Raising The Curtain On The 'Equality Theatre' In Recruitment To The Healthcare Workforce

Background: In the UK National Health Service (NHS) provider organisations are mandated to assure racial equality in job appointments and career opportunities. However, recruitment continues to discriminate against ethnically diverse candidates (British and overseas) and NHS providers are failing to attain the many benefits associated with an ethnically diverse workforce. Aim: To explore the extent to which an employer-led open market recruitment approach to first jobs in nursing and the allied health professions is perpetuating racial inequality.Methods: Survey data from newly qualifying students and qualitative interviews with 12 clinical recruiting managers in 2 NHS trusts. Semi-structured face-to-face interviews used a non-judgemental approach. A conceptual lens was developed, a healthcare workforce diversity lens, to explore racial equality issues by drawing on structured searches of the research and policy literature. Questions were devised to examine issues about organisational workforce diversity goals, workforce diversity data, recruitment diversity data, diversity-led recruitment practices, strategies for effective allyship, and transformative change.Results: While recruiting managers appreciated the benefits of an ethnically diverse workforce, they adhered to organisational policies for recruitment and selection that emphasise objectivity and standardization. Some recruiting managers sense there is “an uneven playing field” but lacked information about ethnic diversity in the workforce or recruitment to make informed judgements. In the context of a pressurised health system, recruiting managers prioritise candidate selection of those who can “fit in” and “hit the ground running” rather than taking the long view and building workforce diversity.Conclusion: A recruitment approach optimized for objectivity and standardization, masquerades as equality, while preserving racial inequality in first job success. Inadvertently, recruiting managers are unwittingly complicit in an ‘equality theatre’ that discriminates against candidates from diverse ethnic backgrounds. The lens could help get a grip on race equality and a shift towards asset-based and diversity-led recruitment approaches.