How The BMJ’s racism special inspired a Leeds GP to set up an ethnic minority staff network
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3477 (Published 08 September 2020) Cite this as: BMJ 2020;370:m3477
Leeds GP Mo Sattar was already involved in discussions about ethnic minority issues through the Royal College of General Practitioners—then The BMJ published its special issue on racism in medicine, in February 2019 (bmj.com/racism-in-medicine). “When The BMJ hit it just really fired up in my belly,” Sattar says of how the issue inspired him to set up what he believes was England’s first ethnic minority staff network in primary care.
The BMJ prompted Sattar to realise that something local was needed to enable faster action than national structures allowed to tackle inequality—such as the fact that white applicants to NHS jobs are nearly 1.5 times as likely to be appointed from shortlisting than ethnic minority applicants.1 “When we get people involved nationally, things take a long, long time, and there’s a real sense that we want to move at pace,” he tells The BMJ.
Sattar, a partner at Woodhouse Medical Practice in the north of the city, asked local primary care groups for support and set up an initial meeting of interested people and organisation representatives, which took place in March this year.
Participants shared their own experiences of racism in medicine, including Sattar’s recent encounter with a patient who didn’t want to be seen by him because of his ethnicity. “What was difficult was that the relatives didn’t say anything, and nobody else in that room said anything,” he recalls. “It illustrated to me there was a silence … so what do we do?”
The meeting resulted in some ideas on which the group decided to take action, including ethnically diverse interview panels, a celebration of the contribution of ethnic minority staff to the local NHS and healthcare, and the staff network, whose members will set the group’s objectives, Sattar says. “It’s something that’s been done very well across the country in secondary care, but not primary care,” he says of the network, “and we think that one of the reasons is that [general practices] don’t have to commit or submit any WRES data.” The NHS Workforce Race Equality Standard requires healthcare providers to show progress against several indicators of workforce equality, accountability that Sattar’s group wants to emulate for general practices in Leeds.
Measuring achievement
“All practices are little businesses that have a lot of things to do, so how can we create a little bank of information and policies that we all sign up to?” Sattar asks. “We need a WRES for primary care that we build and we grow and we commit to.”
The ambition is to embed this WRES into the local quality improvement standard (QIS) to achieve financial “buy in,” including from practices in “leafy suburbs,” explains Sattar. “We’re also looking at buddying practices from more diverse populations with practices that are less diverse.”
Jim Barwick, chief executive of the Leeds GP Confederation, which represents 94 practices in the area, is “confident we can pull this off.” He says, “When there’s a solution being offered in the way that Mo’s described I would be surprised if people weren’t receptive to that.
“One of my roles then is to work with the CCG [clinical commissioning group] around our QIS … Let’s build that in so that there’s incentive to do it, as well as it just being something that’s important to do.”
The group has started discussions about setting up a reciprocal mentorship scheme, and it is working on some public health messaging aimed at local people, starting with a Facebook Live on covid-19. The network held its first official meeting on 4 August, one of 12 initially planned, each with a different theme.
Spreading the progress
Sattar is deeply frustrated by what he sees as a lack of progress on racism and equality in medicine at a national level, such as among NHS organisations and medical royal colleges. For example, only 8% of board members in NHS trusts are from an ethnic minority background.1 He says, “This equality and diversity issue is not on the agenda of many, many, many medical colleagues. They have been silent—and it’s the same people that then sit on councils and educate and are the examiners, and so we have a real problem.”
The activity in Leeds is clearly driven by Sattar’s own energy and enthusiasm for the cause, but he insists it is not about him. “It’s got to be about the group, and it’s got to be about the people, and it’s got to go on its own steam.” Barwick agrees that local primary care organisations, including the CCG, are backing what he calls the “movement.”
“Mo’s energy has unlocked the question of what we should be doing in primary care,” Barwick says, “[but] Mo isn’t speaking as one voice: he’s got multiple voices behind him.” NHS Leeds has provided £500 in funding support for the group’s work.
Primary care colleagues around the country have started contacting Sattar about setting up their own ethnic minority staff networks, and he insists that anyone can do what he has done. “Some of these conversations take courage, [but] you can lead from your feet: you don’t need to be a GP partner, you don’t need power,” he says.
Footnotes
Competing interests: None declared.
References
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