With emerging evidence of the impact of COVID-19 on BAME communities, on 15 April 2020 NHS England CEO Simon Stevens convened a meeting of leaders in healthcare and representative bodies such as the British Medical Association and Royal College of Nursing to agree a plan of action to support staff.

The NHS response has since been underpinned by three principles of protecting, supporting, and engaging our staff.

Risk assessments

Following the mid-April summit and acting on a precautionary principle, all employers are recommended to risk-assess staff at potentially greater risk and make appropriate arrangements accordingly. With our support, on 30 April NHS Employers published risk assessment guidance signposted to NHS leaders, and since updated on 28 May.

We have produced a summary of the actions the NHS have taken to address the disproportionate impact of COVID-19 on NHS staff.

Case studies

Primary care

• AT Medics – How a large London primary care organisation conducted risk assessments to empower and protect their staff.
• Black Country and West Birmingham Sustainability and Transformation Partnership (STP) – how an STP worked with partner organisations to take urgent action on risk assessments to protect BAME staff within its workforce.
• North West London integrated care system – How an ICS worked with members organisations to support line managers in risk assessing and protecting staff.
• Pan Healthcare – how a community pharmacy approached protecting its staff and the public during the COVID-19 pandemic.
• Thistlemoor Medical Centre – How a primary care medical centre changed working practices to reduce Covid-19 transmission and support its staff.

Secondary care

• Derbyshire Community Health Services NHS Foundation Trust – How an NHS Trust rapidly set up a versatile COVID-19 risk assessment tool and training to support line managers.
• Leeds Teaching Hospitals NHS Trust – How a large hospital trust supported BAME staff having a disproportionate impact emerging from COVID 19.
• Mersey Care NHS Foundation Trust – How a large NHS trust used equality impact assessments (EQIAs) to protect staff in the wake of COVID-19.
• Newcastle-upon-Tyne Hospitals NHS Foundation Trust – how a large foundation trust engaged with Black, Asian and minority ethnic (BAME) staff to mitigate the disproportionate impact of COVID-19.

Infection prevention control

• Barts Health NHS Trust – how one of London’s largest hospital trusts adopted a new standard operating procedure (SOP) protecting Black, Asian and minority ethnic (BAME) colleagues who wear religious head coverings, and colleagues who have beards for religious and cultural reasons.
• United Lincolnshire Hospitals NHS Trust (ULHT) – How a large acute hospital trust managed IPC issues when staff were wearing a hijab or headscarf and alternative solutions.

Education programmes for staff

• Surrey and Sussex Healthcare NHS Trust – How an NHS Trust ensured that staff were using PPE appropriately and in particular those who don’t speak English as their first language.
• Ashford and St Peter’s Hospitals NHS Foundation Trust – How an NHS Foundation Trust ensured that staff were fully trained on using PPE.
• Chelsea and Westminster Hospital NHS Foundation Trust – How an NHS Foundation Trust ensured that outsourced staff were given the appropriate level of protection, training and care as those employed by the NHS.

Case studies which could help employers support their staff can be sent to covid19.workforce-comms@nhs.net

Protecting all staff

NHS employers are recommended to assure themselves that all their staff – including porters, ancillary staff, and agency and contract workers – are following national infection prevention control guidance to:

• use the right level of personal protective equipment, in line with this guidance from Public Health England
• keep themselves, colleagues and patients safe with regular reminders and advice on core information that all staff need to know:
  • good hand hygiene:
    • How to wash your hands (videos)
    • Best practice hand rub
    • Best practice hand wash
  • PHE’s guidance on social distancing (2 metres) inside and outside clinical areas: eg during work breaks and when in communal areas
  • keeping hands away from face when wearing any face protection
  • declaring all COVID-like symptoms, however mild, and not attending clinical areas for work
  • wherever possible, reducing movement between different areas
  • understanding the risk of surface contact transmission and frequently cleaning any shared equipment: eg mobile phones, desk phones and other communication devices, tablets, desktops, keyboards etc.

All those working in health and care settings can find essential information to use daily through the e-learning for healthcare.

Freedom to speak up

• Freedom to Speak Up has never been more important than now. A letter published from the National Guardian’s Office and WRES team asks NHS leaders to keep safe speaking up channels available and promoted to those whose voices are not so often heard
• Information for staff on speaking up channels is available.

Regional support

NHS England and NHS Improvement’s regional teams are providing complementary support to the national guidance. For example, in the South East, a new regional advisory group has been established to offer consistent and best practice health and wellbeing support to colleagues about the disproportionate impact of COVID-19 on our BAME workforce and communities in the South East. By ensuring robust risk assessments of all BAME colleagues across the South East are undertaken and acted on, the group is determined that its commitment and action will form part of a positive legacy from COVID-19.