Estwar Sanichar Chair, Staff Side, Northumbria Healthcare NHS Trust, was the Inspiring Diversity and Inclusion Lead of the Year– Role model winner at this year’s National BAME Health & Care Awards. He outlines the discrimination barriers BAME health professionals often face, his own experiences, and how to create more BAME leaders in healthcare.

What inspired you to enter the healthcare sector?

As a full-time church minister in Trinidad, I would like to think that I cared for people from the cradle to the grave. Although I had studied five years full-time to become a church minister, I felt very limited in my ability to address increasing demands from church members and others with mental health issues. Whilst exploring viable routes to pursue studies in this field, I was on a visit to the UK and had a conversation with a couple of lecturers in the mental health field. At the time, I played competitive cricket, and this appeared to have counted in my favour towards gaining a scholarship for post-graduate studies in mental health.

Why are awards like the National BAME Health and Care Awards so important?

Winning this award has injected a degree of pride in my NHS Trust, increased discussions and dialogues, led to local and regional publications about BAME matters, created a greater momentum towards BAME issues, and made the BAME community in my workplace more visible. I think it’s also helped raise the profile of BAME people and issues in the community. For example, after my award was publicised in some regional press, I got phone calls from people in the community to say how they were not aware that the BAME population faced such problems. Also, the percentage of BAME staff in the NHS is not always reflected in other national awards. Whilst there could be different and justifiable reasons for this, having national awards, especially for BAME workers, can help address this disparity and highlight the issue.

What are the common problems you see BAME healthcare workers face?

Culturally, BAME workers seem to believe that only through hard work and academic achievement will they be recognised and progress to the top. They do not seem to recognise that there are systemic roadblocks, both intentional and unintentional, in their way.

I also know some BAME staff who come from cultures where it is not customary to sell themselves in relation to their educational achievements, skills, and experience. One such worker told me she failed several interviews because, in her view, her application form should be the determining factor and not how well she is able to present at an interview.

Some of my BAME colleagues said that career progression and promotion are still influenced by who you know. My own experience demonstrates that, as a BAME worker, you could have more degrees than anyone, but, in many instances, this does not count in your favour when you are up against a non-BAME worker.

Have you experienced discrimination yourself in this space?

I did early on in my career with the NHS, and I did not know what to do. I was supported by an HR officer, but this was more along the lines of if I needed occupational health input and, it seems in hindsight, to prevent any injury/legal claims. With subsequent experiences, I sought support from my union, and they were very good at challenging the alleged discrimination.

In one instance of alleged discrimination, the employer failed to offer me any suitable redeployment jobs over a few years. I was being offered jobs below my banding, and all positions at my substantive bandings were deemed unsuitable for me by the employer. I took them to an employment tribunal, and five days before the hearing, I was offered two jobs at my substantive banding. The message here is it is crucial to seek support, call out racism and discrimination for what it is and formally challenge it. Having the right support, whether from BAME or non-BAME workers, both senior staff and others, is crucial.

What is your advice for ethnic minority healthcare workers who want to become leaders?

Continue with training and study, don’t give up, and believe that you can do it – nothing is impossible. Consider accessing training and study that are leadership-based. Formalise this in your appraisal and secure the right support to make this happen.

For example, I mentored a clinical BAME staff member at band 5 (NHS banding) who wanted to move into leadership. Her white manager refused to support her, telling her that she needed more experience and was not ready. I supported her through some difficult meetings with her manager, advised and assisted her in completing various application forms for NHS scholarships for leadership training, and even supported her by accompanying her to an open session at a University. Eight years on, she has completed a Master’s degree in leadership and is now a senior operational manager and looking to move into a deputy director role.

I would also say speak to senior managers as they can often point you in the right direction. Get a mentor who you can work with, shadow, understand the skills you need, and appreciate those you already have. Also, participate in reverse mentoring regardless of whether it’s from white or BAME senior managers.

Why are BAME role models so important in the healthcare sector?

The percentage of BAME staff in the care sector is not reflected at the senior manager level. BAME role models in healthcare can provide inspiration and affirmation that progress is achievable. Seeing is believing, and to see BAME role models speak of success stories and to learn from them ensures they are not the exceptions. It shows that anything can be achieved if one has the confidence, motivation, determination, and right support.

Do BAME healthcare workers need better mental health support since COVID-19?

Having spoken to several BAME NHS workers, they assert that much more is required of them than their white counterparts in the normal course of their work, and they are also held to a higher degree of accountability. During the pandemic, this became much worse. Staff stated to me – “having survived the pandemic, we now have residual mental health issues”.

Whilst mental health support is crucial for all staff, it is even more crucial for BAME staff who appear to be reluctant to access mental health support for various reasons, including cultural beliefs. Further, some, if not many, BAME workers are isolated, and a long way from families, and have limited or no social networks. Whilst there should be a recognition of the specific issues facing BAME workers, everyone copes with mental health issues in different ways, and support should be tailored to individual needs rather than for a specific group. In Northumbria Healthcare, we have provided what we think is a safe and confidential arrangement for BAME and all staff to access mental health support.

What actions of BAME colleagues inspired you during this period?

Just a simple gesture of asking “how are you” meant a lot. People offered assistance and kept in touch regularly. People at high risk continued to work on the frontline, even when the news said that BAME workers were more at risk of infection and death; this was an example of their sheer resilience.

What role should management play in helping BAME staff into leadership roles?

They should encourage more BAME staff to do targeted leadership training. They should also recognise staff for their skills, knowledge, and experience and not only how well they present at interviews. There should also be dedicated opportunities for BAME aspiring leaders to shadow senior managers. Mentoring, including reverse mentoring, is also a good idea. Here’s an example in Northumbria Healthcare – where Executive and Non-Executive Directors have undertaken, as part of their own Personal Development Plan (PDP), with support from the Trust Board, to mentor and be mentored by aspiring BAME leaders.

To find out more about the National BAME Health & Care Awards, please click here.

To nominate yourself or someone else for an award for next year’s outing, click here.