In this blog, Claire Light, our Head of Equality, Diversity and Inclusion, explains how we’re supporting the Medical Workforce Race Equality Standard (MWRES), led by NHS England and NHS Improvement. She also reflects on how the MWRES will help to drive fairness in medicine and support our work to tackle inequalities in healthcare.
Whether it’s a fitness goal or reducing screen time, most of us measure performance in some way in our lives. And so do effective organisations and systems. Measurement helps to focus our attention on whether our efforts are paying off; if we’re making progress or if we need to change our approach to move something forward.
Most organisations are confident and comfortable in setting measures for productivity, timeliness, and financial expenditure for example. Yet, when it comes to measuring equality, there’s often nervousness. If we want to pick up the pace to tackle inequalities in medicine and health, it’s vital that we’re bold and confident with measures and targets linked to fairness.
Measuring fairness in medicine
The diversity of the medical profession is a huge asset for the UK’s health services and for patient care. In 2020, 61% of joiners to the register identified as being from an ethnic minority group, compared to 44% in 2017*. But we know from research and our conversations with doctors that discrimination within healthcare is ever present. The extent of inequalities experienced by those who work tirelessly in our health services is one of the most shameful realities. This has to change.
Reflecting on my own experiences, I’ve seen first-hand that what gets measured, gets done. So, I strongly believe that the Medical Workforce Race Equality Standard (MWRES), led by NHS England and Improvement, will be a key step in measuring and driving fairness in medicine. We’re pleased to be involved in this important work and to contribute our data to it.
Equality indicators have been in place more broadly for all health workers in England through the Workforce Race Equality Standard, which launched back in 2015. But the MWRES measures give us a more detailed picture of how fairness issues are affecting doctors. And it provides data on significant areas outside our regulatory remit, such as the likelihood of white applicants being appointed for consultant posts compared to ethnic minority applicants. It also shows the ethnicity pay gap for doctors across various grades.
Using our data to tackle inequalities
We have data on some crucial equality indicators which we’re contributing to the MWRES ; including on fitness to practise referrals from employers, which are higher for ethnic minority doctors and international medical graduates. And we’ve provided key information on postgraduate training. Ethnic minority doctors and international medical graduates have very different experiences of training and as a result, this shows up in differences in their performance in exams. This pattern is seen in almost every aspect of medical education and training. **You can find all our data on postgraduate training, including exam results and the Annual Review of Competence Profession outcomes, in our national training survey reporting tool.
The MWRES also supports the targets we’ve recently set ourselves to eliminate disproportionate fitness to practise referrals by 2026, and to eliminate discrimination in medical education and training by 2031. These are complex issues. But there is strong evidence that inclusive and supportive working and training environments have fairer outcomes and will help to tackle these areas of inequality. We’ll continue to offer our data, insight and practical support to those who are driving change in these areas.
The impact of the pandemic continues to be felt widely, particularly among ethnic minority healthcare workers, and patients, who are more vulnerable to the virus. But we can’t and won’t let the challenges of the pandemic stop our efforts to tackle healthcare inequalities. The MWRES is an essential part of pushing this forward and will help doctors of all backgrounds get the support they need and deserve to deliver safe patient care.
*Reference: The state of medical education and practice in the UK 2020
** Our national training survey reporting tool will be refreshed with updated data at the end of July, when the 2021 survey results are published.