The barriers and enablers to system-led Schwartz Rounds for global majority staff
01 December 2025
Raj Dhanjal, Schwartz Rounds lead at West Yorkshire Staff Mental Health Wellbeing Hub, and Corey Morgan-Forsyth, who evaluated Rounds at the site, share what they have learned about the barriers and enablers for participating in Schwartz Rounds for staff from global majority backgrounds.
Do I belong here? A West Yorkshire perspective
As the West Yorkshire Staff Mental Health Wellbeing Hub prepares to close its doors, we would like to take a moment to reflect on some work that has taken place across West Yorkshire to evaluate the value of Schwartz Rounds for staff from global majority backgrounds.
The aim of this work was to address the inequalities that are present with us globally and sadly transgress into our health care system. In the first half of this blog, Raj Dhanjal shares her perspectives of leading this initiative. In the second half, Corey Morgan-Forsyth shares how the invitation to understand global majority staff experiences resonated with him both personally and professionally, leading to a much-needed piece of research.
Raj Dhanjal
It feels important to share with you the story of how this work has evolved. After all Schwartz is about stories! In 2021, the hub introduced Schwartz Rounds for all colleagues from Health and Social Care, in an attempt to break down barriers that often exist between different groups. This was also an opportunity to create increased access to colleagues who do not have opportunities for reflective spaces. Alongside this, we wanted to ensure Schwartz Rounds reflected the community, society and workplaces we all live in and serve. We are proud that in this time, 43 Rounds were held, and over 2,000 staff members attended across the region. Despite this, our local evaluation of Schwartz Rounds mirrored the national data and highlighted that there was a lack of diversity in Schwartz Rounds, which did not reflect the healthcare system we serve.
Building healthy cultures can take years, if not decades, but they can easily be destroyed in seconds. The ethos of Schwartz Rounds and developing compassionate cultures has never been more important. Given this, I had a passion to share hidden authentic stories representative of the workforce. However, the journey was far from easy, and I realised that this can’t be achieved in isolation and rather it must be a collective effort.
In trying to make sense of this, it led me to think about the barriers that I had experienced and observed in facilitating and attending or sharing a story at Rounds.
I can recall attending steering groups in my capacity as a Schwartz Rounds lead and having to raise uncomfortable issues relating to challenging our biases at a systems level. This felt terrifying as the only ethnically diverse person in the room and the thought crept in my mind, “do I have the right to say this?”
Alongside this, there was my personal journey of sharing my own story at a Round and the worry I held, “will anyone connect with my story, or will I be overlooked again?”
It became clear that psychological safety, structural racisms, misuse of power and lack of representation were all factors impacting Rounds, and needed to be understood.
I started out with a simple approach to work towards building diversity in its broadest sense. This meant developing diversity and inclusion from the leadership level, to steering groups, to facilitation and to story tellers. My hope was that this would create a ‘domino effect’ and engage a more representative workforce at such spaces.
At the same time, I was also curious as to what the literature and research would tell us about the experiences of staff from a global majority background. The irony was, there was a significant gap in the research literature. This felt unsettling given that we know staff from global majority backgrounds report higher rates of bullying, harassment and barriers to accessing developmental opportunities, including leadership roles and reflective spaces (Kline, 2014; Chastney et al., 2024).
So, the journey to truly understand began. I commissioned a service evaluation with the University of Leeds Doctoral training programme. The aim was to explore the barriers and enablers for attending Schwartz Rounds, for staff from global majority backgrounds in West Yorkshire. The next chapter begins with Corey…
Corey Morgan-Forsyth
When I saw Raj’s project among the service evaluation options from the University of Leeds, it resonated immediately. As a mixed-race trainee clinical psychologist with 11 years of NHS experience, I’ve navigated questions of belonging and representation my entire life, from growing up in a predominantly white area of Merseyside to working across healthcare settings where I’m often “one of few”.
My mother, a single white parent, worked incredibly hard to help me understand my heritage and the realities of race and equality. But no amount of preparation prevents the constant evaluations you make in predominantly white professional spaces: “Is it safe to speak about race here?” “Will my contributions be judged differently?” “Am I here to represent my entire community?”
Given the current climate, hostility toward immigration, dismantling of EDI initiatives, and erosion of free speech about structural inequalities, understanding whether reflective spaces like Schwartz Rounds can genuinely provide safety for global majority staff felt urgent.
The findings were both powerful and concerning. I interviewed seven staff members from diverse global majority backgrounds who had engaged with Schwartz Rounds as storytellers, facilitators or participants. What struck me most was their investment. These weren’t reluctant participants; they were deeply passionate about these issues and courageously honest despite the risks.
Participants described rounds as “therapeutic” rare spaces to reconnect with meaning. But psychological safety was fragile, depending heavily on visible representation. As one reflected, “the same thing that somebody else said, if I said it, might be perceived differently”.
Crucially, no one reported discrimination within Rounds themselves. The barriers were systemic: workload pressures, lack of protected time, hierarchies determining who has autonomy to attend.
Analysis of four race and equity-focused rounds showed global majority representation varied most likely due to multiple factors. It illustrated how quickly inclusion can collapse without sustained action.
Three clear patterns emerged:
- Representation matters but risks tokenism if not authentic. As one participant warned: “representation is simultaneously important and also a pitfall”.
- Facilitation quality determines safety. When facilitators genuinely “hosted”, creating warmth, honouring stories and providing aftercare, people felt held. One participant beautifully expressed: “It wasn’t what people thought of the story… it’s how it was honoured”.
- Intersectionality compounds barriers. Frontline global majority staff face layered constraints while senior staff can ring-fence time.
The message from participants is clear. Schwartz Rounds hold significant potential, but only when designed to actively remove barriers, not just create opportunities.
This work has felt very personal, giving voice to experiences I’ve carried since childhood while amplifying the courage of staff who shared honestly. It’s reinforced what my mother tried to teach me, understanding your identity and speaking up about injustice matters.
“Do I belong here?” shouldn’t be a question anyone has to ask when entering spaces designed to support them.
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In closing, we are pleased that the Point of Care Foundation will be sharing the poster presentation of Corey’s research at its final conference in December 2025. We are also looking forward to developing this learning into the Community of Practice workshops in the new year and putting these findings into action for our facilitators across the country.
Watch this space!
Barriers and enablers to system-led Schwartz Rounds for global majority staff: evaluation summary