Why equality monitoring matters – the iceberg of faith and religious belief in the medical workforce

by Emma Wiley

Faith is important to share with employers and member organisations so they can best meet religious needs

Location: UK
Published: Monday 22 March 2021

Religious identity in the NHS is a Johari Window. No-one really knows how many healthcare professionals of any given faith background there currently are in the medical workforce.

We know about gender and we are talking about the gender pay gap, we know about race and we are talking about WRES (workforce race equality standard). Yet faith remains an iceberg in the NHS.  Unseen, unmeasured and undiscussed. We don’t know who senior doctors of faith are, nor their level of engagement with medico-politics. We simply have no denominator. The BMA, essentially, has no denominator.

Yet the BMA is our trade union. It’s our professional association. If we lack data on religious identity, how can we serve the full spectrum of our membership? How can we advocate for doctors of all backgrounds and faiths?

Research on the intersection between religion and the workplace is hard to find because few studies collect data on people’s faith or belief. However, those that have demonstrate that a lack of congruence between faith and work identity can affect employee wellbeing.

Conscientious objection and medical ethical issues present challenges for healthcare professionals from faith backgrounds (MDA multi-faith religious equality roundtable on 7 February 2019). We know that a secular workplace invokes a lack of sense of belonging amongst healthcare professionals of faith (NHS employers/University of Surrey multi-faith focus group May 2019).

NHS staff from all religions report experiencing discrimination. Furthermore, we know that policies such as Bare Below the Elbows are associated with undermining behaviours towards Muslim women and adverse impacts upon their career choices.

We know that NHS policies such as Prevent are linked to fear and self-censorship and that the BMA has passed a motion in support of doctors wishing to abstain. We also know that religion at work may be associated with prosocial and citizenship behaviour and better patient care through an individualised and compassionate service.

We lack data on whether promoting a pluralistic workplace could create a stronger sense of congruence, belonging, and organisational productivity. We lack data on the interventions that will get us there.

We also lack data on whether differential attainment (the gap in attainment on postgraduate examinations and appraisals) may be stratified by religious background as well as race.

If the BMA had more complete data on the religion or belief of our members, it would provide a better picture of our current state. We would have measured our baseline.

The data could be used to drive a national discussion on diversity and inclusion in medico-politics, workforce, policy, education and practice, initiating conversations with leaders, educators, and at grassroots level.

Data would enable equality analyses that could regularly be conveyed to trusts and the senior levels of the NHS and begin to drive inclusive change. More complete datasets could provide a springboard to compassionate leadership events and access schemes, faith networks, reverse mentoring programmes and the opportunity to celebrate diverse festivals at the BMA and across the NHS.

Having this data enables introspection and self-scrutiny at a challenging time for our workforce, and helps us to ensure that the BMA is representing and meeting the needs of our diverse membership.

So, let us dip our toe in the water, acknowledge the iceberg and deep dive our way into the majestic blue sea. It’s warm once you get in and the fruits de mer taste delicious.

The hardest bit is the decision to take the plunge. If we want inclusive, compassionate leadership, to release staff to become their authentic selves and a yearlong NHS festival of multi-faith food, this is a long overdue conversation we need to have!

And for those anxious about providing their data, remember that disclosing information on religion and belief (and any other protected characteristic) remains voluntary, will be anonymised by the BMA and will not be used for any other purposes than equality monitoring.

Help us to help you deliver a more inclusive and insightful professional association. Complete your data!

Emma Wiley is a consultant microbiologist at Croydon University Hospital with a specialist interest in NHS Equality and Diversity. She is a member of the BMA equality, diversity and inclusion advisory group, as well as being the Muslim Doctors Association’s equality lead and a member of the GMC equality, diversity and inclusion forum. During her infection control fellowship year, Dr Wiley led a national campaign on NHS Dress Codes and religion and belief under the British Islamic Medical Association which involved research, policy and advocacy work with the BMA for safe and inclusive NHS dress code policy and practice. Dr Wiley is also the co-founder of an NHS Faith Equality roundtable which aims to address workforce faith inclusion in the NHS.