Diversity, Equity and Belonging

In 2022, we considered the use of the term ‘Equality, Diversity and Inclusivity’ and decided instead to move to using ‘Diversity, Equity and Belonging’ to align more with our organisational values. A great deal of thought by the Diversity Steering Group and the Diversity, Equity and Belonging Manager went into the decision and the proposed change was then taken to the Board of Trustees who, as representatives of the members, acting on their behalf, unanimously agreed with the changes.


Equality vs Equity

The Cambridge Dictionary and Google define equality as - the right of different groups of people to have similar social position and receive the same treatment, resources or opportunity.

Equity recognises that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome or in the words of social-change.org equity is about giving people what they need, in order to make things fair.

Inclusion vs Belonging

Oxford Languages define inclusion as - The action or state of including or of being included within a group or structure. www.inclusion.me.uk determine that it is seen as a universal human right. The aim of inclusion is to embrace all people irrespective of race, gender, disability, medical or other needs.

The Cambridge dictionary describes belonging as a feeling of being happy or comfortable as part of a particular group and having a good relationship with the other members of the group because they welcome you and accept you. A sense of belonging is one of humanity's most basic need.

The College’s rationale for this change of terms, stems from the fact that the paramedic profession is not a diverse one. We have the lowest numbers of Black, Asian and minority ethnic staff of all the allied health, nursing and medical professions (NHS WRES data 2021). The proportion of disabled staff is also very low (1:5 people with disabilities in the UK with 3.4% only in the ambulance services) and 4.65% of staff declare that they are LGBT+. Whilst this data provides a picture of the demographics of our profession it does not reflect the experiences of each group in the workplace. We know for instance that Black & minority ethnic staff are 1.14 times more likely to enter the formal disciplinary process compared to white staff and as a profession, ambulance staff (operational) were least likely to believe that their trust acts fairly with regard to career progression and promotion (70.7%), with the lowest levels of belief amongst Black & minority ethnic women (62.1%) and Black & minority ethnic men (60.5%) in this profession. Whilst 10.6% of ambulance (operational) staff experienced discrimination from a manager/team leader or other colleagues in last 12 months, the highest levels were amongst Black & minority ethnic men (19.2%) and Black & minority ethnic women (18.6%) (NHS WRES data 2021).

Why is this change in terminology important?

Having a diverse workforce, brings new ideas, viewpoints and ways of working, and has a positive impact on business and organisations. It is also very important that our local populations are represented in the workforce to reduce health inequalities and ensure clinical practice is of a high standard for all.

The challenge our profession faces, is that we struggle to attract diverse candidates. This illustrates that the issue does not lie with those minority groups, but with the systems, culture and attitudes of the people within the profession. We do not always make staff from these minority groups feel welcome, or that they belong. We do not work to change our culture but expect them to adapt to ours.

Changing our focus from equality, diversity and inclusion, to diversity (because this is a priority for us), equity (to ensure we are adapting to meet the needs of the diverse workforce) and belonging (which will also help to retain our future diverse population) is a small change, but one with an impactful message that demonstrates that the College of Paramedics values all of its members and strives to improve the experience for each member and the general population we serve. 

Increasing diversity, equity and belonging within the College and paramedic profession is embedded in the College of Paramedics' 2019/24 Strategy. It is vital that we ensure the voices of paramedics from all backgrounds are heard loud and clear in everything the College of Paramedics engages in. This will ensure diversity, equity and belonging, and the associated messages, are front and centre in all College discussions, events and communications.

Tracy Nicholls, our Chief Executive, is committed to this:

“I recognise that our profession is woefully lacking in diversity, which is unacceptable. I commit to College of Paramedic members that inequality of any description is no longer an option that can be tolerated, and I promise to do better for our profession. We will also actively support organisations who employ paramedics, or use their skills in volunteering, to reflect the professionalism that we and the HCPC expect of those who hold such positions of trust. This will need us to work in partnership even more now than ever before. When we do not get this right, we should expect and welcome challenge. With guidance from our own Diversity Steering Group and other expert national networks we will continue to learn and do our utmost to be better; much better! All of us!"

It is important to us, as we grow and develop further, that we are representative of our profession and the public we care for.

Pictured below, College members show their support for the College by wearing their college
lanyards at the London Ambulance Service Black History Month in October 2019...

Pictured left to right - Okezie Ogbulafor (LAS EAC), Abidemi Yusuf
(LAS recruitment coordinator) and Elijah Adesanya (LAS paramedic)

Happily for the College they were happy for us to share this photo with our members as we ask you - how can we support you, our members? please let us know what you want from this page by emailing questions and comments to imogen.carter@collegeofparamedics.co.uk


Our Diversity Steering Group advise the College on equality, diversity and inclusion issues and focus on the five strands of BME, LGBTQI+, disability, gender equality and socio-economic status, working with universities and employers to increase diversity within the profession.  

Click here for diversity specific blogs.

Commission on Race and Ethnic Disparities

The College of Paramedics was delighted to have been given the opportunity to provide evidence in the form of a round table discussion to the Commission during their evidence-gathering phase of the report’s formation. This enabled those members with lived experience to share their personal, and often difficult, stories with members of the Commission in the hope that this would make a tangible difference for future paramedic students and graduates of the profession.

We appreciate the level of evidence that the Commission gathered in order to write and analyse their report across a number of specific areas, but we feel the findings were widely misaligned with those of our members from black and ethnic minority backgrounds. However, whilst we feel this was, at best, a missed opportunity to highlight some of the realities of being a paramedic from a diverse background, the College of Paramedics has an exceptional Diversity Steering Group (DSG) who are passionate, dedicated and committed to making a different and more equitable process for those who come after them.

As we at the College have stated, we need actions, not words, however well-intentioned. The College developed its Belonging and Inclusion strategy in line with its five-year strategic aims and are making progress against this, although we recognise we need to do more. The College secured the services of an Equality and Diversity Advisor in Bo Escritt who has supported much of the work in guiding the DSG, the staff and the Board of Trustees in all matters relating to adopting change and making us scrutinise ourselves much more critically. We have actively made changes in many of our areas of work and acknowledge, whilst we continue to be a `work in progress’, we are absolutely committed to making a difference and encouraging a more diverse and representative workforce, both within the College itself and through collaboration with the employers of paramedics, wherever they work.

We appreciate and value our members, therefore, whilst the report is not reflective of their experiences and feelings, we remain deeply committed to continuing our own journey to make positive change.

Race and Ethnic Disparities Report – A Statement from the Diversity Steering Group

Thank you for providing the College of Paramedics’ Diversity Steering Group (DSG) the opportunity to respond to the report on Race and Ethnic Disparities.

The College’s Diversity Steering Group (DSG) would like to make it emphatically clear, that we do not agree with the findings of the Commission on Race and Ethnic Disparities report, that institutional racism does not exist and is not one of the reasons for the inequalities, that black and ethnic minority people face, in the UK today.

We find that this view bears no resemblance to the lived experiences of those in our group, as well as many other College of Paramedics members, from black and ethnic minority backgrounds, including those that gave evidence to the Commission.

We know from past government reviews, research data, and the lived experience of black and minority ethnic people, that racism is experienced on a number of levels, including systemic and institutional racism, in many areas of their lives, including employment, education, health inequality and accessing of health care.

We would all wish for the narrative to be different and that our structures and systems were fairer for all. Unfortunately, instead of making recommendations to dismantle racism at every level, the report aims to change the narrative without doing the work. It is our view that this amounts to denial of one of the core roots of inequality. We feel that this report has missed a great opportunity to make a positive impact, and that there are political motivations behind its conclusion.

A member of the College of Paramedics who gave evidence to the Commission responded:

Having read the report, I am disappointed with the overall findings as the Commission had a wealth of lived examples demonstrating the gap in equality between white and non-white demographics. While I agree in part with some, the recommended actions they have proposed are nothing new to those in healthcare, as many of the recommendations have already been voiced over the last decade and ignored. This leaves very little confidence that these will be taken forward in any serious capacity simply because it is the findings of the commissioners.

[…] In my opinion the outcome was predetermined, by central government, to minimise the very real issues we see and face every day across the country, in every corner of industry.

One of our strong concerns is that the report gives organisations a defence to the abdication of their responsibilities in tackling institutional racism, by denying its very existence. We believe that doing nothing is not an option.

We are reassured that the College of Paramedics will continue the work it has started through the Belonging and Inclusion Strategy and action plan. It will be vigorously supported by the DSG to work towards a fairer and inclusive College, for all its members and staff, and work in partnership with other organisations to eradicate inequality and aim for a fairer society for all.

The College of Paramedics acknowledges that it still has a long way to go, as does the profession, as well as the organisations that regulate, employ, and educate the profession.

This statement is supported by all members of the College of Paramedics Diversity Steering Group:
Islam Faqir (Chair), Gemma Howlett, Colm Buckley, Matondo Manzeninga, Rebecca Connolly, Maisie Williams, Sharon Hardwick, James Bridge, Graham Clark, Bo Escritt, Imogen Carter


This General Medical Council video provides excellent learning for all patient facing clinicians. It gives clear, brief guidance that will make a beneficial difference to your transgender patients, when you apply it in your practice. Click here to watch. 

This National Ambulance LGBT Network leaflet was designed to help ambulance clinicians when supporting trans people. We are sure you would find it useful in any patient-facing setting or just as a learning tool for your own development. Best practice guidance, understanding terminology, understanding health inequalities and presenting conditions are all included. Click here to read.

This report on the research of Kathleen Henwood Understanding Trans Service Users: Ambulance Service Perspective, on the experiences of Trans people of the ambulance service, is extremely useful to clinicians wanting to improve their understanding and practice. Reading the words of people who have experienced the care of our colleagues is invaluable in working on improving our care. Click here to read.

The NALGBTN Ambulance Service Trans Toolkit is a professional development resource comprised of four books of information. The first three are designed to help you understand the lives of transgender people and then apply this knowledge to patient-facing situations and working with staff who are transitioning. The fourth book is for interest and includes information about transgender people in the media and sport and how transgender people are recognised around the world. More.

Another excellent professional development resource from NALGBTN:

Providing care to people living with HIV is another excellent resource from the NALGBTN. This professional development resource comprises one book which is split into two halves. The first half looks at patient experience and staff knowledge, and the second focusses on updating your knowledge on treatments and best practice. More.

Related Articles

The Angel of Platform 6 - Lt. Abbie Sweetwine

Posted on 14/10/2020
The Harrow and Wealdstone rail crash of 1952. The Angel of Platform 6 - Lt. Abbie Sweetwine.

Helpful Links...

Workforce Race Equality Standard

Download the 'English Ambulance Services WRES data 2019' PDF here

Download the 'WRES 10 Things You Can do in Your Organisation' PDF here

Getting Over Your Fear of Talking About Diversity

Ask better questions, read up, lean into the uncomfortable and just get started - clear advice from Daisy Auger-Dominguez that we can follow in the important drive to increase diversity and inclusion within our profession. Read the article here 

Help and Support

Please visit our Paramedic Mental Health and Wellbeing page for more information and links to help and support.

Paramedic Insight Podcasts

Listen to our latest podcasts. The College of Paramedics presents a new series of podcasts bringing news, interviews, discussion and up to date analysis from around the world of paramedic practice.

Tweet by Harry de Voil - Equality and Diversity Stats from Ambulance Trusts