A. Adonis1,2, J. Hammond3, J. Walumbe4,5, A. Wright6, G. Ramdharry4,2
1Imperial College Healthcare NHS Trust, London, United Kingdom, 2University College London, London, United Kingdom, 3St George's University, London, United Kingdom, 4University College London Hospitals NHS Foundation Trust, London, United Kingdom, 5University of Oxford, Oxford, United Kingdom, 6Integra Therapy, London, United Kingdom
Background: While the healthcare workforce in the UK is ethnically diverse, less than 10% of senior positions (such as consultant) are held by people from an ethnic minority background (the Global Majority). This is also reflected in physiotherapy. The pandemic and #BlackLivesMatter movement have shone a spotlight on structural inequalities that continue to exist.Previous research has identified issues for racialised minority students, but none has explored the experiences for qualified physiotherapists, particularly those at more senior levels.
Purpose: The main aim of the study was to explore the lived working experiences of qualified physiotherapists from racially minoritized backgrounds who are aspiring to or have achieved consultant level practice. In addition, the project aimed to explore the practices that perpetuate privilege and how these might be disrupted and how physiotherapists from the global majority may be supported.
Methods: The research was informed by critical theory. Purposive sampling was used via various online support networks (such as BAME and consultant level) known to the researchers. A 2-stage data collection process of 1)semi-structured interviews, conducted online with each participant, to explore past and present experiences of working towards consultant level practice; 2)A facilitated follow-up focus group where experiences were shared, support provided and outcomes co-constructed. A critical discourse analysis approach was used to analyse the data and search for common inequalities.
Results: Seventeen physiotherapists from a range of ethnic backgrounds participated with 41% working at consultant level practice. Inequalities identified included:
i) internalised undervaluing of skills, knowledge and experience,
ii) skills, knowledge and experience not being recognised by gatekeepers as equivalent or valid and
iii) the absence of visible and viable pathways to career progression.
Covert and overt racism was experienced by all participants and was an enduring social wrong that had significant emotional and sometimes physical manifestations for individuals.
i) internalised undervaluing of skills, knowledge and experience,
ii) skills, knowledge and experience not being recognised by gatekeepers as equivalent or valid and
iii) the absence of visible and viable pathways to career progression.
Covert and overt racism was experienced by all participants and was an enduring social wrong that had significant emotional and sometimes physical manifestations for individuals.
Conclusions: The findings assert that structural racism persists at all levels of physiotherapy practice in the UK that hinders career progression for those individuals from the Global Majority. Future research is needed to explore this amongst other AHP professions as well as globally. Furthermore, action research that enables co-construction of new ways of working and policies and guidance for recruitment along with career progression is also warranted.
Implications: The findings have implications at many levels within the physiotherapy profession, particularly those with leadership responsibilities and those who are gatekeepers.There is a need to disrupt the systemic issues, by examining the impact of white-bodied supremacist ideas that underpin oppressive behaviours, which reproduces discriminatory policies, procedures and practices. This can identify ways that harness diversity and model inclusive practice.This research calls for re-calibrating recruitment processes, reviewing career progression policies/guidance that are more representative of diversity. Fundamentally, the emphasis is NOT on changing the behaviour of the individual experiencing racism and marginalisation, but shining the spotlight on the practises of individuals and gatekeepers who are maintaining the status quo through discriminatory policies, practices and conduct. This work is ongoing and essential for a fairer and more equitable profession.
Funding acknowledgements: Health Education England commissioned the work from 2021-22.
Keywords:
Racial minority
Workforce development
Career progression
Racial minority
Workforce development
Career progression
Topics:
Professional issues: diversity and inclusion
Education: continuing professional development
Professional issues: business skills, leadership, advocacy & change management
Professional issues: diversity and inclusion
Education: continuing professional development
Professional issues: business skills, leadership, advocacy & change management
Did this work require ethics approval? Yes
Institution: Kingston University
Committee: Kingston University Research Ethics Committee
Ethics number: Ref No: 2784-BAME
All authors, affiliations and abstracts have been published as submitted.
