MDX academic's report highlights major barriers for BME staff in NHS recruitment and promotion

9 September 2022

A caring nurse assisting an elderly woman in a wheelchair in a hospital corridor.

The No More Tick Boxes report reveals how BME, women and disabled NHS staff are facing discrimination, bias and an unequal level of opportunities

A Middlesex University academic has produced a comprehensive report highlighting the barriers Black, Minority and Ethnic (BME) staff face when applying for various NHS roles and trying to get promoted in the health service.

MDX Research Fellow Roger Kline has written a detailed review of research on recruitment and career progression for NHS East of England called No More Tick Boxes which outlines how lead employers and organisations can create fairer and sustainable outcomes for BME, women and disabled staff.

Mr Kline draws together and references dozens of research projects which have shown BME, women and disabled NHS staff are facing discrimination, bias and an unequal level of opportunities.

“The very fact it is 1.61 times more likely a shortlisted White candidate will be appointed than a perfectly capable BME candidate is completely unacceptable in any line of work let alone our nation’s health service," MDX Research Fellow Roger Kline.


In the 163-page report, Mr Kline argues that while “the proportion of White people who are overtly racist is a minority, assumptions about inferiority which undermine the employment and well-being of BME staff, are widespread and deeply ingrained”.

No More Tick Boxes reveals how:

  • Across the workforce it was 1.61 times more likely a White candidate will be appointed after shortlisting compared to a BME candidate.
  • 6.8% of staff in the Very Senior Manager (VSM) pay band are of BME heritage, compared to a 21% representation in the workforce.
  • 28.8% of BME staff do not believe that their Trust provides equal opportunities for career progression or promotion – more than twice the proportion for White staff.
  • Just 10% of NHS board members are from a BME background.
    Mr Kline said: “Recent NHS data on recruitment and promotion was shocking and highlighted the serious disparity that remains in opportunities for White candidates and those from a BME background.

“The very fact it is 1.61 times more likely a shortlisted White candidate will be appointed than a perfectly capable BME candidate is completely unacceptable in any line of work let alone our nation’s health service.

“We need real action not countless presentations and initiatives within individual employers about ‘changing culture’.

“We need real progress and results not further diversity panels and training in the hope of a ‘silver bullet’ to solve all our problems.

“We need much more than just the good intentions in diversity action plans which repeatedly fail to show any confidence in their proposals.

“Leaders at every level must reflect on their own biases, assumptions, stereotypes and behaviours in the recruitment and promotion process.

“There must be an evidence-based strategy driven by honesty and a credible theory of change to move forward.”

As part of the report, Mr Kline outlines a series of nine key recommendations for lead organisations and employers to follow to create fairer recruitment and career progression for BME, women and disabled staff.

In 2014, Mr Kline authored ‘The Snowy White Peaks of the NHS’ which documented discrimination in governance and leadership of the NHS and the impact on patient care.

He designed the Workforce Race Equality Standard (WRES) and was joint national director of the WRES team between 2015 and 2017.

Read the full No More Tick Boxes report published by NHS East of England and Mr Kline’s blog on MDX Minds.

Stock photo by Shutterstock.