‘Racialised patterns’ of occupational risk found for emergency clinicians during pandemic

A new report by the Royal College of Emergency Medicine, published on Thursday, found nearly one in five (19 per cent) of respondents from a black, Asian or minority ethnic background had not been risk-assessed by their trust.

The report said the “inadequacy” of risk assessments and “lack of consideration of ethnicity as a risk factor” emerged as two key themes from respondents’ answers. 

It also found that nearly half (48 per cent) of all BAME respondents had failed a PPE fit-testing either “very often”, “often” or “sometimes”, compared with 37 per cent of white clinicians.

RCEM published several recommendations. It urged NHS England to include ethnicity as an independent risk factor for all staff and to develop “culturally appropriate” risk assessments, accounting for “racialised patterns” of occupational risk for ethnic minority staff.

The body also asked NHS trusts’ boards to report the number of risk assessments being completed for staff, including those from BAME backgrounds and with disabilities, in their board assurance frameworks, and to view the “unequal treatment” of BAME staff during the coronavirus pandemic as a “corporate risk”.

Hodon Abdi, co-chair of RCEM’s equality, diversity and inclusion committee, claimed risk assessments for BAME staff have “clearly been inadequate” and are a risk to their safety. He said: “While these issues appear to have improved slightly over the course of the pandemic, it is imperative that policies around risk assessments, and access to appropriate PPE must be monitored closely by senior leadership and rigorously scrutinised by trust boards.

Dr Abdi added: “It is widely known that there is a disproportionate risk of mortality amongst BAME staff, and there is growing evidence that, throughout this pandemic, ethnic minority staff did not feel like they could speak out about their concerns to management about staying safe at work.

“These are systemic issues, and we are asking senior leaders to take a proactive approach to tackling racialised patterns of occupational risk within trusts.”

Miriam Deakin, director of policy and strategy at NHS Providers, a membership organisation which represents NHS trusts, told HSJ: “Trusts take these issues very seriously. They have been doing a lot of work in this area, and are following national advice to identify various levels of risk, without prescribing a ‘one size fits all’ approach.

“Risk assessments have paved the way for more engagement between staff and managers on health and wellbeing issues. Trusts must be given appropriate support so that this vital work can be sustained to ensure that people from all ethnic backgrounds and nationalities have confidence that their wellbeing is the highest priority.”

When asked for a response, an NHSE/I spokesman said: “By 2 September 2020, 96 per cent of all BAME staff had received a risk assessment with mitigating steps agreed.”