NHS understaffing will make it difficult and potentially divisive to transfer black, Asian and minority ethnic health workers away from the coronavirus frontline, hospital bosses fear.
The ongoing reassignment of those with underlying health problems and pregnant staffers will further complicate attempts to enact NHS England guidelines that BAME staff should be “risk-assessed” and redeployed where possible.
However, growing numbers of hospitals are responding to the disproportionate number of minority ethnic people dying of Covid-19 by taking steps to help BAME personnel, including ensuring they have the protective equipment they need and are a priority to get tested.
Hospitals, ambulance services and providers of mental healthcare in England were told by NHS chiefs on Wednesday that they should allow BAME staff to transfer to different roles if they wish.
In new guidance to trust bosses, NHS England said that “on a precautionary basis we recommend employers should risk-assess staff at potentially greater risk and make appropriate arrangements accordingly”.
NHS trusts bosses have begun discussing what they can do to help BAME staff reduce their risk. But there are major doubts about the viability of NHS England’s order, especially given the huge extra pressure the health service is under from treating so many people with Covid-19.
One official said: “Redeployment of BAME staff is really tricky, because you have to make quite difficult decisions about certain people being on the frontline [dealing with Covid patients] and not others. It’s not like trusts are awash with staff they can start redeploying [to cover BAME colleagues], especially as they have already had to redeploy people to staff Covid wards.”
Dr Asif Munaf, a specialist registrar at Lincoln county hospital, said: “The guidance is at best vague as it does not outline the exact measures that will need to be taken. Does it mean BAME healthcare professionals will be redeployed to undertake more admin tasks, as everything is ‘high risk’ at present?
“Secondly, it will be impossible to enact as an already skeleton service of doctors and nurses cannot afford to have BAME colleagues moved away from the frontline, especially with almost half of all UK doctors and a quarter of all nurses coming from BAME backgrounds.”
He also warned the guidance would lead to huge variations in practice as trusts took different interpretations and said that it showed “the disconnect between those writing up official guidance and those in charge of enacting”.
Trusts where as many as half their staff are from BAME backgrounds cautioned that they would find it particularly challenging to allow widespread reassignment.
An official at one such trust said: “Hospital bosses are very worried about this very high death rate among BAME staff. But it’s not obvious exactly what we can do. If you have a high proportion of BAME workers, how do you provide normal care if a substantial number of them move away from their usual roles? It’s difficult.”
However, at the four hospitals run by Imperial Healthcare NHS trust in London, where 52% of staff are minority ethnic, “PPE helpers” who go round the wards ensuring that staff are using their personal protective equipment (PPE) correctly are particularly focusing on BAME workers. The trust is also ensuring that 52% of the tests for coronavirus now being offered to their staff are undertaken by minority ethnic staff.
It has also urged BAME staff in a letter this week to raise any concerns about how their usual working environment is affecting their level of risk and pledged to take action.
Dr Ramesh Mehta, the president of the British Association of Physicians of Indian Origin, said the key was testing for comorbidities in BAME staff and making sure they had the correct PPE. The NHSE advice had been interpreted wrongly, he added. “The wording could have been better. They should have said these people should be screened and if they are fit they should be allowed to work.”
Unions welcomed the NHS England guidance and the move to assess BAME staff.
Dr Chaand Nagpaul, the British Medical Association council chair, said: “BAME doctors and healthcare workers have done and continue to play an absolutely crucial role in our health service and in the fight against Covid-19. The NHS has a duty of care as an employer to protect its staff from harm and those that are at greater risk of serious infection.
“As such, those healthcare workers at high risk can be redeployed to areas where they are less at risk or work remotely – in any case they will still be providing a vital service to the NHS which still needs to provide wider healthcare.”
