Ethnic inequalities among NHS staff in England: workplace experiences during the COVID-19 pandemic

Rebecca Rhead; Lisa Harber-Aschan; Juliana Onwumere; Catherine Polling; Sarah Dorrington; Annahita Ehsan; Sharon A M Stevelink; Kamlesh Khunti; Ghazala Mir; Richard Morriss; Simon Wessely; Charlotte Woodhead; Stephani Hatch

doi:10.1136/oemed-2023-108976

Ethnic inequalities among NHS staff in England: workplace experiences during the COVID-19 pandemic

Occup Environ Med. 2024 Mar 8;81(3):113-121. doi: 10.1136/oemed-2023-108976.

Authors

Rebecca Rhead^{1

2}, Lisa Harber-Aschan^{3

4}, Juliana Onwumere^{3

5}, Catherine Polling^{3

5}, Sarah Dorrington^{3

5}, Annahita Ehsan³, Sharon A M Stevelink^{3

6}, Kamlesh Khunti^{7

8}, Ghazala Mir⁹, Richard Morriss^{10

11}, Simon Wessely^{3

6}, Charlotte Woodhead^{3

2}, Stephani Hatch^{3

2}

Affiliations

¹ Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK rebecca.rhead@kcl.ac.uk.
² Centre for Society and Mental Health, King's College London - Strand Campus, London, UK.
³ Psychological Medicine, King's College London - Institute of Psychiatry, Psychology & Neuroscience, London, UK.
⁴ Demography Unit, Stockholm University, Stockholm, Sweden.
⁵ South London and Maudsley NHS Foundation Trust, London, UK.
⁶ King's Centre for Military Health Research, King's College London, London, UK.
⁷ Diabetes Research Centre, Leicester General Hospital, Leicester, UK.
⁸ Real World Evidence Unit, University of Leicester, Leicester, UK.
⁹ Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
¹⁰ Institute of Mental Health, University of Nottingham, Nottingham, UK.
¹¹ NIHR ARC East Midlands, University of Nottingham, Nottingham, UK.

Abstract

Objectives: This study aims to determine how workplace experiences of National Health Service (NHS) staff varied by ethnicity during the COVID-19 pandemic and how these experiences are associated with mental and physical health at the time of the study.

Methods: An online Inequalities Survey was conducted by the Tackling Inequalities and Discrimination Experiences in Health Services study in collaboration with NHS CHECK. This Inequalities Survey collected measures relating to workplace experiences (such as personal protective equipment (PPE), risk assessments, redeployments and discrimination) as well as mental health (Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder 7 (GAD-7)), and physical health (PHQ-15) from NHS staff working in the 18 trusts participating with the NHS CHECK study between February and October 2021 (N=4622).

Results: Regression analysis of this cross-sectional data revealed that staff from black and mixed/other ethnic groups had greater odds of experiencing workplace harassment (adjusted OR (AOR) 2.43 (95% CI 1.56 to 3.78) and 2.38 (95% CI 1.12 to 5.07), respectively) and discrimination (AOR 4.36 (95% CI 2.73 to 6.96) and 3.94 (95% CI 1.67 to 9.33), respectively) compared with white British staff. Staff from black ethnic groups also had greater odds than white British staff of reporting PPE unavailability (AOR 2.16 (95% CI 1.16 to 4.00)). Such workplace experiences were associated with negative physical and mental health outcomes, though this association varied by ethnicity. Conversely, understanding employment rights around redeployment, being informed about and having the ability to inform redeployment decisions were associated with lower odds of poor physical and mental health.

Conclusions: Structural changes to the way staff from ethnically minoritised groups are supported, and how their complaints are addressed by leaders within the NHS are urgently required.

Keywords: COVID-19; Ethnic Groups; Health services research; Mental Health; Occupational Health.

MeSH terms

COVID-19*
Cross-Sectional Studies
Humans
Pandemics
State Medicine
Workplace

Grants and funding

WT_/Wellcome Trust/United Kingdom