Intended for healthcare professionals

Rapid response to:


Don’t accept racist abuse, Hancock tells NHS staff

BMJ 2019; 367 doi: (Published 07 November 2019) Cite this as: BMJ 2019;367:l6425

Rapid Response:

Re: Don’t accept racist abuse, Hancock tells NHS staff

Whilst Mr Hancock's remarks are helpful, the following findings of an employment tribunal as quoted by the EAT(1) indicate the degree to which racial abuse/racially motivated violence is still downplayed in the NHS.

" The Claimant’s claim of indirect race discrimination succeeded in relation to the incident reporting failing. As to this matter, the Tribunal made the following findings:

“151. It was clear that the policy was that all incidents of racial abuse should be the subject of an incident report. So much was evident from the MVA training pack at page 540, from the evidence of Mr Heath, and from the definition of an incident at page 363 which included any incident which could have resulted in mental injury. The categories of incident reporting available via menus on the electronic form included “verbal abuse to staff” and a potential sub-cause was “racism”.

152. Equally, it was clear that not every incident of racial abuse was reported using the incident report system. The grievance reached that conclusion (page 318). It was evident from staff interviews that there were more instances of racial abuse than were formally reported. The recommendations included that there be a review and that steps should be taken to ensure that all staff knew they should report such matters.

153. Indeed, Mr Liffen accepted not only that staff were not reporting such matters but also that the comments made by patient A at the community meeting on 6 April 2017 ought to have been the subject of an incident report if the policy were applied strictly.

154. The Tribunal unanimously concluded that a perception had formed amongst many black staff that reporting every single racist incident was pointless. The consequence was that the incident report system fell into disrepute in that respect…

155. Further, we concluded that there were steps which the Respondent should have taken to reinforce the message to staff that they should do an incident report after every such incident. The failure to take those steps contributed to the negative perception held by many black staff about the value of incident reporting…”

"In determining the effect of the failure to take such steps, the Tribunal held as follows:

“156. Of course, the failure to take such steps to encourage incident reporting would be immaterial unless it contributed to the claimant’s exposure to racial abuse and physical violence from patient A on 7 April 2017. The Respondent’s case was that the gaps in the incident reporting system were not material because those incidents of racist abuse were recorded in other ways. They would go in the nursing notes and then be fed into the monthly CTM, and thereby form part of the patient risk assessment and any behaviour management plan. Further, the Respondent suggested that given the patient population, some level of racist comment was unavoidable.

157. Although we recognised that the absence of an incident report did not mean that racial abuse went unrecorded, we were satisfied unanimously that the failure to create a culture in which all such incidents were formally reported in that way contributed to an environment in which racial abuse from patients was more likely to occur. There was a perception among some staff that it was simply part of the job and had to be tolerated. That made it more likely that patients would not be challenged over racist comments and abuse. At a corporate level the absence of incident reports on every occasion meant that the risk of verbal racist abuse was under-appreciated and therefore not sufficiently prioritised as a risk to be addressed. At ward level the confidence of staff to challenge such behaviour was impaired by the perception that management were not taking the issue as seriously as they should…”



Competing interests: No competing interests

08 November 2019
Jay Ilangaratne
East Yorkshire