COVID-19 has had a disproportionate impact on people of BAME heritage. Ninety four percent of the doctors who have died from COVID-19 were from a BAME background.2 This is a pandemic within the pandemic.
The reasons for the stark difference in diagnosis, recovery and death rates between people of BAME heritage and the rest of the population are not clear. Analysis often fails to capture the effect of comorbidities1 and deep-rooted structural inequality that feed into these glaring differences.1 Discrimination may be behind emerging evidence that staff from BAME communities have been disproportionately affected by PPE shortages in the NHS.* 4, 5
We must not wait to fully understand the causes behind the differences. It is clear that the impact of this virus has weighed heavily on the shoulders of those from BAME backgrounds and their communities. Action must be taken now to specifically protect our many BAME members and all BAME NHS staff from COVID-19.
NHS staff must feel empowered to cease or amend their work if they feel unsafe or at undue risk. Adequate safety equipment must be prioritised for BAME workers, and all of our colleagues working in NHS services must feel able to report concerns to their manager and feel confident that these will be acted upon in a positive, timely and sensitive manner.
We look to our health leaders to actively seek and prioritise the voice of BAME staff members and networks in decision-making. Action must be taken to address under-represented groups in leadership roles. The NHS must be a safe and supportive environment for the people working in it, and leaders have a responsibility not simply to facilitate this, but to actively listen and act upon concerns and fears raised by colleagues.
COVID-19 has exacerbated an issue that was already there. As paediatric services begin to reset, restore and recover, we have an opportunity to advocate for incremental, long-term changes. We have actively contributed to the NHS Risk Assessment Tool for staff and encourage our members to undertake this risk assessment via local Occupational Health departments.
Our commitment must also extend to the children and young people in our care. BAME communities are often faced with disadvantages in society. They are more likely to experience poverty, have poorer educational outcomes and have less access to high-quality care and other professional services.
We will continue to listen, support and act as allies for our BAME members, now and into the future. The RCPCH calls for healthcare leaders to use this opportunity for reflection and action, so that we not only recognise inequalities where they exist, but work towards eliminating them.
The RCPCH will be reflecting on its own next steps as an organisation to achieve better representation on its committees and groups. As well as seeking more participation from its BAME colleagues, the RCPCH recognises the need to engage other under-represented groups to represent the full breadth of its membership. We will be publishing more on this aspect in the coming weeks.
- Public Health England: https://www.gov.uk/government/publications/covid-19-review-of-disparities-in-risks-and-outcomes
- Cook, Kursumovic, Lennane: https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article
- Intensive Care National Audit and Research Centre: https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
- British Medical Association (BMA): https://www.bma.org.uk/news-and-opinion/bame-doctors-hit-worse-by-lack-of-ppe
- Royal College of Nursing (RCN): https://www.rcn.org.uk/professional-development/publications/rcn-second-ppe-survey-covid-19-pub009269
- Public Health Scotland: https://publichealthscotland.scot/news/understanding-the-impact-of-covid19-on-people-from-ethnic-minorities-in-scotland/
- BBC News, 3 June ‘The role of the app in contact tracing is often overstated’: https://www.bbc.co.uk/news/live/uk-northern-ireland-politics-52899842
- Welsh Government: https://gov.wales/written-statement-covid-19-and-bame-communities
- Policy Research Unit in Maternal Health and Care (2010 – 2018): https://www.npeu.ox.ac.uk/prumhc/maternity-care-womens-experience-and-outcomes-218
- Local action on health inequalities: Understanding and reducing ethnic inequalities in health: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/730917/local_action_on_health_inequalities.pdf
- RCPCH State of Child Health report 2020: https://stateofchildhealth.rcpch.ac.uk/key-priorities/reduce-health-inequalities/
- Gov.uk, People living in deprived neighbourhoods: https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity/demographics/people-living-in-deprived-neighbourhoods/latest
- *. The work on PPE shortages within the NHS (5) and NHS staff fatalities (2) draws on UK-wide data. Analysis from Public Health Scotland on general population data shows no increased risk to BAME people from COVID-19, but the organisation notes the limits of the data available and that more work needs to be done. (76) In Northern Ireland, research is currently being carried out on the risk of COVID-19 to people from BAME groups.(7) The Welsh Government has worked with PHE and NHSE to understand the disproportionate impact of COVID-19 on people from BAME groups and will continue to do so.(8)