Highlights:
The NHS could be facing a loss of experienced British Asian and other minority ethnic managers, with one in five managers surveyed saying they plan to leave the health service within the next three years.
The warning comes from a survey of 950 Black, Asian and minority ethnic (BAME) NHS managers by the NHS Alliance. Almost four-fifths said they had experienced racism, exclusion or barriers to career progression during their working lives.
While the survey does not publish a separate figure for South Asian managers, its findings are particularly relevant to Britain's Asian communities, which make up a significant part of the NHS workforce.
NHS England's latest Workforce Race Equality Standard found that 28.6 per cent of NHS trust staff, 434,077 people, were from BME backgrounds in March 2024. Yet only 48.8 per cent of BME staff said their trust provided equal opportunities for career progression or promotion, compared with 59.4 per cent of white staff.
The disparity becomes more pronounced higher up the NHS hierarchy. In 2024, 12.7 per cent of very senior NHS managers were from BME backgrounds, despite ethnic minority staff making up more than a quarter of the overall NHS workforce. NHS England also found that at 80 per cent of trusts, white applicants were significantly more likely than BME applicants to be appointed after shortlisting.
For British Asians, the issue is therefore not simply about representation. It is about whether those already inside one of Britain's biggest public institutions have a fair route to the top.
British Asians and the NHS: the numbers matter
The latest NHS data shows a substantial ethnic minority presence across the health service. In 2024, BME staff accounted for 28.6 per cent of the NHS trust workforce, up from 26.4% the previous year.
But representation falls at senior levels. NHS England's data shows that ethnic minority representation at very senior manager level was 12.7 per cent, far below their 28.6% share of the overall workforce.
The same pattern can be seen among clinical staff. NHS England reported that 48.7% of doctors in NHS trusts were from BME backgrounds in 2024, but representation fell to 44.6 per cent among senior medical managers.
For nursing and other clinical professions, the gap is also significant. NHS England says BME representation among clinical staff outside medicine was 29.4% in 2024, while representation at senior clinical levels from bands 8C to very senior management was only 13 per cent.
That creates the central question for British Asian professionals: if ethnic minority people make up such a substantial part of the NHS workforce, why are they still significantly less represented as they move toward the most senior positions?
Progression, not just representation, is the real issue
This is where I would make your story particularly strong.
The NHS has increased minority ethnic representation, but getting into the organization is not the same as getting ahead within it.
The WRES data found that only 48.8 per cent of BME staff believed they had equal opportunities for career progression or promotion, compared with 59.4 per cent of white staff. At the same time, 80 per cent of NHS trusts reported that white applicants were significantly more likely to be appointed than BME applicants after shortlisting.
The NHS Alliance's manager survey adds a more personal dimension. Managers described exclusion from informal professional networks, lack of diversity in senior teams and what the report calls “progression disparities.”
One Asian manager described a culture of nepotism and said they believed they had the experience, knowledge and ability to be promoted but felt the culture was too strong.
Another manager of African heritage said the lack of diversity at senior levels made it difficult to feel seen, supported or inspired to progress.
For British Asian professionals, these findings will resonate beyond the question of whether there are enough Asian faces in NHS workplaces. The issue is whether those faces are reaching the rooms where decisions are made.
