Your support matters

Black, Asian and minority ethnic staff make up almost a quarter of the NHS workforce. But data from the 2022 Workforce Race Equality Standard report, published earlier this year, shows they are far more likely to experience bullying, harassment, and discrimination than white staff – and are also less likely to be appointed or promoted.

These findings may not come as any surprise to CSP members who have a lived experience of encountering racism, discrimination or workplace inequalities, but an awareness of the ongoing reality of these experiences is of relevance to all healthcare professionals, regardless of their own backgrounds and experiences. Calling out, combating and acknowledging discrimination in the workplace is a shared responsibility, and the ability to provide support when such incidences occur can have a career-changing impact. CSP member Rekel Kerr knows this only too well.

Rekel (pronounced Re, as in reed, and kel as in kelp) is head of physiotherapy and orthotics at Birmingham Women’s and Children’s Hospital, and has also recently completed a year-long population health fellowship, in collaboration with Coventry and Warwickshire Partnership Trust and Coventry University.

Over the years he has noticed signs that the physiotherapy profession is broadening out and becoming more diverse, but he says he got used to ‘being the only one of “me” very early on’ in his career.

‘When I started my training in 1997 there was nobody on my course that looked like me, and nobody on the physio lecturing staff that looked like me,’ he recalls.

And after qualifying he soon found himself encountering upsetting situations that many of his fellow students and peers would never have to experience.

‘I remember one of my first experiences was while I was working at a hospital on my first rotation,’ Rekel says.

I was a bright, youngish physio treating patients on the ward and one day, at the end of my morning round, I got to the end of a bed and a patient said, “I’m not being treated by him.”

‘I kind of stopped,’ Rekel says, remembering his shock. ‘And I trudged back to the department. On my way back I went past my superintendent’s office, and she saw me walking along and noticed I was a bit crestfallen (as I’m normally quite buoyant) so she called me into the office. She said, “What’s wrong?”, so I told her: “A patient refused to be seen by me…basically because of the colour of my skin” and I couldn’t even finish my sentence.

‘She was straight up out of her seat. She frog-marched me back to the ward, stood at the end of the patient’s bed and said,

“Rekel’s one of my best physios. You either have physio from him or you don’t have physio at all, so I’ll leave you to think about that.” 

‘I was stood at the end of the bed and I was amazed, and the patient’s jaw had also hit the bed. 

‘When I gathered myself, I said to the patient: “Okay, well, shall we?” And she kind of said, yes, so we worked together for a week and I did her rehab.’ 

At the end of the week, Rekel did a final assessment with the patient, to ensure that she could safely climb a flight of stairs before she was discharged.

‘This lady looked at me as she got to the top of the stairs, and she smiled and said, “You people are all right”. And I kind of thought, you know what? That’s the closest I’m going to get to a turnaround. 

‘It wasn’t an out and out victory, but I like to think it may have changed some of the conversations she had when she went home - that maybe she would tell her friends that she had a Black physio who delivered her rehab and helped her get better, so in a way I had been positive role modelling.’

The value of support

Many years later Rekel saw an article in Frontline about physios having to deal with patients who were discriminatory, which reminded him of this experience.

‘After reading that article, I actually tracked down my old boss. Her name’s Louise Coleman. She’s retired now, but I phoned her up and said “Thank you – because you’re the reason I still have a career. If you hadn’t taken those actions, I probably would have crumbled and not come back to work the next day”.

‘Because I was facing racism so early on in my career, and I hadn’t realised up until that point how much it could potentially impact on my career with people refusing to be treated by me. 

It was a lesson to me that my professionalism, my intellect and my ability can all count for nothing in the face of racism

From his own experience Rekel knows the incredible value of receiving support from a colleague, but he says he’s not fond of the term “allyship” or the idea that people need to be trained in order to be “allies” when it comes to promoting equity and diversity in the workplace.

‘My worry is that “allyship” will be a fad and it will fade away and the funding will go, and then we may be left with people saying, well, there’s no training now for me to learn to be an ally,’ he explains.

‘What my old boss did, that wasn’t “allyship”, it was just her being a decent human being. And people shouldn’t really have to be taught how to be decent human beings…We should be able to do it without being taught or told how to do it.’

Dealing with discrimination

Sanchez-Jeremiah Davis is a physiotherapy lecturer at St. George’s University, London, and also practises privately as an MSK physiotherapist.

Sanchez-Jeremiah teaches at both undergraduate and postgraduate level and is passionate about ensuring that physiotherapy students develop all the skills and knowledge they will need as the profession expands to meet new and changing challenges.

But during his own student days and in his subsequent career journey, Sanchez-Jeremiah has unfortunately had to deal with microaggressions and racial discrimination, which he has experienced from both patients, supervisors and colleagues.

‘The first experience I had was on my second placement,’ he explains.

‘I was paired with another student, who was failing due to various issues such as professionalism. But for some unknown reason, I started to get branded with the same kinds of behaviour as him – despite the fact that that I wasn’t behaving like him at all. 

‘I was turning up on time, seeing all of my patients, completing my notes on time and engaging in everything that was required and asked of me, while they were being late, not turning up or not completing notes.’

Sanchez-Jeremiah used appropriate channels, such as politely communicating via email, to question why he was being judged in the same way as the other student.

‘But when I started to question why I was being treated the same way as an underperforming student, I was suddenly labelled as being aggressive and intimidating – even though that’s not in my nature at all.’

As a result, Sanchez-Jeremiah reported what was happening to his link tutor. 

Initially I had thought I was being compared to the other student because we were from the same university

‘But through the conversations that my tutor had with my educator, it became apparent to her that there was some kind of stereotyping or microaggressions happening, as the educator appeared to be viewing me as the quote-unquote stereotypical, “aggressive black man” and as somehow intimidating.

‘So, my link tutor had quite a serious conversation with the university and my educator. And for the remaining two weeks of that placement, I then had a completely different experience, and it was much more positive.

‘After that, I went on to pass that placement with a 2:1…but before that they were going to fail me.’

To this day Sanchez-Jeremiah still appreciates the support and insight that his link tutor provided, especially as she was able to identify what was really happening.

‘She was also my personal tutor, and I’m still in touch with her now,’ he says.

‘She identifies as a white, British female, but she is also somebody that identifies as an ally for people facing discrimination, whether it be due to their race or their gender, or their sexuality or other characteristics. And she’s supported me through other things during my life.’

As a result, Sanchez-Jeremiah understands how important allyship can be. Especially as, after qualifying, he experienced an even more disturbing situation, which proved far more difficult to endure because this time he had no one to turn to for advice, and none of his peers or colleagues came forward to support him.

The damaging impact of a lack of support

‘I’d started working for a private organisation that had an NHS contract, and this happened to coincide with when we just went into the first Covid-19 lockdown,’ he explains.  

‘It was also around the time when George Floyd was killed, so there was also a lot around about the Black Lives Matter campaign, and also a lot in the media about the first eight medical professionals to die from Covid, as they had all been from Black or ethnic minority backgrounds.’

Amid all these circumstances, Sanchez-Jeremiah attended an emergency first aid training session at his workplace. 

‘Because of all the Covid precautions, and also the government inquiries that were looking into people from Black backgrounds potentially being at a higher risk, I asked a question about PPE for protective purposes. 

A colleague of mine then turned around and said “Oh, it’s always the same with you Black people, isn’t it? It’s always the same.” 

‘So, I asked what they meant by that, and he said “I don’t believe any of the stuff that’s in the news. It’s not true. You’re not more affected by Covid. You don’t need the PPE.”

‘This was in front of the whole class, and the instructor stated that what I said was true, but nobody challenged the colleague’s comments…So, I got up and left.’

Sanchez-Jeremiah then reported the incident to his line managers and the CEO. But despite him continually chasing up the issue, it took them approximately four months to formally respond. And when they finally did the end result only consisted of a muted apology from the colleague who had made the comments.

Throughout this time, Sanchez-Jeremiah felt he was “battling” on his own as none of his colleagues had appeared to acknowledge or express the seriousness of what had happened, or subsequently inquired as to the impact it might have had on him.

'I was the only Black person in the organisation at the time,' he says.

‘And nobody messaged me to see how I was feeling or to check up on me, and there was no pastoral support at all in relation to it.

‘So, I eventually ended up leaving that place because it had a huge impact on my mental health.’

Thankfully, Sanchez-Jeremiah says, he went on to find employment in a far more supportive environment.

‘I know I have allies where I work now. So, if something were to happen, I feel safe because I know I’d get support.

‘Whether you are a student, or a professional, or a support worker, you need to know that there is somebody you can go to if you are subject to certain things. You need to know that you’re not alone.

It can be mentally exhausting, especially if when something does occur and you want to challenge it, you’re then labelled as aggressive or intimidating

Sanchez-Jeremiah believes allyship within the profession is a vital asset, but he’s also keen to point out that you don’t have to be in a senior role or in a position of authority to offer effective and impactful support.

‘Anyone can be an ally, irrespective of your title.’

Creating a support network

Dawn Robertson agrees that anyone, no matter their background or the status of their role, has the potential to provide meaningful support to others.

‘During my career I’ve had mentors I could reach out to, who have supported me through my journey and some of the challenges I’ve had,’ she explains.

‘And those mentors were not necessarily from Black communities. They tended to be white British, but irrespective of race or ethnicity they supported me.’

Dawn, who is an MDT team manager for discharge to assess, is based within the REACT team at St John’s Hospital in West Lothian and has worked for NHS Lothian for seven years, having previously worked for the NHS in England for over a decade.

She says she is keen to encourage the development of more support networks, not only for physiotherapy staff and healthcare professionals, but also for ethnic minority groups in the community.

When I first started in physiotherapy, there weren’t a lot of people from the Black community

‘And I don’t remember seeing anybody else from a Black background when I was studying or when I did my masters in rehabilitation sciences.’

‘But having been in the NHS for a while now, I’ve seen an increase in people from different ethnic groups and more people coming to work from different countries, so I feel there is a growing need for more support networks for Black and ethnic minority groups,’ she says. 

‘Not just to allow people to meet and come together, but also to support their growth and their learning, and to address what their needs are,’ she explains. 

‘For example, it would be great if we could have workshops for people who come to work in the UK, to explain the kind of things they should expect as physiotherapists and allow them to hear from people who have been in the system longer and can signpost them to different areas if needed.’

Reach out for help

At present, however, Dawn is aware that many physio staff from Black or ethnic minority backgrounds, including those who have trained overseas, are potentially at risk of feeling isolated or unsupported in their workplaces – especially if they also encounter microaggressions or discrimination whilst at work.

‘One of the things I would say to people is if you’re struggling at work, reach out for support,’ Dawn urges.

‘I know it’s difficult because I’ve had conversations about this and people have told me that sometimes there’s been no one for them to reach out to, so they’ve just suffered in silence.’

In these types of circumstances, and from her own experience, Dawn recommends a proactive approach to gaining help and support, which may sometimes mean looking further afield than your immediate workplace or local area.

‘I found a support network of physiotherapists (and others healthcare professionals) by just contacting researchers or by going to my senior physios to get support from them.

‘And one of my mentors I actually met by reading Frontline,’ she adds.

‘She was featured in the magazine talking about the work she’d done, so I emailed her and just said “Would you be interested in chatting about it with me?”.

‘So, I would encourage people to be proactive and reach out, not just to gain support, but also if you want to grow and expand your career as well.’

Dawn says joining CSP networks, like the BAME Network, can also be a good starting point, as well as linking in with specialist interest groups and networks in your chosen field. 

‘I think the CSP should also give members the opportunity to meet up via workshops, where people can come and talk about their experiences, and how they can support other people as well,’ she says

Because we do need to create more opportunities for people to reach out through different means, so they can have those conversations around “This is what happened. This is how I feel. What can I do?

Ideally, Dawn says, support networks should not only be focused on enabling people to raise concerns, but should also have the purpose of allowing people to reflect on positive progress, share good advice and be inspired by stories of success.

‘To me that’s a big one,’ she adds.

‘Because we need to be able to celebrate who we are, create room for opportunities and celebrate our achievements as well!’ 

Author: Robert Millett