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A new report shows the “shocking” extent that millions of people from ethnic minority backgrounds are being failed within the health service across all age groups and clinical areas.
The major review into ethnic inequalities in healthcare was published by the NHS Race and Health Observatory and found ethnic inequalities across each area studied. Whilst there were differences between ethnic minority groups, some communities were found to have particularly poor access, experiences and outcomes.
The university-led review spanning a 10-year period explores differences in reference to access, experiences of, and outcomes in mental healthcare, maternal and neonatal healthcare, digital access to healthcare, genetic testing and genomic medicine, and the NHS workforce.
Persistent ethnic inequalities in healthcare in the UK
It found that ethnic minority groups experienced distinct inequalities in mental health support provision, and in gaining access to mental health ‘talking therapies’.
GPs were less likely to refer ethnic minority patients to the Improving Access to Psychological Therapies (IAPT) programme, compared to White patients. Barriers were also faced by patients who delayed or avoided seeking help for health problems due to their fear of racist treatment from NHS healthcare professionals.
With respect to the NHS workforce, the impact of racism on careers and professional development was also explored in the review, and there was evidence of an ethnic pay gap affecting Black, Asian, Mixed and Other groups, and to a lesser extent, Chinese staff.
Dr Habib Naqvi, director of the NHS Race and Health Observatory, said: “It is clear that existing evidence on the stark health inequalities faced by ethnic minority communities has not led to significant change. This is why the Observatory has been established: to synthesise what already exists, translate it into actionable policy recommendations, and to challenge leaders to act. This report should be a tool for them; highlighting the best quality evidence and making concrete recommendations for change.
“By drawing together the evidence, and plugging the gaps where we find them, we have made a clear and overwhelming case for radical action on race inequity in our healthcare system.”
The rapid review now urges further ‘critical action’ to be undertaken by organisations including NHS England, NHS Improvement and NHS Digital, with recommendations outlined by topic area.
The Royal College of Physicians said it is unacceptable that people from minority ethnic health backgrounds are experiencing racism when they are interacting with the NHS and facing poorer health outcomes.
Professor Ramesh Arasaradnam, academic vice president, added: “As the report highlights, we must do more to understand the full scale of these challenges as in a number of key areas the scope of existing research is too limited.
“There is an urgent need to do better in this area and I hope that all the important recommendations set out in the report will now be taken forward. Ultimately change will come from increasing the diversity of those who lead and work in the NHS. That is why the RCP has called for wider participation in medical schools.”
Moral duty to put this right as matter of urgency
The British Medical Association called the report a shocking indictment of the scale of harm that racism is causing millions of people in the UK
Dr Chaand Nagpaul, BMA council chair, said: “The data in this report is unacceptable and shows that racism within the healthcare service follows millions of people – right from birth to death. This can no longer be ignored – there is a moral duty to put this right as matter of urgency.
“The Government must openly acknowledge structural racism within the NHS and the barriers that it creates – something it failed to do in its own race disparity report last year. Those responsible for our health service must develop a cross-government action plan with tangible outcomes, timescales and agreement across the NHS.
“Crucially this action plan must be done in an open and transparent manner with involvement from people from ethnic minority backgrounds. Frankly, people are tired of hearing about processes all while experiencing shocking levels of care on a daily basis – we need action now. We need a health service that delivers based upon its founding principles.”
The academic team undertook a comprehensive stock-take of available UK research, screening over 13,000 research papers, identifying 178 studies that were included in the final review.