“Concrete action” is needed to tackle racism in the NHS, health leaders have said.

And wider health inequalities need to be “as important to trust leaders as the size of waiting list”, NHS Providers said.

The comments come as the Royal College of Midwives (RCM) said that “now is the time to focus on race equality and equity”.

In a speech to the NHS Providers’ virtual annual conference, chief executive Chris Hopson said: “Over the last nine months, two seismic events have shone a bright light on inequalities in our nation.

“First we had Covid-19, with its disproportionate impact on people of colour. Then we had the murder of George Floyd, together with the Black Lives Matter protests it triggered. Both exposing the invidious impact of health inequalities and of structural racism on our staff, our patients and our communities.

“Structural racism is not new. But it is often misunderstood. These events are the latest in a series of ‘moments’ that have highlighted its all-pervasive and persistent impact. But this time, these events need to push us to take far-reaching action with a lasting impact.

“Perhaps it jars for me with my white, privileged, middle-class background, to be addressing these issues. But it is my business. Just as I think it is yours.

“We need an honest conversation about racism. The fact that it exists in our society, and in our NHS and that, without that honest conversation, we can’t move forward.

“It’s an uncomfortable conversation where many of us, as white leaders, are not sure how to proceed. Where we worry that we may say or do the wrong thing. Where we can feel like we are treading on egg shells.”

He added: “It’s important it’s ‘not just more words’. We need concrete action. At pace.

“And it’s not just cultural competence, it’s cultural interest. Ensuring colleagues from minority communities are fully valued. To enable them to feel psychologically safe.”

On wider health inequalities, he added: “Alongside tackling racism, we need to think more broadly about health inequalities.

“And we need to make tackling those health inequalities a much more central part of what we do.

“If we are to truly tackle health inequalities, this issue has to become as important to trust leaders as the size of waiting lists, the daily performance statistics or progress with cost improvement savings.”

The remarks come as the RCM opened its own annual conference with a call for greater equity and equality for those working in – and supported by – maternity services.

Gill Walton, chief executive of the RCM, told delegates: “For too long, we have tinkered at the edges of tackling race issues.

“Now is the time for us to focus on race equality and equity: the future must look different.

“It is unacceptable that black and Asian midwives and maternity support workers are more likely to experience bullying at work and face disciplinary processes and are less likely to advance in their careers. It’s time to level up.”

Charlie Massey, chief executive an registrar of the doctors’ regulator – the General Medical Council, told the NHS Providers conference that black and minority ethnic (BME) doctors were “more likely to be treated as outsiders”.

He said: “The last few months have illuminated the painful reality of structural inequality, not least in the disproportionate deaths of BME healthcare workers.

“BME doctors are twice as likely to be referred to the GMC by their employer than their white counterparts, they’re more likely to be treated as outsiders, and to find themselves working in isolated roles without adequate support.

“We must tackle these inequalities. Not just in the interests of fairness and justice, but also because BME doctors make up a growing part of the workforce. Indeed, this year 61% of those joining the medical workforce are from BME backgrounds compared to 44% in 2017.

“All of this should tell us that supportive and inclusive working environments are more important than ever.

“There are plenty of examples of great practice that we have all seen over the last few months, and I think our challenge is to sustain and embed that across the NHS.”

On the subject of inequalities, the head of the nursing regulator said that despite nurses and midwives being the largest professional group in the health service, they “do not get the voice they should” because of a “sexist society”.

Andrea Sutcliffe, chief executive and registrar of the Nursing and Midwifery Council, said almost nine in 10 nurses (89%) are female.

“I do think that nurses and midwives- as the largest professional grouping in the health service – do not get the voice that they should in terms of influencing policy,” she said.

“And one of the reasons for that , I think, is because it is a predominantly female (profession) and we still live in a sexist society which does not necessarily recognise and respond to women breaking through the glass ceiling in in the ways that we really ought to be.”

By Ella Pickover, PA Health Correspondent