What will it take to fix pharmacy’s stubbornly unchanged ethnicity pay gap?

Pharmacists are one of few clinical professions in the NHS that can boast of having a majority black, Asian and minority ethnic workforce.

Some 30.6% of nurses in the UK are recorded as being from Asian, black, mixed or ‘other’ ethnicities, while 47.6% of doctors — including 34.8% of GPs — report the same.

Meanwhile, 52.4% of pharmacists were recorded by the General Pharmaceutical Council in September 2023 as being of Asian, black, mixed or ‘other’ ethnicity, while a further 39.2% are recorded by the regulator as being white.

Despite this — and efforts across the NHS to promote inclusion within the pharmacy profession — pharmacists from black, Asian and minority ethnic backgrounds are still paid lower on average than their white counterparts. 

Above average

A statistical analysis of responses from 1,226 UK pharmacists to The Pharmaceutical Journal’s annual salary and job satisfaction survey found an overall median pay gap of 7.2% between white pharmacists and those from ethnic minority backgrounds (see Box), with white pharmacists receiving a median hourly pay of £29.20, compared with £27.10 for pharmacists from ethnic minorities (P<0.001). 

The pay difference equates to an additional £4,095 per year in cash terms, based on a 37.5-hour week.

Not only did the analysis uncover a pay gap between white pharmacists and ethnic minority pharmacists as a group, but the higher hourly pay for white pharmacists was statistically significant when compared with Asian pharmacists earning £28.20 (a 3.42% gap; P=0.016), black pharmacists earning £26.20 per hour (a 10.2% gap; P<0.001), and Chinese pharmacists earning £25.60 per hour (a 23.9% gap; P<0.001). 

“The pay and job satisfaction disparity across ethnicities is, unfortunately, not surprising”, says Elsy Gomez Campos, immediate past president of the Pharmacists Defence Association’s BAME Network. 

“In fact, I believe the gap would be even more pronounced if the survey had a higher response rate. The reality is that if you are white, you are more likely to be employed at a higher pay band and receive better employment perks, including training opportunities, flexible working conditions and enhanced wellbeing support.”

While the data is not directly comparable to the pay gaps seen between these groups in the wider population, the most recent Office for National Statistics (ONS) data, published in November 2023, suggest that some in the pharmacy profession are worse off when it comes to fair pay. 

When adjusted for factors such as occupation, qualifications, geography, age and sex, the ONS data show that among people born in the UK, black employees have the largest pay gap at 5.6%, while UK-born Asian employees are paid 1.9% less than white employees. The situation is even more bleak for those born outside the UK, with black employees in this category earning 12% less than their white counterparts and non-UK born Asian pharmacists experiencing a 9.7% pay gap.

Ongoing pay gap

Much like in the wider UK population, the overall ethnicity pay gap for pharmacists remains virtually unchanged since the previous analysis of data collected by The Pharmaceutical Journal in 2021, when a gap of 7.3% was reported. 

This is despite continued efforts to improve inclusive practices within the profession. The Royal Pharmaceutical Society’s (RPS’s) Inclusion and Diversity Strategy 2020–2025 aims to champion inclusive leadership practices, noting that “there’s a significant lack of racial diversity at senior levels in pharmacy”. “This isn’t fair, and it’s a waste of talent,” the strategy adds.

The Inclusive Pharmacy Practice initiative has been running since 2017. As a joint project between the RPS, the Association of Pharmacy Technicians UK, NHS England and other stakeholders, one of the aims is to ensure fairness and equity in the workplace: including in promotion and diversity of leadership. 

A substantial piece of work to come out of the IPP initiative was the first ‘Pharmacy Workforce Race Equality Standard (PWRES)’report in September 2023. The report, which uses workforce data from NHS Trusts in England only, showed that pharmacists of black, Asian and minority ethnic origin were underrepresented at the higher agenda for change (AfC) bandings: Band 8a and above. 

“Experiences of racism, discrimination and lack of career progression amongst black, Asian and minority ethnic pharmacy professionals and wider team members in NHS trusts are unacceptable,” said David Webb, chief pharmaceutical officer for England at the time. “More must be done to make sure pharmacists, pharmacy technicians and wider pharmacy team members in trusts have equity of experience and opportunity.”

A year on and the report’s findings are echoed in our statistical analysis, with hospital pharmacists reporting a median pay gap of 3.4% (P=0.002) in favour of white pharmacists. While this does represent a reduction in the ethnicity pay gap for hospital pharmacists compared with 2021, when The Pharmaceutical Journal’s survey found a gap of 10.5% in the hospital sector, the pay is still inequitable.

“It is extremely encouraging that the hospital sector has reduced the pay gap between white pharmacists and people from ethnic minority backgrounds,” says Amandeep Doll, head of professional belonging and engagement at the RPS. “However, there is still a lot of work to do, as demonstrated by the NHS England PWRES data, to ensure people from different ethnicities have positive and equitable experiences and opportunities to thrive within hospital.”

The issue appears to be more acute in community pharmacy, where pharmacists reported a median pay gap of 8.8% (P<0.001).

“If you look at the community pharmacy element, it’s not improved, and that is worrying,” says Mahendra Patel, a professor of pharmacy and national inclusion and diversity lead at the University of Oxford’s Primary Care Clinical Trials Unit. Our previous survey in 2021 found that the ethnicity pay gap was lower at the time at 7% in favour of white pharmacists.

“What plan of action do we need to look at that allows organisations and leaders in the community sector to look at this meaningfully and with positive effect?

“If you look at the hospital sector, then there is an improvement, which is very encouraging, but what we need to do is more of what we are already doing, and spreading it wider so that gap continues to narrow.”

Patel highlights that the WRES report shows “that pharmacists from black and South Asian ethnic minority backgrounds are under-represented in the top Agenda for Change banding, particularly Band 9”. 

“That is more prominent for female pharmacists. This [Pharmaceutical Journal data] is a 2024 survey; it will be interesting to see if this marries with the new WRES data that will be coming through,” he says. 

“There’s a clear message that community pharmacy should look at their own organisations; where people from black and other ethnic minorities sit in terms of reaching up to those higher levels, and what support and mechanism is in place. And then to evaluate that so that there is something that you’ve got a benchmark to work on as a programme of regular activities.”

Mandatory reporting 

While all companies with more than 250 employees — and therefore, all of the major pharmacy multiples — publish their gender pay gap, there is currently no legal requirement for any company to publish their ethnicity pay gap.

This may soon change with the Labour Party committing to introduce mandatory ethnicity pay gap reporting for large employers as part of its election manifesto.

“As we’ve argued for years, mandatory ethnicity pay gap reporting is a vital first step in identifying and measuring the scale of racial disparities in any organisation,” says Shabna Begum, chief executive of the Runnymede Trust, a race equality and civil rights think tank. 

“We welcome the inclusion of mandatory reporting in the King’s speech, and we hope to work with the new government and employers to focus not just on reporting, but on actually reducing the stark gaps we already know exist and removing the structural barriers that are still holding people of colour back.”

Paul Day, director of membership and communities at the Pharmacists Defence Association (PDA)  and PDA Union Director, says: “The PDA has a long-standing policy that the ethnicity pay gap should be treated with the same importance, and in the same way as the gender pay gap.  

“The survey figures will inevitably only reflect the data provided by those who responded which can vary from time to time, whereas if larger employers were obliged to audit their payroll data, as they are for gender pay gap reporting, there would be comprehensive data about the actual ethnicity pay gap which could then be understood and resolved. The country needs to move on from reliance on indicative surveys and treat this issue with the priority it deserves.”

The gender factor

However, since gender pay gap reporting became mandatory in 2017, the gap has only narrowed by 1.6%. A report published by PwC in June 2024 said that although it was “encouraging to see the gender pay gap reducing each year, the rate of change remains modest” and that at the moment, “gender pay parity remains out of sight”. 

In The Pharmaceutical Journal’s analysis, accounting for gender alone, a pay gap of 4.1% (P=0.026) in favour of male pharmacists was revealed, with male pharmacists earning a median hourly rate of £29.40, compared with a median hourly rate £28.20 for female pharmacists. 

Although significant progress seems to have been made in limited areas, as Boots eliminated its median gender pay gap in 2022/2023, when the survey data is analysed to take into account ethnicity as well as gender, a larger pay gap was observed. 

A pay gap of 12.8% between white male pharmacists and ethnic minority male pharmacists was revealed as white male pharmacists received a median hourly pay of £29.70, compared with £25.90 for ethnic minority male pharmacists. Meanwhile, white female pharmacists earned a median hourly pay of £28.80, compared with £27.60 for ethnic minority female pharmacists. 

Based on a 37.5-hour week, this pay gap equates to a difference of £7,410 per year between white male pharmacists and ethnic minority male pharmacists. 

“It is disappointing to see the data demonstrating ethnic minority male pharmacists being paid the least compared to their white counterparts, and also ethnic minority female pharmacists; something that needs to be explored further to better understand the reasons behind this,” says Doll.

The pay gap also persisted even when age was accounted for — as a proxy for experience levels. The average hourly rate for white male pharmacists at 44 years was £30.39, compared with £26.92 for non-white males: an 11.4% pay gap. The average hourly rate for white female pharmacists at 44 years was £29.04, compared with £28.26 for non-white females: a gap of 2.7%. The top 5% of earners were excluded for this part of the analysis to remove anomalous data points.

Kemi Adelaja, UK Black Pharmacists Association regional lead for North of England, says the findings “not only highlight the inequalities in pay but also underscores the broader systemic challenges faced by ethnic minority pharmacists”.

“We need a comprehensive and sustained approach to tackle this issue, involving concerted efforts from employers, pharmacy professional leaders and policymakers,” she says.

Adelaja calls for “key actions” for employers including standardising pay structure, particularly in community pharmacy; offering career development opportunities; and providing leadership and accountability for driving diversity, equity and inclusion initiatives.

“Employers should invest in training to address unconscious bias and structural racism, helping to create an environment where all pharmacists are treated and compensated fairly,” she adds.

“While ethnicity pay gap reporting is a step in the right direction, it is far from sufficient,” says Gomez Campos. “We need a robust system where nepotism can be challenged and reversed, and where unfair recruitment practices are not tolerated. Until such a system is established, we will continue to see these gaps persist, leading to lower job satisfaction and unequal opportunities among ethnic minority groups.

“It’s not just about reporting the numbers; it’s about creating a fair and equitable work environment where all employees, regardless of their ethnicity, have equal access to career advancement, professional development and workplace benefits. 

“Only then can we hope to close these gaps and ensure that job satisfaction is not determined by the colour of one’s skin but by the quality of the work and the opportunities provided,” she says.