An indirect impact of COVID-19 has been to shine a light on unaddressed health inequalities between racial groups. A report published by Public Health England (PHE) in June highlighted the health and racial inequalities that affect black and ethnic minorities (BME) communities, and some of their root causes.
However, studies released by the government such as The Black Report in 1980, and articles like Racism, the National Health Service and the Health of Black People published in the International Journal of Health Services in 1988, have already shown the interplay between ethnicity and health. Yet, little effort has been made to address these inequalities.
To reiterate a collective message that all these studies, articles and reviews have repeatedly said over the years, racial discrimination has been shown to have a profound impact on a person’s mental and physical health, level of attainment, trust in engaging with healthcare services and socioeconomic status. A combination of these factors can contribute to poorer health outcomes and higher mortality rates in BME groups, as highlighted by this pandemic.
Unfortunately, the NHS is still not immune to racial discrimination. A report published by NHS England last year found that there had been a rise in BME staff experiencing harassment, bullying or abuse from colleagues from 27% in 2016 to 29% in 2019, while their white counterparts’ figure remained at 24%. This increase could lead to staff from ethnic minorities being less likely to report concerns about their safety and personal protective equipment (PPE).
If we truly want to take steps towards supporting BME staff, then our first must be practising compassion. I am fortunate to have a compassionate supervisor with whom I felt safe and comfortable enough to have an open and honest conversation while filling in my individual risk assessment. Although I have been made to feel valued and included within my organisation, my feelings of inclusion are tainted with guilt.
I know so many black community pharmacists from inside and outside the UK Black Pharmacists Association (UKBPA) who have not been given the opportunity to have this quality of interaction, and do not feel valued or appreciated. This is why compassion needs to be used as a tool to ensure that employees feel safe to identify and review risk. More importantly, employers must ensure there is provision of adequate PPE, guidance and support following the completion of risk assessments.
Another way of improving support for BME staff is by boosting representation. As a young, black, female pharmacist I have always struggled to find role models in visible senior positions that look, and sound like me. Often, I have had to look at other professional bodies for inspiration.
There are very few black people with senior positions within the board of the Royal Pharmaceutical Society’s (RPS) English branch, the General Pharmaceutical Council (GPhC) or the Pharmacists’ Defence Association. This absence of black representatives on national boards personally feels uninspiring, questionable, and not reflective of the members they serve.
It is 2020 and BME groups are still highly underrepresented across all staff levels. This continues a trend noted in 2014 in The “snowy white peaks” of the NHS research published by Middlesex University, written by Roger Kline. The report says that BME members made up only 2.5% of very senior managerial roles of London NHS trust boards, despite more than two in five of their workforce being from a BME background.
Other reports, like NHS England’s Improving through inclusion from 2017, have shown that not only does greater representation empower individuals from ethnic minorities to raise concerns within their organisation, but it can also boost productivity, quality of service to patients, and help staff feel understood.
The results of surveys like PHE’s one from June are exactly why pharmacy organisations, trusts and decision-making boards must open up conversations with their BME staff and identify barriers such as biased recruitment, reduced opportunities for education and promotions, workplace bullying and social exclusion in their workplace, which keep their BME staff from participating equally.
When it comes to supporting BME patients, pharmacists and their teams are perfectly poised to target BME communities. The trust built within their community can anchor culturally appropriate programmes designed to help BME communities better manage long-term conditions they are more likely to have.
For example, C+D clinical advisory board member Dr Mahendra Patel has reached more than 40,000 Muslims via TV channels, radio stations and an interactive Zoom session. His key information on COVID-19 was relayed in English, Hindi, and Urdu. For the future of BME communities, these types of interaction could greatly improve engagement and trust in services and health outcomes.
While I strongly encourage the notion for further robust research, trials, and surveys to better understand the interplay between co-morbidities, socioeconomics, culture, religion, racial discrimination, and their impact on BME communities. I do sincerely hope to no longer see reports that are repetitions of what has already been said.
I look forward to seeing how we tackle underrepresentation of BME staff across all staff levels in pharmacy, and a change in how we talk about racial and health inequalities in the future.
Kemi Gibson is secretary of the UKBPA
Disclaimer: This article does not represent the views of the UKBPA