Health workers from other foreign-born ethnic minorities face a double disadvantage due to the combined effects of their ethnicity and immigration status, according to a new study published in JRSM Open.
This is the first analysis to use data from the UK-REACH national cohort study to examine how immigration status, which is often overlooked in personnel records, intersects with ethnicity to influence career progression in the NHS.
A cross-sectional study of more than 5,700 healthcare workers employed under the NHS Agenda for Change (AfC) pay scale (including nurses, midwives and allied health workers) found that overseas-born staff were significantly less likely to be placed in higher AfC pay bands, even after controlling for education, job duties and years of professional qualification. In particular, overseas-born Asian and black healthcare workers were less likely to reach higher salary levels compared to UK-born and trained white healthcare workers.
Our findings highlight that although migration status plays an important role in shaping health workers’ career prospects, this data is not routinely collected. These disparities can only be addressed if they are first recognized and documented. ”
Dr Ji Soo Choi, First Author, NIHR Infectious Disease Academic Clinical Fellow, University of Leicester
Ethnic minority and migrant health workers make up nearly a quarter of NHS staff, but they remain underrepresented in senior roles within the AfC framework. Migrant workers may face additional challenges that differ from their non-migrant ethnic colleagues, such as difficulties in recognizing international qualifications, limited professional networks, and limited access to training.
The lack of regularly collected migration status data means that these issues are often overlooked in research, creating gaps that hinder efforts to address workforce inequalities. The authors urge NHS policy makers to include migration status in routine data collection to enable more targeted and effective interventions.
“Ethnic minority health workers make up more than a third of NHS pay band 5 staff, but their presence has plummeted to just 10% in senior roles,” said lead author Professor Manish Parikh, clinical professor of infectious diseases and director of the Center for Population Health Development at the University of Leicester. “This lack of diversity in leadership limits their influence over important workplace decisions such as pay, schedules and policies, which may contribute to a less supportive environment for ethnic minority staff. As NHS staffing challenges continue, these inequalities risk causing higher turnover rates.”
The authors recommend that NHS workforce policies explicitly address the distinct barriers faced by migrant health workers, including access to training, accreditation, and opportunities for mentoring and leadership.
sauce:
Royal Society of Medicine
