We have now known for months that Black, Asian and minority ethnic (BAME) healthcare workers are hit much harder by Covid-19. A look at the death wall is frightening and distressing for anyone, and especially so for those of BAME origin.
Yet, six months from the onset and three months into the pandemic in the UK, there is still an ongoing debate about what to do. After the initial disaster of limited release of information which only caused more anguish, recommendations from the full report of PHE are welcome, although it’s very clear that we are yet to take even early baby steps, and it may take generations to make any tangible difference in the inequalities.
It’s baffling that we don’t even have good quality data that can provide better insight. The recommendations fail to suggest any short and medium term measures.
NHS England and NHS Employers have published guidance, but it hasn’t been very specific. There is still debate around what tool is best, and its implementation. Many have still not received a risk assessment at all.
Various media outlets appear to have taken up the issue, but there has been a lack of clarity on actions to take.
A Health Service Journal analysis suggested that staff working in high-risk areas who have enhanced PPE have been hardly affected. A logical conclusion from here shall be to provide enhanced PPE for at-risk groups including BAME in perceived low-risk areas. Though there has been a lack of PPE in general, the enhanced PPE has not been considered as an option or a part of the solution. This needs to happen now, as we learn to live with the virus.
Many organisations have left it to the staff to come forward for risk assessments. We can all imagine why so many of us shall be reluctant to come forward. Most of my colleagues are worried about the impact on their colleagues if they happened to be redeployed, or that they may be perceived to be taking the easier option. When nearly 40% of staff is BAME, there is that real risk to the sustainability of the service.
Stand up for your BAME colleagues, because you are their only hope
Organisations need to support their BAME staff so that they don’t feel obliged to continue to work on the frontline, risking their lives. This approach has to come from the top down, and be a genuine and sincere attempt, rather than ticking a box.
This is a challenge for small practices that have to rely on the goodwill of their neighbouring practices to stay open if anyone has to be redeployed or remote-deployed. There is an urgent need for specific support for such practices and they should not be left on their own or at the goodwill of their neighbouring practices, networks, or commissioners.
BAME staff work in a high-risk environment with a higher risk of complaints and investigations, as well as disproportionately higher adverse performance outcomes. Adding the higher anxiety from the risk of Covid-19 and remote triage, which brings in its own added uncertainty, the whole mix suddenly becomes very toxic and challenging.
Hopefully, we can all have a mature discussion around the long-term actions needed to reduce the disparities, but there is an urgent need to protect these lives now.
Race is a protected characteristic, and we need the same level of proactive action, as well as a pragmatic approach, in the same way as any of the other protected characteristics.
This will require us all to be bold and stand up for our BAME colleagues because, you are their only hope.
Dr Kamal Sidhu is a partner at Blackhall and Peterlee Practice and New Seaham Medical Group; vice-chair at South Durham Health Community Interest Company; and vice-chair at County Durham and Darlington LMC. He writes in a personal capacity.
