Doctors and nurses demand action over BAME report findings

Doctors and nurses have demanded “urgent and tangible action” to protect key workers after a report found that racism and social inequality have contributed to the increased risk of black, Asian and minority ethnic communities (BAME) contracting and dying from Covid-19.

According to the Public Health England (PHE) report, historical racism may mean people are discriminated against when it comes to personal protective equipment (PPE) and may result in people from BAME backgrounds being less likely to seek care or demand better protection.

It set out a raft of recommendations from stakeholders, including the need to develop “occupational risk assessment tools that can be employed in a variety of occupational settings and used to reduce the risk of employees’ exposure to and acquisition of Covid-19”.

This is especially true for BAME workers in health and social care and on the front line in occupations that put them at higher risk, it said.

It comes after the Government was accused of holding back this second PHE report when a first report on the issue was published at the start of June.

Dr Chaand Nagpaul, council chair at the British Medical Association (BMA), said the release of the recommendations should be followed by “urgent and tangible action” with timescales established on when they will be implemented.

“This pandemic has brought to sharp focus the longstanding inequalities affecting BAME communities in this country, with greater numbers of people from a BAME background living in deprived areas and overcrowded housing, and a higher proportion as key workers that exposed them to the virus and who were often not provided with necessary protections,” he said.

Dr Nagpaul added: “The time for reviews, reports and commissions is over.

“What matters now is that the ministers must act swiftly to provide fair protection to people from ethnic minority backgrounds and to address the socio-economic and racial inequalities that have pervaded our nation for far too long.”

Professor Andrew Goddard, president of the Royal College of Physicians, said the review showed “how Covid-19 has disproportionately impacted those from BAME communities and widened health inequalities even further”.

He added: “Now that we have these recommendations, they must be placed at the core of both the NHS and the Government’s plans to restart services, as well as plans for further Covid-19 outbreaks.

“There is no time for complacency, and leaders at all levels should be made accountable for delivering these recommendations and regularly reporting on progress.”

Susan Masters, the Royal College of Nursing’s director of nursing, policy and practice, commented: “If UK Governments had acted on the advice of previous reviews and reports, BAME nursing staff across the UK would have been better protected going into this pandemic.

“We’ve been calling on employers in all health care settings to take swift and comprehensive action to support and protect BAME staff through targeted risk assessments.

“These new recommendations show clearly why they must take place to avoid needless loss of life.”

The report, which was based on stakeholder engagement with 4,000 people, also said that ethnic inequalities in health and wellbeing had become “more apparent and undoubtedly exacerbated” by the pandemic.

It said the unequal impact of Covid-19 on BAME communities may be explained by factors ranging from social and economic inequalities, racism, discrimination and stigma, occupational risk and inequalities in the prevalence of conditions that increase the severity of disease such as obesity, diabetes, cardiovascular disease and asthma.

The report highlighted participants’ “deep concern and anxiety” over the impact of potential future waves of Covid-19 if “lessons are not learnt”.

At the weekend, shadow justice secretary David Lammy said it was a “scandal” that the recommendations in the study had been “buried”.

The first report looked at why people from BAME communities may be at higher risk from Covid-19 but made no recommendations and made no reference to the 17 sessions held with stakeholders.

The latest report says that stakeholders “expressed deep dismay, anger, loss and fear in their communities about the emerging data and realities of BAME groups being harder hit by the Covid-19.”

Stakeholders pointed to the racism and discrimination experienced by BAME key workers “as a root cause affecting health, and exposure risk and disease progression risk”.

The study said there are issues around stigma and BAME fears of being diagnosed with coronavirus.

It added: “For many BAME groups, lack of trust of NHS services and healthcare treatment resulted in their reluctance to seek care on a timely basis, and late presentation with disease.”

Stakeholders called for immediate action in areas such as housing to reduce inequalities, and “targeted messaging on smoking, obesity and improving management of common conditions including hypertension and diabetes”.

Other recommendations include:

– Better data collection about ethnicity and religion, including having this recorded on death certificates.

– Making it law for health risk assessments to be carried out for BAME workers.

– Culturally sensitive public health messaging so that people, particularly those who may not speak English as a first language, can follow advice on how to protect themselves from Covid-19.

The report did not look at whether genetics plays a role in BAME risk.

A spokesman for the Government Equalities Office said: “This valuable insight will help inform the next stages of our work to tackle the disparities highlighted by the Public Health England review.

“This work will be led by the minister for equalities as we look to build on the good work that is already being done to protect our communities from the impact of the coronavirus.”

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