The hidden consequences of stalled progress

The NHS takes pride in its diverse workforce. But while one in four NHS staff comes from an ethnically diverse background, leadership tells a different story. Professionals from minoritised ethnic groups make up nearly half of junior doctors—yet they hold just 10% of NHS executive roles. (England.nhs.uk)

This leadership gap isn’t just a numbers issue—it has real consequences for patient outcomes, workforce retention, and NHS efficiency – especially its financial health. When diverse voices are missing from the top, decisions get made without fully understanding the needs of the staff and communities the UK healthcare and the NHS serve.

And the cost? Lower staff morale, worsening patient disparities, and an overstretched healthcare system struggling to retain its best talent.

Why this isn’t just a ‘diversity’ issue

Diverse leadership brings varied perspectives essential for innovation and effective decision-making. Without it, the NHS risks stagnation, missing out on the myriad of benefits that true inclusivity offers.

When leadership remains unrepresentative, staff disengagement increases, and patient trust declines. Research shows that patients from minoritised ethnic groups are more likely to experience poorer health outcomes due to systemic biases and unequal access to care.

A homogeneous leadership can inadvertently lead to policies that don’t address the nuanced needs of a diverse patient population. This oversight can result in misdiagnoses, ineffective treatments, and ultimately, longer hospital stays—all of which strain NHS resources.

The human cost

Beyond the financial implications, there’s a profound human cost. Professionals from minoritised ethnic groups often face barriers to progression, leading to feelings of frustration and undervaluation. This environment can stifle potential leaders who could drive the NHS forward.

At the same time, NHS retention rates are plummeting, particularly among experienced staff from ethnically diverse backgrounds. Many report hitting a career ceiling, leading to an exodus of skilled professionals to private healthcare, overseas jobs, or entirely different careers. The NHS is effectively training and developing top-tier talent—only to lose them because the path to leadership is unclear or inaccessible. (NHS England)

Having diverse leadership isn’t about ticking boxes—it’s about ensuring policies and decisions are informed by a broader range of lived experiences.

Fixing the system: what needs to change?

Professionals from minoritised ethnic groups aren’t looking for shortcuts—they’re looking for fair career progression based on skill, capability, and leadership potential. To achieve this, the NHS must:

• Address patient disparities through leadership – Leadership must reflect the communities it serves to ensure care policies meet real needs.
• Make career progression transparent – NHS staff need clear pathways into leadership, not vague promises.
• Prioritise retention over recruitment – Hiring diverse talent means little if they leave due to systemic barriers.

The issue isn’t a lack of ambition —it’s a lack of opportunity. Until leadership structures are redesigned to support and sustain diverse talent, the NHS will keep losing the very professionals it claims to value.

Join the Conversation at the B.I.D.E Workforce Summit

This isn’t just about representation—it’s about building a stronger, more effective healthcare system that benefits both staff and patients. If we want real change, we need to start asking the hard questions and driving action that goes beyond good intentions.

On 25th September 2025, the B.I.D.E Workforce Summit will bring together healthcare and NHS leaders, decision-makers, and frontline staff to discuss how we tackle these issues head-on.

Find out more and be part of the change by visiting the B.I.D.E Summit page.