Report: Experiences of racial discrimination and harassment in London primary care

  • Latest news

In May Health Education England (HEE) London published a report based on a survey of over 1,000 people working in primary care, looking at their experiences of discrimination from both patients and people working within the health system.

The report and accompanying research were led by Dr Naureen Bhatti, HEE London Workforce Race Strategy Primary Care Strategic Lead. Dr Bhatti is also a member of Tower Hamlets LMC and the Londonwide LMCs board, although this report was produced exclusively in her capacity as HEE lead.

Headline statistics

  • Half of those taking part said that, in the past year, they had been harassed or discriminated against at work based on their personal characteristics (49%). We cannot generalise because those who took part may have been more likely to have something to report. However, the survey indicates that this is a sizable issue.
  • 4 out of 10 people said they had been harassed or discriminated against by patients in the past year (39%).
  • 3 out of 10 said that colleagues or managers had harassed or discriminated against them due to their personal characteristics (29%)

Response rate

1,025 people working in primary care responded, with 926 of them coming from general practice. This represents about 3% of the total primary care workforce in London or 4% of the general practice workforce.

The geographical breakdown of all respondents is as follows:

  • 176 working in North Central London
  • 286 working in Northeast London
  • 134 working in Northwest London
  • 244 working in Southeast London
  • 181 working in Southwest London


The report does not suggest specific actions, but it does highlight issues that the authors believe need to be mitigated.

  • Many people and teams do not feel supported and empowered to racial discrimination and harassment.
  • They also do not know from whom to seek help and/or were not confident that anything would be done as a result, with this being exacerbated due to the small business structure of GP practices, pharmacies, dentists, opticians etc.
  • The lack of standardisation of policies and practices between employers means managers can be perceived as part of the problem.
  • Respondents felt changes at an individual level (for example, diversity and inclusion training) and organisation level (for example, independent advice and oversight) would help to improve workplaces.
  • Cultural and system changes were also identified, including the possibility of patient education publicity campaigns and more representative senior leadership.

Next steps

As part of a pan-London workshop in March, the following interventions was identified and will be monitored to see what progress is made:

  • The London Primary Care in Workforce Race Strategy Working Group will continue to support Training Hubs in the development of the Primary Care WRES Multi-Professional Leadership Networks.
  • Primary Care colleagues will have access to Speak up Guardians and staff networks in all ICS areas.
  • All primary care colleagues have access to EDI training in all ICS areas.
  • A regional task and finish group will be established to develop the ‘Primary Care WRES Gold Standards Framework’.
  • The London Primary Care in Workforce Race Strategy Working Group will continue to work collaboratively with the Equality and Inclusion Workforce NHS England and NHS Improvement team providing support where needed in relation to the Core Managers Programme, White Allies Programme, WRES Experts Programme, NHS Debias and Selections toolkit as well as programmes to help close the ethnicity gap in relation to disciplinary procedures.
  • The London Primary Care in Workforce Race Strategy Working Group will continue to connect with the London Workforce Race Strategy (LWRS) – Nursing and Midwifery Steering Group providing support in development and training opportunities for nurses and AHPs in Primary Care.
  • The London Primary Care in Workforce Race Strategy Working Group will work closely with HEIs to establish current provision of education and training in undergraduate and postgraduate courses.