Black, Asian and minority ethnic (BAME) staff within the NHS are reportedly less likely than their white colleagues to raise concerns about patient safety. This reluctance stems from fears that their concerns will not be taken seriously or understood, according to a March 2025 report by the NHS Race & Health Observatory and recent research.
The report notes that BAME staff, who make up more than 40% of the medical and dental workforce, continue to experience harassment and discrimination in their daily work, promotion opportunities, and disciplinary processes. This environment contributes to stress, burnout, and poorer mental health among staff.
Research funded by the National Institute for Health and Care Research found that racism, exclusion, and barriers to progression impacted BAME NHS staff's wellbeing and their ability to speak up about patient safety issues. Staff described not being heard, unclear routes for raising concerns, and fear of backlash, leading to reduced trust and, in some cases, staff leaving.
NHS England has pledged new staff standards requiring trusts to address racism and ensure equal representation, opportunities, and fair treatment. However, it is suggested that these standards must also mandate trusts to create psychological safety, allowing BAME staff to raise concerns about safety and racism without fear of repercussions.