Healthcare Inequalities and Social Justice Blog Series: Transcultural leadership, anti-racism, and psychological safety

The NHS employs 1.6 million people, with 42 integrated care systems (ICSs) and 215 trusts across England, but it has less than ten chief executives from minoritised communities.1 There is also less than 13% representation of minoritised executive directors and very senior managers, despite 24% of the workforce being from minoritised backgrounds. One in three trusts has entirely White boards (HSJ, 2020; NHS England, 2023). There are 35 NHS Trusts in London and only three minoritised CEOs. Yet over 50% of London’s population and health and social care workforce comes from minoritised communities. They face the highest percentage of racism in the sector. Black women are almost four times more likely to die in maternity services in the UK than White women. Black people are five times more likely than White people to be sectioned under the Mental Health Act 1983 and less likely, together with Asian people, to receive treatment and support from mental health services and therapy). I can think of only one good example of transcultural board leadership off the top of my head: East London Foundation Trust, the only mental health Trust in London with an outstanding CQC rating, which I believe is not coincidental. Out of the ten Executive Directors, six are visibly from minoritised backgrounds. With psychological safety, representation, and innovation from the top down, it showcases hope, trust, and inspiration for all staff.