Search

IntroductionThere are limited data on the outcomes of COVID-19 risk assessment in healthcare workers (HCWs) or the association of ethnicity, other sociodemographic and occupational factors with risk assessment outcomes.MethodsWe used questionnaire data from UK-REACH (UK Research study into Ethnicity And COVID-19 outcomes in Healthcare workers), an ethnically diverse, nationwide cohort of UK HCWs. We derived four binary outcomes: (1) offered a risk assessment; (2) completed a risk assessment; (3) working practices changed as a result of the risk assessment; (4) wanted changes to working practices after risk assessment but working practices did not change.We examined the association of ethnicity, other sociodemographic/occupational factors and actual/perceived COVID-19 risk variables on our outcomes using multivariable logistic regression.Results8649 HCWs were included in total. HCWs from ethnic minority groups were more likely to report being offered a risk assessment than white HCWs, and those from Asian and black ethnic groups were more likely to report having completed an assessment if offered. Ethnic minority HCWs had lower odds of reporting having their work change as a result of risk assessment. Those from Asian and black ethnic groups were more likely to report no changes to their working practices despite wanting them.Previous SARS-CoV-2 infection was associated with lower odds of being offered a risk assessment and having adjustments made to working practices.DiscussionWe found differences in risk assessment outcomes by ethnicity, other sociodemographic/occupational factors and actual/perceived COVID-19 risk factors. These findings are concerning and warrant further research using actual (rather than reported) risk assessment outcomes in an unselected cohort.

ObjectivesThe coronavirus disease 2019 (COVID-2019) pandemic has had far-reaching consequences for people’s lives. In the UK, more than 23 million have been infected and nearly 185 000 have lost their lives. Previous research has looked at differential outcomes of COVID-19, based on socio-demographic factors such as age, sex, ethnicity and deprivation. We conducted a qualitative study with a diverse sample of adults living in the UK, to understand their lived experiences and quality of life (QoL) during the pandemic.MethodsParticipants were recruited with the help of civil society partners and community organisations. Semi-structured interviews were conducted between May and July 2021. Interviews were recorded with permission and transcribed. Transcripts were analysed following an inductive analytical approach as outlined in the Framework Method.Results18 participants (≥16 years) representing different ethnicities, sexes, migration and employment statuses and educational qualifications took part. Five key themes and 14 subthemes were identified and presented using the QoL framework. The five key themes describe how COVID-19 affected the following aspects of QoL: (1) financial and economic, (2) physical health, (3) social, (4) mental health and (5) personal fulfilment and affective well-being. The narratives illustrated inequities in the impact of COVID-19 for individuals with intersecting social, economic, and health disparities.ConclusionOur findings demonstrate the multidimensional and differential impact of the pandemic on different population groups, with most of the negative economic impacts being borne by people in low-paid and insecure jobs. Similarly, adverse social, physical and mental health impacts particularly affected people already experiencing displacement, violence, physical and mental illnesses or even those living alone. These findings indicate that COVID-19 impacts have been influenced by intersecting health and socioeconomic inequalities, which pre-existed. These inequities should be taken into consideration while designing pandemic recovery and rebuilding packages.

ObjectivesTo investigate how ethnicity and other sociodemographic, work, and physical health factors are related to mental health in UK healthcare and ancillary workers (HCWs), and how structural inequities in these factors may contribute to differences in mental health by ethnicity.DesignCross-sectional analysis of baseline data from the UK-REACH national cohort studySettingHCWs across UK healthcare settings.Participants11,695 HCWs working between December 2020-March 2021.Main outcome measuresAnxiety or depression symptoms (4-item Patient Health Questionnaire, cut-off >3), and Post-Traumatic Stress Disorder (PTSD) symptoms (3-item civilian PTSD Checklist, cut-off >5).ResultsAsian, Black, Mixed/multiple and Other ethnic groups had greater odds of PTSD than the White ethnic group. Differences in anxiety/depression were less pronounced. Younger, female HCWs, and those who were not doctors had increased odds of symptoms of both PTSD and anxiety/depression. Ethnic minority HCWs were more likely to experience the following work factors that were also associated with mental ill-health: workplace discrimination, feeling insecure in raising workplace concerns, seeing more patients with COVID-19, reporting lack of access to personal protective equipment (PPE), and working longer hours and night shifts. Ethnic minority HCWs were also more likely to live in a deprived area and have experienced bereavement due to COVID-19. After adjusting for sociodemographic and work factors, ethnic differences in PTSD were less pronounced and ethnic minority HCWs had lower odds of anxiety/depression compared to White HCWs.ConclusionsEthnic minority HCWs were more likely to experience PTSD and disproportionately experienced work and sociodemographic factors associated with PTSD, anxiety and depression. These findings could help inform future work to develop workplace strategies to safeguard HCWs’ mental health. This will only be possible with adequate investment in staff recruitment and retention, alongside concerted efforts to address inequities due to structural discrimination.Summary boxWhat is already known on this topicThe pandemic is placing healthcare workers under immense pressure, and there is currently a mental health crisis amongst NHS staffEthnic inequities in health outcomes are driven by structural discrimination, which occurs inside and outside the workplaceInvestigating ethnic inequities in the mental health of healthcare workers requires large diverse studies, of which few existWhat this study addsIn UK-REACH (N=11,695), ethnic minority staff had higher odds of Post-Traumatic Stress Disorder symptoms; we report many other factors associated with mental-ill health, including those experienced disproportionately by ethnic minority staff, such as workplace discrimination, contact with more patients with COVID-19, and bereavement due to COVID-19These findings underline the moral and practical need to care for staff mental health and wellbeing, which includes tackling structural inequities in the workplace; improving staff mental health may also reduce workforce understaffing due to absence and attrition

Pressures such as high workload, stretched resources, and financial stress are resulting in healthcare workers experiencing high rates of mental health conditions, high suicide rates, high rates of staff absences from work, and high vacancy rates for certain healthcare professions. All of these factors point to the fact that a systematic and sustainable approach to mental health support at different levels and in different ways is more important than ever. In response, we present a holistic analysis of the mental health and wellbeing needs of healthcare workers across the United Kingdom healthcare ecosystem. We recommend that healthcare organisations should consider the specific circumstances of these staff and develop strategies to counter the negative impact of these factors and help safeguard the mental health of their staff.

IntroductionHealthcare workers are experiencing deterioration in their mental health due to COVID-19. Ethnic minority populations in the United Kingdom are disproportionately affected by COVID-19, with a higher death rate and poorer physical and mental health outcomes. It is important that healthcare organisations consider the specific context and mental, as well as physical, health needs of an ethnically diverse healthcare workforce in order to better support them during, and after, the COVID-19 pandemic.MethodsWe undertook a qualitative work package as part of the United Kingdom Research study into Ethnicity and COVID-19 outcomes among healthcare workers (UK-REACH). As part of the qualitative research, we conducted focus group discussions with healthcare workers between December 2020 and July 2021, and covered topics such as their experiences, fears and concerns, and perceptions about safety and protection, while working during the pandemic. The purposive sample included ancillary health workers, doctors, nurses, midwives and allied health professionals from diverse ethnic backgrounds. We conducted discussions using Microsoft Teams. Recordings were transcribed and thematically analysed.FindingsWe carried out 16 focus groups with a total of 61 participants. Several factors were identified which contributed to, and potentially exacerbated, the poor mental health of ethnic minority healthcare workers during this period including anxiety (due to inconsistent protocols and policy); fear (of infection); trauma (due to increased exposure to severe illness and death); guilt (of potentially infecting loved ones); and stress (due to longer working hours and increased workload).ConclusionCOVID-19 has affected the mental health of healthcare workers. We identified a number of factors which may be contributing to a deterioration in mental health across diverse ethnic groups. Healthcare organisations should consider developing strategies to counter the negative impact of these factors. This paper will help employers of healthcare workers and other relevant policy makers better understand the wider implications and potential risks of COVID-19 and assist in developing strategies to safeguard the mental health of these healthcare workers going forward, and reduce ethnic disparities.Key messagesWhat is already known about this subjectHealthcare Workers (HCWs) are experiencing deterioration of their mental health due to COVID-19Ethnic minority populations and HCWs are disproportionately affected by COVID-19More research is needed on the specific factors influencing the mental health of ethnically diverse healthcare workforcesWhat are the new findingsProminent factors influencing the mental health and emotional wellbeing of this population include:anxiety (due to inconsistent protocols and policy)fear (of infection)trauma (due to increased exposure to severe illness and death)guilt (of potentially infecting loved ones)stress (due to longer working hours and increased workload)How might this impact on policy or clinical practice in the foreseeable futureHealthcare organisations should consider the specific circumstances of these staff and develop strategies to counter the negative impact of these factors and help safeguard the mental health of their staff

The WHO, the International Council of Nurses and Nursing Now, had planned to raise the global public profile of nursing in 2020 as a consequence of Florence Nightingales 200th anniversary. However, with the unexpected arrival of the coronavirus pandemic in late 2019, nurses and the nursing profession found themselves having unexpected media attention. The degree and type of media attention that nursing achieved during this time were never anticipated. This article considers the reality of nursing, both the role and profession in the UK in 2021 compared with the public perception and temporal media portrayal. The media mediates public perception(s) through imagery and messaging. However, with reduced public understanding of healthcare services, inadequate understanding of healthcare professional roles and responsibilities, and reduced health literacy in the general population,1 there is ample opportunity for misinformation and psychological bias (such as confirmation bias or stereotyping) to operate in the mainstream discourse dictating and perpetuating a false image of nursing.2 Given that nursing is the largest global occupation of predominately female employees3 and the National Health Service (NHS) is the largest employer in Europe, qualified nurses in the UK make up 26% of the total NHS workforce.4 The consequences of nursing having a poor public image subsequently impact the profession being undervalued, with poor recruitment, retention and indirectly influence patient healthcare.4 Since the 1970s, nursing had forwarded Advanced Clinical Practice and specialist roles.5 Conversely, for decades, the media has portrayed nurses as predominantly subservient to doctors and referred to nurses as the doctor’s ‘handmaiden’ and not as independent practitioners. The idea of nursing subservience is rooted in a gross misunderstanding of the nurse’s role,6 7 with outdated patriarchal and gendered ideas around male-doctor dominance and female subservience.8 9 From the outsider and non-informed perspective, the …

People from ethnic minority backgrounds in the UK have been disproportionately affected by coronavirus disease 2019 (COVID-19), with higher death rates and suboptimal health outcomes compared with those from white ethnic backgrounds. This trend is reflected in healthcare staff from ethnic minority backgrounds, including nurses, who are disproportionately affected by COVID-19 and have higher death rates from the disease. The theory of intersectionality contends that social categorisations such as gender, race and class can contribute to discrimination and result in disadvantages. In this article, the authors outline several intersecting factors that could be contributing to the disproportionate effects of COVID-19 among nurses from ethnic minority backgrounds, as well as making recommendations for further research in this area.

Aim To ascertain British South Asian male nurses' views on the barriers and enablers to entering and progressing in nursing education and careers. Background There is a shortage of men from Black, Asian and Minority Ethnic groups in the National Health Service nursing workforce. There is a dearth of evidence on the views of British south Asian men on this subject. Methods A qualitative interpretative intersectional approach was used to carry out one-to-one interviews (n = 5) with British South Asian male nurses using a semi-structured topic guide. Interviews took place between July 2018 and February 2019, across England. A framework analysis approach was used to analyse the interview transcripts. Results The main themes emerging as barriers were as follows: poor pay and conditions; negative immediate, extended family, community views; and a lack of knowledge and awareness of the nursing profession. The main themes emerging as enablers were as follows: personal circumstances (including role models) and ethnicity (including the role of religion and masculinity). Conclusion Findings suggest that the intersection between ethnicity and gender presents as an important enabler, as well as inhibitor, for British South Asian men. Nursing careers and salient barriers exist at a systemic level and include institutional racism. Implications for nursing management Managers review policies and practice on unconscious bias and institutional racism in the recruitment, retention and progression of British South Asian men. Employers provide continuous professional development including mentoring support to help career progression for these men. Human resources colleagues develop culturally specific interventions to reduce the stigma associated with the nursing profession in the British South Asian community. Nurse recruitment colleagues consider places of worship as venues for delivery of these interventions when promoting nursing.

Background: There is a recognised shortage of nurses globally and specifically in England. There is also a particular need to expand and diversify the current nursing workforce. Previous evidence shows that both South Asians and men have long been underrepresented on nursing courses and in the nursing workforce. This study aimed to carry out a secondary review of applications, acceptance and attrition data for nursing preregistration courses in England to understand the relationship between sex, ethnicity and success rates. Methods: Secondary descriptive analysis of national data on applications (n=150, 445 applicants), acceptances and attrition rates (n=416,457 enrolled students) in relation to nursing preregistration courses in England from 2013 to 2016. Study conducted in January 2018. The sample was restricted to undergraduate courses. Results: Using proportion ratios, using 95% confidence intervals, British South Asian men are significantly more likely to apply to nursing courses than their White counterparts. They are half as likely to be accepted for those nursing courses. British South Asian men are also significantly more likely to leave their nursing course without any award than British White men. These results have implications for nursing educators and specifically those involved in widening participation policy for minority groups and the nursing profession. Conclusion: These results indicate the need to further consider why British South Asian men are applying for nursing education courses in proportion to their prevalence in England, why are they so unlikely to be accepted on nursing courses in comparison to other groups? and why are they so likely to leave their nursing course without any award? This should be done to identify policy implications and organisational practice that may act as barriers for this cohort successfully completing their nursing education.

Background: UK ‘home grown’ (people of South Asian ethnicity, born or socialised in Britain) South Asian (Pakistanis, Bangladeshis and Indians) are underrepresented in the NHS nursing and the allied health workforce. One of the key goals of Health Education England’s (HEE) national framework- Widening Participation-It matters! is to increase understanding and evidence on the specific needs of underrepresented groups as they apply, commence and progress on healthcare courses and careers. There is a dearth of evidence on the views of UK ‘home grown’ South Asian prospective students. This study aimed to explore UK ‘home grown’ South Asian students views on the barriers and enablers to choosing nursing and midwifery courses and progressing into healthcare employment.\ud Methods: A total of nine focus groups were conducted. Four focus groups in two schools/colleges in the town of High Wycombe (n=28) and five focus group discussions in two schools/colleges in Luton (n=27).\ud \ud Results: The main themes emerging for barriers to choosing nursing and midwifery courses and careers were: limited personal, parental and community knowledge influencing perceptions of nursing and midwifery, the role of religion and culture, gender roles-‘not man’s work’, the end of NHS bursaries and racial and religious discrimination. The main themes for enablers were presented as: good information available on applying for nursing or midwifery courses and suggestions on how to widen participation for South Asian groups.\ud \ud Conclusion: To increase numbers of UK ‘home grown’ South Asians on nursing and midwifery courses and in healthcare employment, targeted interventions that raise the profile and status of nursing in the South Asian community should be designed and delivered.