Local NHS manager warns racial inequalities persist despite progress
Norfolk and Suffolk NHS Foundation Trust says tackling racial inequality remains a priority, acknowledging there's more work to do
A senior mental health manager who has spent more than 25 years working in Norfolk and Suffolk says ethnic minority NHS staff still face barriers to career progression, despite efforts to tackle racial inequalities.
Percy Mupemhi, an operations manager at Norfolk and Suffolk NHS Foundation Trust (NSFT), says improvements are being made but questions remain over whether opportunities are equally accessible to staff from different ethnic backgrounds.
Speaking to us during Black History Month, he also highlighted concerns about disparities in disciplinary procedures, which the trust is working to address.
His comments come as the organisation continues implementing its race equity strategy, introduced following concerns about the experiences of ethnic minority employees.
Mr Mupemhi, who co-chairs the trust's Race Equality and Cultural Heritage (REACH) Network, said the availability of opportunities did not necessarily mean everyone could access them fairly.
"Yes, there are loads of opportunities that can be available, but accessing them and, you know, being able to achieve within those opportunities is a different thing altogether," he said.
"So there can be barriers in terms of you getting to that opportunity."
He explained that recruitment processes were one area requiring particular attention.
"For example, you can have, a job can be advertised that you can apply, but it's down to whether you are actually getting shortlisted or a fair recruitment is being done within that."
Concerns over racial disparities in NHS recruitment and discipline
Mr Mupemhi's concerns reflect inequalities previously identified at the trust.
A Care Quality Commission (CQC) assessment published in 2025 examined the findings of an independently commissioned workforce race equality review.
According to the regulator, the review found that ethnic minority applicants accounted for 74% of non-medical job applications between 2001 and 2024, but 21% of appointments.
The same review found that ethnic minority employees accounted for 22% of formal disciplinary actions during the period examined, despite representing 13.5% of the workforce.
The figures demonstrate disparities but do not, on their own, establish the causes of individual recruitment or disciplinary decisions.
The CQC said the trust had acknowledged the findings and committed to addressing them.
Mr Mupemhi, who has been involved in examining recruitment and disciplinary processes, said the aim was to ensure fairness was embedded in how the organisation operates.
"Fairness is to be built into these systems, not just being talked about," he said.
"My role isn't just to assume that something is unfair, it's to ask the right questions, look at the evidence and make sure people have a fair opportunity as well."
He said the trust's work included examining recruitment practices, senior appointments and disparities in disciplinary procedures.
However, he acknowledged that progress would take time.
"Change doesn't happen in a day. It takes time. And for it to take time, there's a lot of educating, role modelling that is to take place as well."
'I questioned whether progression was really possible for me'
Originally from Zimbabwe, Mr Mupemhi moved to the UK aged 19 and qualified as a mental health nurse in 2000.
He began his career with NSFT at the Norvic Clinic, now Northside House Secure and Forensic Service, before working across inpatient, crisis and community mental health services.
He is now an operations manager working in the Great Yarmouth and Waveney area.
Reflecting on his early career, he said the absence of ethnic minority staff in senior positions had made him question his own prospects.
"When I started my career, I didn't see many people from global majority backgrounds progressing into management and senior leadership," he said.
"So, there were times when I questioned whether progression was really possible for me, with also never getting any opportunities presented in front of me as well."
He described that period as challenging but said he had since witnessed changes in the organisation.
"What gave me hope now is that I am seeing the picture changing slightly. There's a lot of work that needs to be done."
He said more employees from ethnic minority backgrounds were progressing into leadership positions, adding that he was proud to contribute to that change.
Why did it take so long for concerns to be addressed?
Mr Mupemhi also discussed the trust's response to concerns raised through workforce surveys and equality reviews.
He said racial inequalities had previously been highlighted without sufficient action being taken.
"This has been an ongoing pattern with issues not being addressed," he said, describing concerns recurring from year to year.
The trust subsequently introduced a race equity strategy covering areas including recruitment, disciplinary procedures and workplace culture.
In its 2025 assessment, the CQC reported that some ethnic minority staff had expressed frustration about what they perceived as a historical lack of action on racial inequalities.
The regulator also acknowledged the commitment of the trust's current leadership to making improvements.
Mr Mupemhi said he wanted colleagues across the organisation, including senior leaders and staff from different backgrounds, to participate in delivering the strategy.
He added that the changes should ultimately improve the experiences of both employees and patients.
How cultural understanding can improve mental health care
Beyond workforce recruitment and progression, Mr Mupemhi believes greater cultural understanding among NHS staff can help improve mental health care.
He said the communities served by the trust had become more diverse over the past two decades, making it increasingly important for services to understand different cultural backgrounds.
"Having a diverse mix of staff does help in supporting and meeting the needs of those service users that we look after as well," he said.
He offered the example of eye contact, explaining that in some cultural settings, looking directly into another person's eyes can be interpreted as confrontational.
As a result, he said, a clinician unfamiliar with those differences could potentially misunderstand someone's behaviour during an assessment.
He explained that his own cultural knowledge helped him recognise when a person's behaviour might reflect social customs rather than their mental health.
The example, he said, illustrated the importance of understanding individual patients rather than making assumptions about their behaviour.
Mr Mupemhi also linked staff wellbeing to the quality of care provided.
"The way I see it is a happy workforce, you know, supports good outcomes," he said.
Senior NHS leaders learning from staff experiences
Mr Mupemhi has also participated in reverse mentoring, an initiative intended to help senior leaders understand the experiences and perspectives of colleagues working in different roles.
He has worked with the trust's deputy chief executive, Cath Byford, as part of the programme.
"It's been incredibly valuable because it's about seeing things from another person's perspective and you are effectively working in each other's shoes and understanding the different pressures and experiences that come within each role," he said.
"I think the most important thing is that mentoring isn't just about giving advice. It's about listening and being willing to learn."
He said the initiative was being extended to other colleagues across the trust.
His involvement in race equity work has also expanded since he shared his experiences at a People and Culture Committee meeting around 18 months ago.
He subsequently became co-chair of the REACH Network, helping represent the experiences and concerns of staff from ethnic minority backgrounds.
What has changed at NSFT?
The trust has publicly committed to reducing racial inequalities in its workforce.
Its 2026–2031 strategy includes an objective to reduce disparities between white staff and colleagues from ethnic minority backgrounds, alongside improving staff survey results.
The organisation also publishes workforce equality data and has introduced measures intended to improve recruitment, workplace culture and staff development.
However, Mr Mupemhi believes the success of those commitments must ultimately be judged by employees' experiences.
"What gives me confidence is that I'm now seeing race equity being discussed at a much more senior level, strategies being put in place and importantly, people being willing to listen," he said.
"For me, the test is whether that translates into people's everyday experience and whether we sustain the change as well."
He acknowledged that improvements could be frustratingly slow but said the willingness of colleagues to engage gave him confidence that further progress was possible.
'I want my children to be recognised for who they are'
For Mr Mupemhi, the importance of equality extends beyond his professional life.
The father of two, whose children are aged 16 and 18, said he hoped they would have opportunities that were not limited by how others perceived their backgrounds.
His daughter has recently started university, where she is studying to become a teacher.
"You know, I want them to be recognised for who they are and what they bring, rather than being defined by being different," he said.
"I also want them to have the same opportunities as everyone else, while also having their individual skills and identity recognised as well."
His own career has included an invitation to 10 Downing Street during celebrations marking the NHS's 78th birthday.
He described the experience as overwhelming, reflecting on his journey from arriving in Britain as a teenager to representing NHS colleagues at the event.
"I used to look at it, you know, every time I would go to London, that end I would look at it from the gates. I never thought I would walk down that street at all," he said.
Mr Mupemhi also recalled meeting Larry, the Downing Street cat, and discussing the NHS and football with then Prime Minister Sir Keir Starmer.
He said the invitation was especially meaningful to his family, several of whom had also worked in nursing.
"My family were incredibly proud. It made me realise that the journey wasn't just mine. It represented something for them as well."
Now, as he continues working to improve opportunities for colleagues at NSFT, Mr Mupemhi says the focus must remain on delivering lasting change.
For him, the measure of progress is not simply whether new strategies have been introduced, but whether the people working within the NHS experience a fairer workplace as a result.
NSFT Response
Caroline Donovan, Chief Executive Officer said "Race equity is a key priority for our Trust, and we are absolutely determined to become an anti-racist organisation where every colleague feels safe, valued, respected and able to thrive.
"We are grateful to Percy for sharing his experiences so openly. Percy is one of the co-chairs of our Race Equality and Cultural Heritage (REACH) Network, which we recently relaunched following additional investment as part of our race equity programme. The network provides a safe space for staff, amplifies the voices of racially marginalised colleagues and helps drive meaningful change across our organisation.
"In 2024, we commissioned an independent race equality review led by Yvonne Coghill, former Director of the national NHS Workforce Race Equality Standard. We fully accepted its findings and have used them to shape a comprehensive programme of change.
"This has included publishing our Race Equity Strategic Plan, establishing a dedicated Race Equity Group, introducing our Routes to Success leadership development programme and Transformational Reciprocal Mentoring, and developing a Trust Anti-Racism Charter.
"While we recognise there is still much more to do, recent workforce race equality data and programme reporting show encouraging progress in areas including recruitment outcomes, disciplinary disparities and experiences of discrimination. Around 17.9% of our workforce are from global majority backgrounds, compared with approximately 8.6% of the population across Norfolk and Suffolk, making it especially important that we create an organisation where colleagues from all backgrounds can succeed and progress.
"We are particularly encouraged by the impact of Routes to Success. Independent evaluation found participants reported increased confidence, a stronger leadership identity, improved career readiness, greater access to sponsorship opportunities and a stronger sense of belonging. Following its success, the Trust Board has approved investment in a second cohort of the programme.
"Our work has also received national recognition, with NSFT shortlisted for Inclusive Organisation/Trust of the Year at the 2026 National B.A.M.E Health and Care Awards and for the Staff Wellbeing and Culture Award at the 2026 HSJ Awards. We were also finalists at the 2026 Picker Experience Network Awards for our work to improve staff experience and wellbeing across the Trust.
"We know there is still more to do, but we remain fully committed to listening, learning and taking meaningful action to create a fairer and more inclusive organisation for everyone."