The largest NHS reorganisation in a decade is disproportionately affecting Black staff, a network representing Black NHS managers and leaders has warned. 

Writing in an open letter to Health Secretary Wes Streeting MP, Health Minister Karin Smyth MP, Chief Executive of NHS England Sir James Mackey and Permanent Secretary to the DHSC Samantha Jones, the Managers in Partnership (MiP) Black Members Network is calling for action to “to protect Black staff” from “consistent patterns of inequity, discrimination and psychological harm”, particularly during organisational change.

The group says the government’s major restructure of the NHS in England is leading to higher rates of job losses among Black staff, declining diversity in senior leadership teams and the removal of representational standards that previously enabled transparent monitoring of equality data.

It warns that these trends are not only affecting staff mental health and wellbeing but also weakening the NHS’s ability to deliver safe, inclusive and effective care.

The network also raises serious concerns about rising racism and Islamophobia, including patients refusing treatment from Black clinicians, discrimination going unchallenged in the workplace and staff feeling unsafe amid a rise in far-right activity. It criticises senior leaders for supporting inclusion publicly while “failing to intervene when racism escalates internally and externally”.

The network describes a culture where senior leaders are perceived to place organisational reputation over the safety, dignity and wellbeing of staff. It says this “represents not only a serious moral and duty of care failure, but also a significant organisational risk”.

The open letter calls for immediate action from government and NHS employers including:

The open letter can be viewed here.

MiP Black Members Network Co-Chair Prince Obike said:

“Racism continues to go unchallenged in many organisations. This isn’t due to a lack of policies, development programmes or inclusive messaging from leadership. Across the NHS, anti-discrimination frameworks are in place, leaders increasingly promote allyship and leadership courses for Black staff are widely available and often oversubscribed.

“The deeper issue is that these efforts are not translating to meaningful change. Too often, those who speak up about the disconnect of what is promised and what is experienced are marginalised or silenced. As a result, many Black NHS staff are left to find other ways to be heard and have their concerns recognised.

“In the process, the humanity is being stripped out of decisions that affect the daily lives of Black staff.”

MiP National Organiser Rosie Kirk said:

“As the NHS is being reorganised, Black staff are losing jobs, losing representation and facing growing uncertainty. Skills are being lost and protections are weakening while racism goes unchallenged.

“Our members are telling us they feel anxious, unsupported, and shut out of decisions that directly affect their livelihoods, with serious implications for mental health and safety at work.

“This directly undermines the NHS’s ability to deliver the ambitions of the 10 Year Health Plan, which cannot be achieved without a supported, diverse and protected workforce.

“We are calling on government to urgently reinstate workforce representation standards, publish full equality impact assessments and enforce zero-tolerance on racism. Without immediate action this will become a systemic failure.”

MiP Chief Executive Jon Restell said:

“This heartfelt letter shows the persistent gap between the espoused values of the NHS and the everyday experience of our Black members. The government’s forthcoming staff standard on tackling racism must bite the problem unlike earlier policy initiatives.” //

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