Across England, NHS leaders are raising alarms that the recent and sudden proliferation of St George’s flags appear to be doing more than simply stirring national pride: these flags are creating informal “no-go” zones for NHS staff on home visits, especially those from ethnic minority backgrounds.
Like many, I have long felt concern about this growing number of flags on lamp-posts, roundabouts and homes. The flags carry a message beyond patriotism, signalling unwelcome or hostile territory for some, and we are now seeing direct reports of this from NHS carers.
Senior NHS staff speak out on exclusionary message of flags for community workers
One NHS Trust Executive speaking anonymously to journalists described staff, a large minority of whom are Black and Asian, feeling “deliberately intimidated” by the flags which create exclusion zones.
He continued: “You add that on top of real autonomous working, that real bravery of working in people’s homes, with an environment … (where) it feels like it’s an area that’s designed to exclude them.” And added that the Trust had seen “individual instances of aggression towards staff”.
Another senior manager described how a staff member who is white, with mixed-race children, had asked people erecting flags to move so that she could park her car. Those putting up the flags filmed the incident and pursued the member of staff who was then subjected to several days of abuse, not as a result of her opposition to the flags, but because of the disturbance she had caused.
The same manager spoke of many similar stories: people attempting to remove flags from outside their homes and being consequently threatened and abused.
They went on to say the “springing up of flags everywhere has created another form of intimidation and concern for many, many of our staff.”
Abuse and intimidation compound the issue of NHS lone working
These reports appear to highlight two worrying trends. The first is that NHS staff, mainly from ethnic minority groups, are being made to feel unsafe. The second is that they work in our communities, outside of hospitals or GP surgeries, and often solo.
Chief executive of NHS Providers, Daniel Elkes said: “The NHS has relied on overseas recruitment for a long time to ensure we have the right workforce. We have a really diverse workforce and without that you can’t deliver the NHS.”
Another Trust said its data showed Black and Ethnic Minority staff experienced more harassment or abuse from the public than white counterparts: 20.1% compared to 13.4%.
And undoubtedly for these workers, home visits are already high-risk enough: unfamiliar houses, often late working hours, etc. Surely, when the overall environment is unwelcoming and even threatening, their duty of care becomes harder to fulfil?
Professor Nicola Ranger, general secretary of the Royal College of Nursing, commented:
“Nursing staff dedicate their lives to caring for others, and too often they are faced with the most appalling hatred and intimidation.
A sustained campaign of anti-migrant rhetoric is fuelling a growing cesspool of racism, including against international and ethnic minority nursing staff, without whom our health and care system would simply cease to function.”
Recent flag displays and their contested meanings
During the summer, we saw a surge of St George’s flags all across England – on lamp posts, roundabouts and even Church of England churches as I previously reported. Many insist they are an act of patriotic celebration, but people like me know the real motivation behind many of these flags. And now we see this message of exclusion reflected at the front line of our NHS, as evidenced by the previous comments from one trust executive.
And does this help draw conclusions? The meaning of a flag is not solely in its design but also in the context it is used. When houses, roundabouts, and a whole area become peppered with just one intimidating and unwelcoming symbol, largely placed by angry white people, and then an ethnic minority nurse enters a home alone, how do we expect that nurse to feel?
Institutional responses to protect community health workers
In response, NHS employers and local trusts have begun to reassess how community-visiting staff are supported. For example, one Kent-area community trust introduced a “yellow/red card” system for patients or visitors whose behaviour became threatening or abusive, with the potential for exclusion altogether for the most serious cases.
National bodies have also responded with the Department of Health and Social Care saying: “There is no place for intimidation, racism or abuse in our country or our NHS.”
“We value the diversity of our NHS, which relies on the skill and dedication of hard-working staff from all backgrounds. They must be treated with dignity and respect.
“Our flags represent our history, our heritage, and our values. They are a symbol of our nation and belong to all of us – not just some of us.”
The surge of St George’s cross flags might seem benign to many, but for our nurses, health visitors and carers who knock on strangers’ doors to deliver essential services they are clearly not – the message is starkly different.
For anyone that thinks the flag really can unite, what we have seen from the front line of the NHS is that it is actually a barrier … and the consequences ripple out to affect staff, patients and community cohesion.
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