FAQs
There is no single reason why this resource exists; the case for further advancing racial equity in nursing and midwifery is multi-dimensional and non-linear. The resource outlines the ethical, statistical, legislative, patient-driven, values-based, emotional and economic reasons - you can refer to these sections for more information. They are organised in the form of a non-hierarchical, interactive tool, giving you the freedom to choose the order in which you explore the various reasons. Taken altogether, they form a clear picture of why further advancing racial equity in nursing and midwifery is both important and extremely valuable to the NHS and other health organisations across the UK as a whole
We use the term 'further advancing equity' to highlight the need to go beyond just decrying racism or committing ourselves to being anti-racist, and towards actively advancing race equity in nursing and midwifery. We acknowledge the positive steps that have already been made by the NHS and the other healthcare institutions to tackle racism, but we posit that there is an ongoing need to do more and go further.
The 'Global Majority' refers to the people in the world who do not consider themselves to be or are not considered to be white. This resource tries to use language that is broadly accepted in both society and the healthcare sector right now. In a survey led by the NHS Race and Health Observatory in 2021, the terms 'ethnic minority', 'BAME' and 'BME' were not considered representative or popular, so this resource does not employ those terms.1 Additionally, the term 'Global Majority' is useful because it decolonises language: it makes little sense to refer to non-white people as 'ethnic minorities' when they make up approximately 85% of the global population.2
This resource was commissioned by NHS England to advance racial equity within nursing and midwifery. That is not to say that other characteristics protected under the 2010 Equality Act are not important or are any less important, but this resource specifically focuses on race. Other resources exist with information on other protected characteristics - you can find some of these in the appendix. Some of the key concepts in this resource, including unconscious bias, microaggressions, phycological safety, and allyship, are useful for advancing all forms of equity.
This resource is not intended to replace existing policies and procedures for speaking up and managing racism from your organisation, the NHS or the Royal College of Nursing.
Equality means that each individual or group of people is given the same resources or opportunities. The concept of equity recognises that people have different circumstances and allocates resources and opportunities as required to reach a more equal overall outcome.3 In this resource, we predominantly use the term 'equity' because we do not have race equality in society today. Instead, this resource focuses on how to move toward creating greater equity.
Yes. Racism is a systemic problem in our society and affects the healthcare sector just as it affects any other industry or walk of life in this country.4 This resource shares some of the ways in which racism manifests, sharing the latest statistics along with some personal stories of the experiences of NHS England staff from the Global Majority.
Yes. Racism is still a serious issue in today's society, despite strides forwards in the last few decades. Racism has been likened to a public health crisis, permeating our major institutions, places of work, education system, politics, media and everyday social interactions.5 The Transatlantic slave trade and colonialism have left behind a legacy of trauma and inequality that is still present.6 The scope of this resource does not include explaining the historical basis of racism in the UK - other resources do this. This resource is focused on establishing an understanding of why further advancing race equity specifically in nursing and midwifery is valuable, and on suggesting some practical actions that can be taken.
This report, commonly known as the Sewell report, has been widely condemned and rejected, including by UN experts.8
Everyone has a job to do, and our patients depend on us. But racism is a very serious issue that can incite incidents of violence and abuse and result in lasting trauma and even death.9 Advancing race equity does not detract from healthcare workers' ability to meet demand and save lives, it should be seen as part of the same mission. You can refer to the case for going further to learn more about how a lack of equity is currently holding the sector back and why we should all value advancing racial equity as part of our jobs.
Just because something is pervasive in our society, it does not mean we should accept it as inevitable and immutable. When we can see that something is unethical or unfair, it is our duty to try to enact change. You can refer to the ethical case for going further section for more on this duty. What is more, the positive impact that efforts to advance race equity can have on people's lives is tangible. You can refer to the emotional case for going further to read some of these stories. We can all play a part, even if it is small, to eradicate racism and advance race equity. And when we add up our individual actions, the collective result can be powerful.
Yes. You can refer to the statistical case for going further for statistical evidence that staff members from the Global Majority are less likely to be promoted and more likely to face disciplinary action, discrimination and harassment, and to the section on unconscious bias to explore why this can happen. The belief that race does not actually impact career progression but is just used as an 'excuse' for a lack of talent or merit is an example of unconscious bias.
The MacPherson Report defines a racist incident as any incident that is perceived to be racist by the victim or any other person.10 Such behaviour could include but is not limited to verbal threats, slurs, name calling, racist insults or jokes, the display of racially offensive material, exclusion from workplace conversation or activities, physical attack, or the incitement of others to commit any such acts.11 If you perceive something to be discriminatory and racially-motivated but are not sure, you could take the perceived victim aside and ask them if they felt that they were subject to racism or discrimination and whether they would have liked you to intervene. Then, the next time you witness something similar you can feel more confident in identifying that a racist incident has taken place and in taking appropriate action. You can also refer to the section on microaggressions to further understand what these can look like.
In line with the NMC Code, nurses, midwives and nursing associates have a responsibility to challenge racism.12 Please refer to the how to speak up and get help section for more information on how to safely and effectively speak up about, report and seek support after an incident.
