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One in five ethnic minority NHS managers plan to leave. A new survey explains why

Qurexa Editorial Team16 September 20265 min read 0 0
One in five ethnic minority NHS managers plan to leave. A new survey explains why

What happened

A new survey has found deep problems with racism among NHS managers in England. The NHS Alliance asked 950 Black, Asian and minority ethnic managers about their working lives. The findings were reported on 15 September 2026. Almost four out of five said they had experienced racism, exclusion, or barriers to getting on in their careers. One in five said they plan to leave the NHS within the next three years. The people surveyed described several things going wrong at once. They saw very little diversity in the senior teams above them. They were left out of the informal networks where decisions and introductions happen. And they described what the report calls progression disparities, meaning they did not get a fair shot at promotion compared with white colleagues. The NHS Alliance warned of a haemorrhaging of managers and senior leaders from these backgrounds.

Why this matters

It is easy to hear the word manager and picture paperwork. That is not really what this is about. NHS managers are the people who make rotas work, who keep wards staffed, who chase equipment, and who decide how a service is run day to day. When experienced ones walk out, patients feel it, even if they never learn why their appointment moved. Replacing an experienced senior manager is slow and expensive. The knowledge they carry about local services, local people and local problems does not transfer in a handover document. There is also a simple fairness point. Roughly three in ten NHS trust staff are from Black, Asian and minority ethnic backgrounds. If that group is far less likely to reach senior roles, the leadership does not look like the workforce, and it does not look like the patients either. That gap has consequences for care. Leaders who share their community's experience often spot problems others miss. There is a recruitment angle too. The NHS is competing for staff with every other employer, and word travels. If experienced people from a particular background are visibly leaving, it becomes harder to persuade the next generation to join in the first place. That is how a staffing problem becomes a long-term one rather than a bad year.

What the evidence actually says

This survey does not stand alone, and that is what makes it hard to dismiss. NHS England runs an annual measure called the Workforce Race Equality Standard. Its figures for March 2024 showed that 28.6% of NHS trust staff were from Black and minority ethnic backgrounds. On career progression, the same data showed a clear gap. Just 48.8% of Black and minority ethnic staff said their trust gave equal opportunities for progression or promotion. Among white staff, the figure was 59.4%. So the new survey of 950 managers lines up with the national picture. Two very different pieces of evidence, gathered in different ways, point the same direction. One honest note about the method. A survey of this kind reflects the views of those who chose to answer, and people with strong experiences are often more likely to respond. That is a real limitation. But the NHS England data covers the whole workforce and is not a self-selecting sample. Together, the two make a stronger case than either would alone.

Practical advice

Most readers are not NHS managers. Here is what is still useful to take from this. **If you work in the NHS and recognise this**, you are not imagining it and you are not on your own. Almost four in five people in this survey described something similar. Freedom to Speak Up Guardians exist in every NHS trust and can be contacted confidentially. **If you manage people anywhere**, the finding about informal networks is worth sitting with. Much of career progress happens in casual conversations, and people are easily left out of those without anyone intending it. Making opportunities visible and written down helps. **If you are a patient**, this does not mean your care is unsafe. It does help explain why some services feel stretched or keep changing staff. **If you want to follow this properly**, the Workforce Race Equality Standard is published each year and is free to read. It is the clearest public record of whether anything is actually shifting.

What to know

The NHS Alliance surveyed 950 Black, Asian and minority ethnic NHS managers in England. Almost four-fifths reported racism, exclusion or barriers to career progression. One in five said they intend to leave the NHS within three years. NHS England's own figures back this up. In March 2024, 28.6% of trust staff were from Black and minority ethnic backgrounds, but only 48.8% of those staff felt their trust offered equal chances of promotion, against 59.4% of white staff. Losing experienced managers affects how services run, which in the end affects patients. Sources: The Guardian, 'One in five black, Asian and minority ethnic NHS managers in England plan to quit amid racism, report finds', 15 September 2026, https://www.theguardian.com/society/2026/sep/15/bame-nhs-managers-england-quit-racism-report; NHS Alliance, 'Survey racism findings "deeply disturbing"', September 2026, https://thenhsalliance.org/news/survey-racism-findings-deeply-disturbing; Personnel Today, 'Four in five NHS ethnic minority managers experience racism', September 2026, https://www.personneltoday.com/hr/four-in-five-nhs-ethnic-minority-managers-experience-racism/. This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional.

#NHS#workforce#racism#health inequality#NHS staffing#patient care

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