New WRES data shows 12.7% of very senior NHS managers are from Black & minority ethnic backgrounds, up from 11.2% in 2023, a significant rise since 2018
The latest NHS data reveals a meaningful shift in leadership diversity: for the first time, more than one in eight senior NHS staff members are from Black and minority ethnic (BME) backgrounds. This milestone, detailed in the 2024 Workforce Race Equality Standard (WRES) report, signals gradual but important progress in representation at the highest levels of healthcare leadership in England.
White applicants are more likely to be recruited in the NHS
The report showed that 12.7% of staff at senior manager level are from these backgrounds – up from one in nine (11.2%) in 2023. This figure represents an 85% increase since 2018, when there were only 201 senior managers from Black and Minority Ethnic (BAME) backgrounds, compared to 372 in the 2024 report.
The proportion of all NHS staff from a BME background has also increased from 26.4% in 2023 to 28.6% in March 2024. However, 80% of trusts reported that white applicants were significantly more likely than BME applicants to be appointed from shortlisting.
Overall, the percentage of BME staff (48.8%) who felt that their trust provides equal opportunities for career progression or promotion was lower than for white staff (59.4%).
BME staff remain underrepresented
In 2024, BME (Black and Minority Ethnic) staff in NHS trusts are more represented in junior roles than in senior ones. For the overall NHS workforce, 42.3% of staff at Band 5 are from a BME background, but this drops to just 12.0% at Band 9 and 12.7% at the very senior level (VSM). In non-clinical roles, BME staff comprise 18.8% of the overall workforce, with the highest representation at Band 6 (20.9%) and the lowest at Band 9 (11.0%). Although BME representation in senior non-clinical roles increased from 8.3% in 2019 to 13.0% in 2024, the overall increase in BME staff has not closed the gap between senior and junior levels, which remains at -5.8%.
In clinical roles outside of medicine, BME staff make up 29.4% of the overall workforce, with the highest number at Band 5 (45.7%), which includes newly registered nurses. Representation drops to 25.2% at Band 6 and 18.8% at Band 7. While BME numbers in senior clinical roles have improved (from 8.6% to 13.0%), the overall clinical BME workforce has grown even more (from 19.3% to 29.4%), making the gap worse, from -10.7% in 2019 to -16.4% in 2024.
This indicates that, despite progress being made, BME staff remain underrepresented in senior roles, particularly in clinical positions.
Report finds that disabled people are fairly represented in NHS boards
The report found that disabled people are fairly represented on NHS boards and that candidates who declare their disability on applications are just as likely to be appointed to NHS jobs as non-disabled candidates. Furthermore, the NHS continues to make reasonable adjustments, enabling disabled staff to carry out their work compared to previous years. Despite this, disabled staff are more than twice as likely to be performance-managed compared to their non-disabled colleagues and experience higher levels of harassment, bullying, or abuse from managers and other colleagues.
Dr Navina Evans, NHS Chief Workforce, Training and Education Officer, said: “It’s vital that NHS staff from black and minority ethnic backgrounds or those with a disability have equal access to career opportunities so that we can provide the high-quality care for patients.
“This report shows whilst we have made some progress over the past year – in particular through better representation of BME staff in very senior management roles – there is still much more work to be done to make sure all staff are treated fairly.
“NHS employers must continue efforts to create an environment where all staff feel they belong, can safely raise concerns, and are empowered to deliver the best care possible.”
