Study links migrant status to slower NHS career progression

Ethnic minority healthcare workers born overseas face a “double disadvantage” in career progression due to the combined effects of ethnicity and migrant status, according to research published in JRSM Open. The study of over 5,700 NHS workers found these staff members are significantly less likely to reach higher pay bands than their counterparts.

Did You Know? Ethnic minority healthcare workers represent over a third of staff at NHS pay band 5, but their presence drops to just 10% in senior roles.

Why do overseas-born minority healthcare workers face career barriers?

The study, which utilized data from the nationwide UK-REACH cohort, found that overseas-born staff are significantly less likely to be placed in higher Agenda for Change (AfC) pay bands. This trend persists even after adjusting for years of professional qualification, job role, and education, according to the researchers.

Asian and Black healthcare workers born overseas are specifically less likely to reach these higher pay bands compared to White staff who were born and trained in the UK. The AfC pay scale applies to a wide range of staff, including midwives, nurses, and allied health professionals.

Dr. Ji Soo Choi, lead author and NIHR Academic Clinical Fellow in Infectious Diseases at the University of Leicester, stated that migration status plays a critical role in shaping career prospects. Choi noted that these disparities cannot be addressed until they are recognized and recorded.

Expert Insight: Samantha Carter suggests that the lack of diversity in senior leadership creates a cycle where those most affected by scheduling and pay policies have the least influence over them. This structural gap could exacerbate the feeling of an unsupportive environment for minority staff.

How does the lack of migration data affect the NHS?

Migration status is often overlooked in Human Resources records, which creates a gap in research and hinders efforts to fix workforce inequality. While ethnic minority and migrant workers make up nearly a quarter of the NHS workforce, they remain underrepresented in senior positions.

Migrant workers face challenges distinct from their non-migrant ethnic colleagues, according to the study. These include restricted access to training, limited professional networks, and difficulties with the recognition of international qualifications.

Professor Manish Pareek, Clinical Professor in Infectious Diseases at the University of Leicester, stated that this lack of leadership diversity limits influence over key workplace decisions. Pareek warned that these inequalities may contribute to higher attrition rates during ongoing staffing challenges.

What could happen if workforce policies change?

NHS policymakers may be able to implement more targeted interventions if they include migration status in routine data collection. This shift in recording could allow the organization to identify exactly where career progression stalls for overseas-born staff.

Jinny Choi – BC-CfE Clinical Research Assistant

A possible next step involves updating workforce policies to explicitly address barriers like credential recognition and training access. The authors suggest that providing better mentoring and leadership opportunities could help bridge the gap between entry-level roles and senior management.

If these barriers are not addressed, the NHS may continue to see a sharp drop in ethnic minority representation as staff move from pay band 5 into senior roles.

Frequently Asked Questions

Who was included in the JRSM Open study?
The cross-sectional study included over 5,700 healthcare workers employed under the NHS Agenda for Change pay scale, including allied health professionals, midwives, and nurses.

What specific challenges do migrant healthcare workers face?
According to the research, migrant workers may face limited professional networks, difficulties with international qualification recognition, and restricted access to training.

What do the researchers recommend to improve career progression?
The authors urge NHS policymakers to routinely collect migration status data and implement policies that address credential recognition, mentoring, and leadership opportunities.

Do you believe that collecting more detailed demographic data is the most effective way to address workplace inequality?