Looking back at the early stages of our pandemic response, it’s difficult not to be shocked by our naivety. A guidance note from one of my senior hospital mangers sent in March advised me to take particular care when dealing with patients who have been in Wuhan or the surrounding area, with no mention of other sources of infection or contamination. It was and has always been seen as an exterior threat to which we were peculiarly immune. I remember also the dread and awe as we saw the pandemic reach Italy and the heroism of the Lombardy healthcare staff. Even then, there was an inward denial that COVID-19 could breach British defences that had survived two world wars. Even on the day that SAGE warned people not to, Boris Johnson boasted of shaking hands with “everyone” on a hospital visit.

COVID may not discriminate, but our industry certainly did

Four months and 40,000 British deaths later, I was having my car MOTed. On learning that I was a doctor in the local hospital, the mechanic asked me with a hushed voice: “Are they blowing this COVID thing out of proportion?”. “No”, I replied with exasperation. “The morgue is full.” I accept this was harsh, as a denial of death and dying is a feature of our human condition. But for me, it was the loss of a critical nurse in my hospital to COVID where reality really dawned. She was young, without any serious long-term conditions, Muslim and from a BAME background. I ticked most of those boxes. As healthcare worker deaths started piling up, I noted that the first ten doctors to die of Coronavirus were also from a BAME background. COVID may not discriminate, but our industry certainly did.

What shocked me the most was that I hadn’t really noticed this systemic racism before. Although I was aware of the “Snowy White Peaks” of the NHS described by Roger Kline, I still believed in it as an institution. As a son of an immigrant doctor for whom the NHS was a jewel worth leaving a homeland for, it was almost sacred. Beyond reproach and beyond criticism – providing care and free at the point of need. Its discriminatory structures were now exposed to me for what it was, with all its warts and scars. The emperor’s clothes were now transparent. Those people furthest from the frontline were advantaged, protected and whiter.

The emperor’s clothes were now transparent. Those people furthest from the frontline were advantaged, protected and whiter.

Since then, I have experienced an unprecedented collegiality between healthcare staff. Just as I have seen my own vulnerability, so have others seen their own and we have been connected by this pandemic in ways I have never experienced. I know colleagues who have lost loved ones or have family members sheltering at home. I have seen the inside of many of my colleagues’ houses and I know we have all done conference calls in jogging bottoms. With this increased connectivity has come a greater understanding, appreciation and empathy of the less privileged across our industry, and a national desire to do more to address the imbalance.

This in itself is not enough. What we know is that all good QI translates the strategic and operational intent to a local response. As Mary Uhl-Bien articulated when she joined Matthew Mezey on a recent Q community Zoom call, what is needed is an entrepreneurial response that drives the adaptive changes focused at a local level. This will drive local innovations and improvements.

Taking action to support our BAME colleagues

It was with this in mind that, along with John Lodge we launched a campaign through our Q Exchange funded project, Hexitime, titled ‘A Community of Opportunity – Supporting BAME Colleagues in the Workplace’. Colleagues are able to offer support to BAME staff on the Hexitime timebanking platform, whose founding principle is that everyone’s time is valued equally irrespective of pay-scale, gender or ethnicity. This allows staff to convert good intentions to practical changes on the ground and takes ‘action from Leadership’ to ‘acts of leadership’.

Dozens of staff from a BAME background have joined Hexitime over the last few weeks. As this is a free, all-inclusive platform, they need not rely on a Little Black Book of contacts that is the privilege of the few. They can spend their initial two timebank credits on the Community of Opportunity support offers, so do not need to rely on charity or suspect the intentions of those offering their time. To gain more credits they then need to offer their own time and consider the assets and the experience they can bring to the community. That in itself is a second way to discover the talent of a group who would otherwise remain the underclass in our industry. By unlocking this potential, we can improve our improvement, as staff become more representative of the patients we serve.

Many of us have reflected on how we want things to be post-COVID. One thing I wish for is that we don’t un-see the systemic discrimination in our industry that disadvantages our colleagues and patients. I ask you to look at your own organisation and teams with fresh eyes and interrogate it for exclusivity. Cast aside the belief that we are somehow immune, consider first “Who is missing?” then ask “What can I do about it?”.

Visit Hexitime’s website to find out more about how you can get involved and support your BAME colleagues. 

Q Exchange 2020 is now open for ideas! Get involved and submit your idea on this year’s theme: ‘Embedding positive changes emerging through new collaborations or partnerships during COVID-19.’  Find out more