average on each of nine key indicators.
The review was carried out by Ibex Gale.
- RCN Foundation-Michelle Cox RCN Foundation Anti-Racism Award
Please see email from the RCN Foundation about the award if applicable to you
Hello,
I hope you’re well.
Celebrating Black History Month, the annual Michelle Cox RCN Foundation Anti-Racism Award is open.
This is an annual award of up to £2,500 which will support a nurse or midwifery-led project aiming to oppose racism and promote racial equality within nursing and midwifery. Applications are welcome from nurses and midwives across the UK however, they must be an RCN member. Applications close at 5pm on 30 October.
Please see attached flyer with further information or visit our website.
I would really appreciate if you could share the opening of this grant with your network.
Any questions, just let me know.
Thank you,
Rosie West
Digital Marketing and Communications Officer
RCN Foundation
20 Cavendish Square | London | W1G 0RN
Email: rosie.west@rcnfoundation.org.uk
Telephone: 020 7841 3323