Review reveals 'vast' ethnic inequalities in NHS services

Critical action is needed to address "vast and persistent" ethnic inequalities in healthcare in the UK, a major study has found.

The review, ordered by the NHS Race and Health Observatory, found "overwhelming" evidence of poor outcomes for ethnic minority groups.

Some of the largest inequalities were found in mental health and maternity care.

NHS England said it is already taking action to improve access to services.

The study, led by academics at the University of Manchester, reviewed 10 years of research evidence across five key areas of healthcare:

• mental health

• maternity and neonatal healthcare

• genetic testing and genomic medicine

• the NHS workforce

• digital access to healthcare

The researchers said they found ethnic disparities across each of the five areas.

In mental health provision, ethnic minority patients were less likely to be referred by a GP for psychological and talking therapies than white patients.

There was evidence that some inequalities were being replicated in younger patients, with parents reporting their children faced the same barriers to access treatment.

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The review also found "strong evidence" of "clear, very large and persisting ethnic inequalities" in psychiatric wards, with higher rates of compulsory admission among minority groups.

Black patients were "more likely to be restrained in the prone [face down] position or put into seclusion" in those wards.

In maternity services, the researchers found evidence of negative interactions, stereotyping, disrespect, discrimination and cultural insensitivity, leading to some ethnic minority women feeling "unwelcome, and poorly cared for".

One part of the evidence showed Asian babies were over-represented in admissions to neonatal units for jaundice.

Babies sometimes get a yellowing of the skin and eyes - known as newborn jaundice - caused by too much bilirubin in their blood. This usually resolves but some need treatment.

The researchers said it was "worth noting" that a visual examination of jaundice is particularly unreliable for babies with darker skin tones, "raising the possibility that postnatal care may disadvantage non-white babies by delaying access to care".

Dr Dharmi Kapadia, a University of Manchester sociology lecturer and the study's lead author, said: "The evidence on the poor healthcare outcomes for many ethnic minority groups across a range of services is overwhelming, and convincing.

"The time for critical action on ethnic inequalities in healthcare is now."

The report also looked at inequalities within the NHS workforce. It found that there was evidence of an ethnic pay gap affecting black, Asian, and mixed groups, and to a lesser extent, ethnic Chinese staff.

The NHS Race and Health Observatory is an independent body established by the health service in 2020 to investigate health inequalities in England. The team of academics screened more than 13,000 research papers over a 10-year period, identifying 178 studies that were included in the final review.

A spokesperson for NHS England said: "The pandemic has shone a stark light on health inequalities across the country, and the NHS is already taking action to improve the experiences of patients and access to services.

"The NHS has set out what local health services should be focusing on over the next year so they can make these improvements in their local communities, and is already working closely with the Race and Health Observatory to drive forward the recommendations set out in this report."