Our members’ experience of racism in the NHS

The figures that inform our health service Race for Equality campaign

Equality is at the heart of everything UNISON does – which is why our healthcare group launched the Race for Equality campaign during Black History Month in October.

To prepare for it, the service group asked members for their experience of ‘unacceptable behaviour’, including their experience of racism in the workplace.

In all, 10,362 people completed the survey, with 8,047 answering the question of whether the unacceptable behaviour they experienced related to race.

Of those, almost 11% – 879 in total – reported experiencing racist behaviour in the workplace in the last year. This compares to 15% of Black staff (and 6.6% of white staff) reporting that they experienced discrimination in 2018, in that year’s NHS workforce race equality standard.

The discrepancy can be explained by the fact that the NHS data reflects a systemic issue – discrimination – where we asked about behaviour by a range of people healthcare staff deal with.

This included:

  • being treated as inferior or less skilled – 58%;
  • name calling, ‘jokes’ or ‘banter’ – 37%;
  • unwarranted criticism – 32%;
  • being given unfair or inappropriate work – 30%;
  • being mocked for appearance, mannerisms or speech – 28%;
  • being blocked from promotion or training – 21%.

Of those 879 UNISON members who reported experiencing racism, 34% said the racism was frequent or regular, while 10% said it occurred daily or weekly.

And 66% said the behaviour in question came from colleagues, 43% said it was from other staff, and 38% said it was from patients.

The health service is already experiencing a staffing crisis, with many employees quitting because of increasing workloads. UNISON is concerned that incidents of racism are adding to the mental strain that workers are facing.

Worries about not being believed or taken seriously can mean that, instead of making a complaint, many suffer in silence ­or ­leave for a job outside healthcare.

Some 26% of our respondents who experienced racism reported the incident to management or the HR department, while 4.6%% reported it to external authorities such as the police.

Just over 21% reported their experience of racist behaviour to their union rep. Members were more likely to talk to a colleague about an incident (46.1%) or a family member or friend outside work (39.5%). At the same time, 27% of people spoke directly to the perpetrator(s) about their behaviour.

And a little under 33% of members who experienced racist behaviour just kept quiet about it.

Worryingly, for an NHS already experiencing staff shortages, 72 people (8.8%) of those who answered left their jobs as a consequence of the racism they experienced.

When we asked why people didn’t report racist behaviour they experienced, the answers revealed a lot about why UNISON felt the need to launch a campaign on the issue:

  • 60% felt nothing would be done;
  • 37% feared retaliation;
  • 31% felt they’d be dismissed as oversensitive;
  • 29% felt it would harm their career;
  • 14% did not want to relive the trauma;
  • 10% felt ashamed.

Many of those who experienced racism at work said it had a damaging effect on their lives.

Around 65% said it made them want to leave work and look or for another job, 62% isolated themselves or avoided some colleagues and situations, 57% felt less confident, 47.5% reported that it had affected their mental health and nearly 28% had to take time off work.

So we asked members who reported racism whether their employers had a policy on harassment or provided training.

Some 32% said their workplace had delivered training, 46% said it hadn’t and 22% said they didn’t know. But 72% reported that their workplace had a policy on harassment, 5% said it didn’t and 24% didn’t know. However, only 16% said the policy was implemented or had teeth, 38% said it didn’t and 46% didn’t know.

Who did we ask and how representative were they? Well, we surveyed healthcare staff, including ambulance workers, occupational therapists and pharmacy staff, from 7 to 31 May.

Overall, they were fairly representative of the NHS workforce –  if slightly older. Most of the health workers who took part in our survey, 60%, were aged between 35 and 55. This compares to 52% in that age range, according to the official workforce figures from NHS England.

Above and below that age range, the categories differ slightly: the UNISON survey included 14% aged between 27 and 34 (and 4% under 27); NHS England’s workforce data shows 23% aged between 25 and 34, with 6% under 25.

On gender, when it came to the 794 people who gave information on this and experienced racism, 76.6% identified as female, 23% as male and 0.4% identified themselves in another way. The NHS data says 77% of the workforce is female and 23% male.

Unsurprisingly, UNISON members who reported experiencing racist behaviour were more likely to be Black than the healthcare workforce in general.

More than 60% of the members who said they had experienced racist behaviour in the past year identified as Black – using the categories of the 2001 census. This compares to just under 20% of the NHS workforce, using the same categories.

This is only a snapshot and UNISON believes that incidents of racism in the workplace are more widespread.

Racial discrimination is against the law, but above all it is simply not right – it wastes talent, damages staff, hurts patients and holds the NHS back.

We want everyone who works in the NHS to be part of the conversation, helping to recognise and challenge racism in the workplace and supporting each other to fight for equality.

Find out more about the Race for Equality campaign 

The campaign pages include a range of downloadable resources, including a Race for Equality leaflet, an action plan for branches and briefing on bullying and harassment, disciplinary action and race, and recruitment, career and race.

• Many of the percentages on specific questions don’t add up to 100%. The questions concerned had non-exclusive answers and members were asked to let us know all that