05/08/2015 20:18 BST | Updated 04/08/2016 06:59 BST

Seven Survival Steps for Black and Minority Ethnic (BME) NHS Staff

If you are from a black and minority ethnic (BME) background, and work in the NHS in the UK, you will already know that survival can be the name of the game. As well as doing the day job, whether you are a consultant, a hospital porter, a chief executive, a nurse or an administrator there are factors you are far more likely to have to negotiate than your white colleagues.

This article is the first in a series of extracts of a forthcoming book "Seven Survival Steps for Black and Minority Ethnic staff working in the NHS". Based on research, case studies, testimonies, personal experience, and the experience of BME staff working in the NHS, this series may be useful reading for others.

Survival Step 1 - Line up your defence

Some will consider it rather offputting and negative that the first step recommended is to have in place a plan of defence. Yet research and statistical data shows unequivocally that if you are of ethnic minority origin and working in the NHS, you are more likely to need it than your white counterparts.

In 2014, the publication of a seminal piece of research by Roger Kline at Middlesex University Business School "The Snowy White Peaks of the NHS" described the background and context of the experience of BME staff in the NHS, and how patient safety and experience is affected by a very damaging situation.

Having a line of defence is recommended as the first step because if you are from a BME background, and working in the NHS, you are statistically more likely to face disciplinary action, bullying, harassment and discrimination. Three recommendations are made under this step of things you need to have in place from the first day of your NHS career.

The three actions you are recommended to have in place are trade union membership, insurance cover, and organised personal finances.

Trade Union and Professional Body Membership

NHS staff sometimes query the value of trade union membership, particularly when having to manage on a limited pay packet, and in the face of the erosion of some of the powers of trade unions. The reality is that when staff run into difficulties at work in the NHS, the absence of trade union membership benefits is often sorely felt.

This step is being recommended here for BME NHS staff to have in place from the first day they start working for the NHS as an employee, whether in training, part or full time, and whatever field you work in.

There are trade unions covering every type of work in the NHS but some of the main ones are Unison, Unite, the British Medical Association, The Royal College of Nursing, The Royal College of Midwives, and GMB. Some of these act as professional bodies for registered and qualified staff, as well as including unions that any NHS worker can join.


Professional Indemnity insurance provides you with cover in the event that you are successfully sued by people who have received your services, who feel they have been harmed or injured as a result. Before taking this out as a separate insurance, check that it is not included in any union or professional body membership you already have in place. If you are employed, your employer is liable for any clinical negligence claim brought in relation to or independent basis, you should ensure clinical negligence cover is in place.

Legal Services Insurance may be needed to cover to pay for the costs of legal services to bring a legal action. This may be included in your union membership, and will pay for the cost of making a claim in the event of an employment dispute. Which has produced a good guide about choosing legal expenses insurance, but quotes are available from comparison websites. Home contents insurance often includes legal services insurance so it is worth checking whether you already have it. If you do not have insurance in place, but need to bring a claim, and cannot cover legal costs yourself, speak with the Citizens Advice Bureau, and discuss with your solicitor special forms of insurance called Before the Event, and After the Event Insurance.

Other insurance to be considered are income protection insurance, and mortgage protection, but first look the life insurance benefits in your employment pension scheme, particularly if you are in the NHS pension scheme, which is highly recommended.

Personal Finances

Effective control and management of your personal finances is possibly the most important line of defence, and this will need to be in place if you are to ensure the ability to continuously and comfortably pay subscriptions for insurance, union membership etc.

There are many personal finance resources and experts, and much of the advice is available in books, websites, blogs, podcasts, a vlogs. Good ones are ones are Money Saving Expert and the Money Advice Service. The single most important advice that is almost universally agreed is the need to have an emergency fund, often described as a financial cushion, or rainy day fund. This is a sum of money that is set aside, in an easy access account, sufficient to cover your expenses for a period of time should an unexpected emergency happen. In the context of this discussion, the sum would need to be sufficient to cover your expenses for a period during which you are not working. The minimum recommended varies, but ultimately your personal circumstances will need to determine how much you need to set aside.

This article recommends taking impartial, independent advice to guide your own decisions on your insurance and financial needs.

Today's preparation determines tomorrow's achievement (Anon)