NHS workforce training

Evidence of gender and ethnic bias present in NHS recruitment processes, new study finds

Those from ethnic minority backgrounds are less likely to be accepted onto NHS Specialty Training Posts, new research has revealed.

The findings come from a joint study by Cambridge University Hospitals NHS Foundation Trust (CUH) and the University of Cambridge, which show some areas of medicine have a gender and ethnic bias.

To carry out the analysis, researchers investigated data from applications to Specialty Training Posts through Health Education England during the 2021-22 recruitment cycle.

Over that period, the research team found there were nearly 12,500 successful applicants which amounts to an almost one in three success rate (32.7%).

Whilst females (37%) were found to be more successful than their male counterparts (29.1%), the researchers also discovered evidence of discrepancies in which specialties each gender tends to apply for more.

Surgical specialties (65.3%) and radiology (64.3%) had the largest proportion of males applying whereas obstetrics and gynaecology (72.4%) and public health (67.2%) had the highest female proportion.

Non-Executive Director at CUH, Professor Sharon Peacock, who was also senior author of the study, described the success of female applicants in many specialties as a “positive step towards gender balance” but also noted the “concerning” nature of the disparities in applications and therefore recruitment by gender.

Just over half (50.2%) of the applicants graduated outside the UK; the overall success rate of this group was a little over one in five (22.8%) – compared to more than two in five (44.5%) for UK graduates.

After adjusting for country of graduation, 11 out of 15 (73.3%) ethnic minority groups were found to be less likely to be successful than those who identified as White British. Those of Mixed White and Black African ethnicity were only half (52%) as likely to as successful as their White British peers.

The study’s first author, Dr Dinesh Aggarwal, said: “The data suggests there’s a need to review recruitment policies and processes from a diversity and inclusion perspective. But the issues extend beyond recruitment – doctors from minority ethnic groups can struggle to progress within the NHS and report disproportionately high levels of discrimination from colleagues.

The study also showed that, despite only a small proportion (1.4%) of successful applicants declaring a disability, those with a disability were more likely (38.6%) to be successful than those who didn’t declare a disability (32.8%).

No disabled applicants applied to 22.4% of the specialties however, with another 36.2% of specialties accepting no disabled applicants at all.

Dr Aggarwal added: “It’s encouraging to see a high proportion of acceptances among individuals disclosing a disability.

"The NHS needs to ensure that application and recruitment processes are accessible and open to adjustments for all disabilities, eliminate any fear of discrimination, and provide assurance that all NHS workplaces will accommodate reasonable adjustments to ensure that disabled doctors can carry out their work.

"This will not only help to encourage more disabled applicants, but also allow disabled clinicians to feel more comfortable disclosing this information.”

Professor Peacock concluded: “The NHS is the largest employer in the UK and it’s vital that it nurtures diverse talent to benefit patient care. People from diverse backgrounds bring different lived experiences and perspectives, which in turn strengthens the pool of knowledge and skills within the NHS.”

To read the full study, click here.

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