The ethnicity pay gap in the English NHS

This report examines differences in basic pay between ethnic minority staff and White staff employed by the NHS in England based on data from the NHS electronic staff record for one month (December 2017). As well as drawing on previous analyses on the ethnicity pay gap among doctors and the gender pay gap by ethnicity, it explores pay differences across the entire NHS workforce and alternative ways of comparing staff groups – by occupation, pay system and pay band.

Key findings

• For the 89% of NHS staff in England paid under the terms and conditions of Agenda for Change, there is no significant pay gap between White staff and ethnic minority staff as a whole.
• However, the picture is much more varied when comparing White staff with specific ethnic groups for staff paid under Agenda for Change conditions of service, with the pay gap ranging from 6% in favour of White staff compared to Mixed heritage staff, to over 15% in favour of Chinese staff.
• Across all NHS staff, doctors, and particularly consultants, exert a disproportionate effect on aggregate pay differences as their pay tends to be much higher than other staff groups, and also because of their very different ethnic composition.
• While there is an overall pay gap of 5.2% in favour of ethnic minority staff across the English NHS, this disguises a much more mixed picture about pay inequalities within the health service. For example, Black/British men earn less on average than any other group in the NHS.
• There is considerable variation in pay gaps between ethnic groups across all NHS staff – from 34% in favour of Chinese staff compared to White staff, to 4.6% in favour of White staff compared to Black/Black British staff.
• For four major staff groups – staff supporting doctors and nurses (such as secretaries and ward clerks), nurses and health visitors, managers and senior managers, and consultants – pay gaps favoured White staff.