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There are many inequalities within the NHS that impact BAME staff and patients, and understanding this is essential for your Medical School interview. This guide outlines everything you need to know about this hot topic and includes some interview questions you might get asked about BAME inequalities.

BAME Staff

Some of the inequalities that face BAME staff includes:

  • Inaccurate representation amongst board members. 19.7% of the NHS workforce is made up of BAME groups, but just 8.4% of board members are from a BAME background.
  • Recruitment problems. Lack of diverse representation at a senior level produces barriers for BAME staff, particularly during the recruitment process. White applicants are 1.46 times likelier to be appointed from shortlisting as opposed to BAME applicants.
  • Less likely to be supported. BAME staff are 1.22 likelier than their white colleagues to enter a formal disciplinary process. The GMC’s Fair to Refer report found Doctors from diverse groups did not always receive effective, timely or honest feedback due to difficult conversations being avoided where the manager is from a different ethnic group to the Doctor. There is also a culture of blame amongst some organisations, which creates additional risk for Doctors who are seen as ‘outsiders’.
  • Likelier discrimination. 15% of BAME staff reported experiences of discrimination in the last 12 months, compared to 6.6% of white staff.
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What Is The NHS Doing To Address This?

  • The interim NHS People Plan has action points to increase BAME representation across the workforce, including at senior – this will make the NHS more reflective of the patient population it serves. Structural racism and unconscious biases still need to be addressed in order for equality to be truly achieved.
  • The NHS is striving to engage further with staff and staff networks so that BAME staff can be heard and share their lived experience, offer action points they feel need to be taken and what support should be offered nationally. Steps towards establishing a stronger network have been introduced in the form of webinars, which was attended by more than 240 heads of BAME staff networks.

BAME Patients

BAME patients also face inequality when they seek to use NHS services. Some of these issues include:

BAME and COVID-19

The impact of COVID-19 has been disproportionately felt by the BAME community. Some of the key issues include:

  • Disproportionate mortality and morbidity. In the first month of the pandemic, 95% of NHS Doctors who died of COVID-19 were from BAME backgrounds. The disproportionate death rate in BAME staff is only partially explained by health conditions, age and socio-demographic factors.
  • Staff scared to raise COVID-19 concerns. BAME staff are more likely to report experiences of discrimination, which may translate to these staff less likely to speak out about their concerns or request. Formal disciplinary processes are more common amongst BAME groups in comparison to their white counterparts, which could be a reason for a fear of raising COVID-19 related concerns or asking for safer alternatives.

What Is The NHS Doing To Address This?

NHS England and NHS Improvement is working to addresses BAME inequalities and inequities that COVID-19 has highlighted. Some of the measures include:

On 30 April, NHS Employers published guidance for NHS organisations to take appropriate measures to mitigate the risk of COVID-19, including taking ethnicity and age into account alongside other factors.

Interview Questions About BAME and the NHS

You may not be asked directly about BAME and the NHS. Instead, you should show you understand this issue by weaving it into some of your answers to other questions. For example, you could mention BAME patients or staff when answering these kinds of questions:

  • What would you do if a patient at a care home you are volunteering at was verbally abused by a Nurse and often not given dinner?
  • What are the challenges you expect to face as a Doctor?
  • What do you think makes a good Doctor?
  • What are the differences in paternalistic versus patient-centred Medicine?
  • Should Doctors and Nurses be allowed to refuse to work to protect themselves against COVID-19?

For more questions, take a look at our Interview Question Bank.

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