Despite sustained efforts to foster inclusion within the NHS, Black and Minority Ethnic (BME) staff continue to encounter systemic obstacles, including constrained career advancement, subtle workplace exclusions, and persistent inequities. While institutional policies advocate for equality, the lived experiences of staff expose disconnect between strategic intent and operational reality. Understanding and learning from these marginalised perspectives is essential to developing truly inclusive practices.

This study explores the lived experiences of BME NHS staff to illuminate how their narratives can inform organisational learning and inclusive workforce development. It also aims to uncover systemic patterns that require reform and identify practices that can enhance cultural safety and equity within NHS settings.

A qualitative narrative inquiry approach was adopted, with data collected through semi-structured interviews with 15 BME staff across two NHS Trusts. Using Braun and Clarke’s six-phase thematic analysis, three key themes, among others, emerged:
(1) Navigating Professional Marginalisation,
(2) Gaps between Policy and Practice, and
(3) Strategies for Resilience and Resistance.

Reflexivity was embedded throughout to ensure methodological rigour and ethical co-construction of participants’ stories.

Participants described both overt and subtle discrimination, inconsistencies in formal support structures, and the emotional labour of underrepresentation in leadership roles. Nonetheless, sources of strength such as personal faith, family encouragement, and informal peer networks emerged as powerful resilience mechanisms. These protected participants’ wellbeing and enabled them to navigate institutional challenges with dignity and agency.

By learning from the margins, this study demonstrates the value of centring marginalised voices in developing inclusive practice. It calls for NHS organisations to move beyond performative policies by embedding co-designed, evidence-informed strategies that address equity gaps. This includes prioritising responsive leadership, enhancing visibility and accessibility of support initiatives, and cultivating spaces for shared dialogue and belonging, thereby translating lived experience into sustainable change.

Keywords: BME Staff, NHS Workforce, Lived Experience, Institutional Racism, Workplace Inclusion, Narrative Inquiry, Thematic Analysis, Cultural Safety, Resilience Strategies, Equity in Healthcare.