“When we all take action, change can happen” – Mohinder’s Race Equality Week blog

Dr Mohinder Kapoor, consultant in old age psychiatry and associate medical director for research and development, shares some key facts about Race Equality Week (REW), and what organisations and employers could do to address the barriers to race equality in the workplace.

Race Equality Week (REW) is an annual UK-wide movement uniting thousands of organisations and individuals, to address the barriers to race equality in the workplace.

Equality means treating everyone the same, giving them the same resources and opportunities. Equity means recognising that people have different needs and providing support tailored to help everyone achieve the same outcome. It is important to note, that while we aim for equity in the workplace, the law protecting against discrimination is focused on equality and is called the ‘Equality Act 2010’.

REW was established in 2020 by Race Equality Matters after George Floyd’s murder. This year’s theme- Every Action Counts, was selected by the Race Equality Matters community. Every single person has the ability to take action. No matter your position in your organisation, no matter how much power or influence you have, when we all take action, change can happen.

Why is race equality important?

Population and health inequalities are inextricably linked.

The Kings Fund reported: “Among ethnic minority groups structural racism can reinforce inequalities, for example, in housing, employment and the criminal justice system, which in turn can have a negative impact on health”.

Research suggests that institutional racism impacts performance assessments, disciplinary procedures, who is subject to scrutiny, who is denied promotions and development opportunities. It is important to call out racism to prevent it from impacting our decisions at work.

The NHS like many organisations is a mirror of our society, and because there is limited investment in learning, reflection, and practice, the system does not really get any better at understanding the issue.

It has been reported that a reliance on policies, procedures, and training ‘will not, in isolation, reduce bullying, improve the effectiveness or safety of whistleblowing, (or) create a disciplinary environment focused on learning’ (Kline, 2023). This could explain why NHS England’s approach for staff who have concerns has not achieved its stated goals and has left it unsafe and/or ineffective for individuals in many organisations to raise concerns despite the Francis Freedom to Speak Up Review (Francis, 2015).

We know that (NHS England, 2023) in addition to facing additional obstacles to raising concerns BME staff are:

• more likely than their white colleagues to be bullied by their managers and colleagues
• more likely that their white colleagues to enter the formal disciplinary process
• much more likely to experience discrimination from managers and colleagues

Barriers to raising concerns

Engaging with racism can invoke a range of emotions – anger, resentment, fear, shame, sadness – which, together, can help explain why concerns about race equality are evaded more often that they are confronted. When staff raise concerns of any kind there is always a risk that retaliatory steps may be taken by colleagues or managers, as was recognised by Francis in his Freedom to Speak Up report. Empirical research consistently shows that the two main reasons why people do not report perceived wrongdoing are fear of retaliation and a belief that even if they do the matter would not be rectified (Lewis, 2013).

What NHS organisations / employers should do next 

New guidance in the Freedom to Speak Up guide for leaders in the NHS and organisations delivering NHS services (NHS England, 2022) states leaders should work hard to understand the barriers that colleague from minority ethnic communities or people who have been recruited from abroad might face.

Employers generally look at events individually but should consider whether there are cumulative patterns or behaviours which required examination. An accumulation of apparently small acts of detriment – such as microaggressions – can have a catastrophic impact on staff which damages their health and may constitute discrimination. Failure to consider whether such acts might cumulatively constitute race discrimination and to then fail to investigate what might be the underlying causes, whether in an investigation or during a hearing, might itself constitute an act of discrimination and harassment.

The primary reliance on policies, procedures, and training in employment relations frequently gives employers false assurance of fairness when handling cases of race discrimination. An employer who relies on individual staff raising concerns about race discrimination, rather than using data and soft intelligence to be proactive and preventative, will inevitably be faced with staff who leave, keep their heads down, or eventually raise concerns but only after relations have become embittered and formalised.

Transactional vs transformational approaches

Evidence suggests that interventions to address racism are often transactional in their nature. The underlying causes of race discrimination – the unthinking norms and assumptions by which we categorise people – remain untouched. Transactional activities are interventions like celebrating Black History Month, hosting award ceremonies for diversity initiatives, or providing mentoring programmes for BME staff. Many reasons are given for pursuing transactional approaches, including a lack of time and resources. Activities such as these may have individual benefit but tend not to change the experience of BME staff as a whole. Therefore, the impact of these activities is limited to surface-level change only. And even if they provide an individual staff member with an initial boost, this tends to be short-lived. The minoritised member of staff still has to navigate a system that is unchanged in its unfairness.

Opposed to transactional activities is transformational work. Transformational activities aim to change the culture of organisations by focusing on the way people interact with others. Fundamental to this is engaging leaders so they are better able to identify and address systemic racism within their organisation and leadership practice. Leaders should be supported to proactively address race discrimination. This means more than reviewing data and listening to the ‘lived experience’ of staff: It also means understanding how their organisation’s normative culture can make it unsafe for minoritised staff (and patients) to speak up. The board and senior leaders need to be to be seen to praise anti-racist behaviour and reward standers (allies) who intervene and stand up for others. But transformational change does not stop with leadership: the whole organisation becomes responsible for engaging in change. Transformational practices deliberatively intend to engage white staff in exploring their beliefs and behaviours. Crucially, the job of creating a more inclusive culture is not left solely to those who experience racism.

However, transformational approach has its own limitations, such as:

• it requires viewing success as learning, development, and behavioural change – and not just how an organisation looks.
• it can take different types of skills and resources.
• it is a longer-term strategy and requires commitment from leadership.

In view of the above, it might be reasonable to state that interventions to address racism could benefit from being both transactional and transformational in nature.

While great strides have been made towards racial equality in many areas of society including NHS, there is still much work to be done to ensure that everyone, regardless of their racial background, has the opportunity to thrive.

References

https://www.raceequalitymatters.com/race-equality-week/https://www.inclusiveemployers.co.uk/awareness-day/race-equality-week/https://oxfordhealthbrc.nihr.ac.uk/race-equality-week-2025/https://27aa994b-a128-4a85-b7e6-634fb830ed15.usrfiles.com/ugd/27aa99_9a9468c5e4da43288da375a17092d685.pdfhttps://www.england.nhs.uk/long-read/nhs-equality-diversity-and-inclusion-improvement-plan/#_High_Impact_Actionshttps://www.england.nhs.uk/publication/the-guide-for-the-nhs-on-freedom-to-speak-up/https://www.england.nhs.uk/publication/nhs-workforce-race-equality-standard-2022/https://nationalguardian.org.uk/2023/06/08/fear-and-futility/