The current debates on immigrants, asylum seekers and foreigners are often highly charged and toxic. People other than white are often depicted as alien, strange and different, often causing social unrest and unhappiness. Many British and overseas Global Majority nurses feel that they too are seen as alien, different and problematic. In my experience, having worked in the NHS for 43 years, Global Majority nurses are a vitally important, if not essential part of the NHS for a range of social, cultural and systemic reasons. 

The NHS is one of the biggest employers in the world and has a duty to provide a fair and equitable service for all members of the population. It is built on principles of compassion, equity and respect for people from all walks of life. A diverse nursing workforce is essential to living out these values in practice, not just in theory. But fair and equitable services cannot be delivered by substantial numbers of the workforce who feel that they are not fully respected or valued. 

Global Majority nurses have worked in the NHS since its inception in 1948. They come from the Caribbean, Asia, Africa and further afield at the invitation of the British Government and latterly, individual healthcare organisations. 

The importance of a diverse workforce cannot be underestimated: it reflects the diversity of the population and encourages people from different backgrounds to seek care and attention. Patients are more likely to feel understood and respected when cared for by staff who share or understand their cultural background.

Global Majority nurses also bring lived experience and cultural insight into the specific health disparities faced by their communities around, for example, higher rates of diabetes and hypertension, or mental health and stigma attached to mental illness. They act as advocates within the system, helping to design and deliver care that is more culturally competent and equitable.

Diversity brings a wide range of clinical approaches, languages and problem-solving styles. Global Majority nurses often possess multilingual skills, cross-cultural sensitivity and resilience, which are valuable in high-pressure health care environments. Senior nurse leaders have a powerful voice to influence change and I call on them to do everything they can to improve equality.

Currently, 1 in 3 nurses are from an ethnic background and come from all corners of the globe. Unfortunately, this is where the good news ends. 

The workforce race equality standard (WRES) was launched in the summer of 2015, 10 years ago. The aim of the WRES was for the first time to give organisations information about the differences in experiences between their white and Global Majority staff. What has become clear is the difficulty in changing an NHS culture that is not fair or equitable for staff from many ethnic backgrounds. An NMC independent cultural review in 2024 highlighted issues of discrimination and racism within our own regulatory body. Currently, there are only 25 chief nurses from ethnic backgrounds in the NHS, while there are over 400 posts at that level. Global Majority nurses, both British and from overseas, are more likely to enter formal disciplinary processes than their white counterparts.  

Race inequality is not going to go away anytime soon. Of this, I’m sure. But as nurses, we have a duty to work with each other with kindness and respect, to ensure there is fairness and equity within our sphere of control and to understand how discrimination and unfairness adversely impacts patient care and safety.