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Call for ‘robust action’ to increase BME nurse director numbers

Lack of information about the number of black and minority ethnic (BME) nurses in position in senior manager or executive positions in the NHS means talent is being lost, say healthcare leaders.

Much more needs to be done to ensure a greater number of talented black and minority ethnic (BME) nurses take on executive positions within the NHS, says the RCN.


The NHS Workforce Race Equality Standard report flagged up
BME under-representation at leadership level. Picture: iStock

The college spoke out more than a year after a major report highlighted BME under-representation at leadership level.

Neither NHS England nor NHS Improvement could provide Nursing Standard with statistics detailing the exact number of BME nurses in director roles when requested.

But figures given to Nursing Standard by NHS Digital show that all staff in NHS trusts and clinical commissioning groups with a job title director of nursing:

  • 241 self-reported as white
  • 2 said they were mixed race
  • 2 said they were Asian or Asian British
  • 2 were black or black British
  • 12 declined to answer
  • 2 were 'unknown'

‘Not nearly enough’

Roger Kline, who steps down as director of the NHS workforce race equality standard (WRES) engagement and research at the end of August, said there were ‘not nearly enough’ BME nurse directors in post and unlikely to be more than a handful.

Mr Kline said the lack of knowledge was an ongoing issue, given that 2016 WRES research was unable to ascertain these numbers due to unreliable data provided by trusts.

He said: ‘There isn't a single consistent breakdown of the ethnicity of nurse directors, but the numbers are tiny.

Lost talent

‘There has been a bit of an effort to provide a pipeline, but there is no magic fix that will suddenly create lots of BME nurse directors.’

He said diverse leadership was more open to being self-critical than a mono-cultural one.

‘If 25% of band 5 nurses are BME, but only 3% are band 8 c, d or e – then that kind of gradient suggests there might be talent being lost on the way.’

He said it was critical to have organisational leadership representative of the workforce it leads and the population it serves.


There appears to be fewer executive and leadership openings for BME healthcare
professionals who are looking to progress further up the career ladder. Picture: Ian Dodds

‘Equality of opportunity’

‘Without this, junior nurses with ambition and talent coming through an organisation will suffer from a lack of role modelling,’ he added.

‘More importantly, there is a fair bit of research showing that representativeness among those leading services is likely to lead to better provision of services to the local community.

RCN head of nursing Wendy Preston said: ‘All nurses should be able to enjoy real equality of opportunity and not have their careers hampered and disadvantaged by discrimination.

‘Robust action is needed if we are to see more BME nurses in organisational leadership roles.

Inclusion a priority

‘It is important that recruitment and selection processes are fairer for everybody and we ensure equality and inclusion is a clear priority in healthcare systems.’

NHS Improvement executive director of nursing Ruth May said there was ‘a long way to go’ to see progress, but that her organisation was supporting trusts to improve and share good practice.

Dr May said: ‘By working with our aspiring nurse leaders we hope to influence the message that nurses with BME backgrounds should be getting the opportunities they need to progress their careers and feel supported in the environment in which they work.

Committed to improvement

‘We have a long way to go but by keeping this conversation going, and being committed to giving everyone a voice, we will see improvement.

‘The NHS has committed to improving race equality in the workforce and it is only right that NHS Improvement continues to support trusts, who are already working hard, to learn where they can improve and share good practice.’

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