Serving as Chair and Deputy Chair of the Chief Allied Health Professions Officer (CAHPO) Black, Asian and Minority Ethnic Strategic Advisory Group (CAHPO BAME SAG) has been one of the most formative experiences of our careers. This voluntary role has offered a rare opportunity to influence national policy, build inclusive leadership capacity, and advocate for equity in a system that often overlooks the value of lived experience.

The CAHPO BAME SAG was established by the current Chief AHP Officer for England (Professor Suzanne Rastrick OBE) in response to the need for race equality in the National Health Service in England, following the death of George Floyd and the global reckoning on systemic racism. Its purpose is to ensure that the voices of Black, Asian and minority ethnic Allied Health Professionals (AHPs) are heard at the highest levels of decision-making. The group has shaped national strategy, including embedding anti-racism principles into the AHPs Deliver strategy for England (Mhlanga & Rastrick, 2022).  It has also created space for feedback, visibility, and career development for those often left behind.

When we joined the group, our motivation was simple: the healthcare workforce should reflect the communities it serves. As AHPs, we’ve witnessed how race and ethnicity shape both patient outcomes and professional experience. We believed in change, but we also understood that change requires more than belief. It demands structure, strategy, and access to decision-making spaces.

Influence Without Authority

In these roles, we didn’t hold formal authority or budgets. Instead, we relied on influence, credibility, and the ability to build consensus. This reflects the principles of adaptive leadership (Heifetz, Grashow, and Linsky, 2009), which emphasise mobilising people to tackle complex challenges in uncertain environments. Facilitating meetings with diverse stakeholders, navigating strong personalities, and ensuring all voices were heard became part of our daily practice. These experiences sharpened our strategic thinking and interpersonal skills in ways that traditional leadership roles rarely do.

Our inclusion in the Senior Quality and Safety Leadership and Development Programme, jointly led by NHS England and the NHS Confederation, marked a significant milestone. As Cooper and Wheeler (2025) describe in their BMJ Leader blog, the programme was designed to build leadership agency among senior AHPs, enabling them to influence quality and safety across systems. It was not just about developing skills, it was about creating a collective voice capable of shaping governance.

Representation in senior leadership spaces is often dismissed as symbolic. But our experience has shown that it is anything but. As Cooper and Wheeler (2025) argue, representation is strategic, it brings essential perspectives into the heart of decision-making. Our presence helped ensure that equity was not an afterthought but a foundational principle in shaping policy and practice.

Leadership Rooted in Lived Experience

We also drew on intersectional leadership frameworks (Crenshaw, 1989; Bourke and Dillon, 2018), which highlight how overlapping identities, such as race, gender, and profession, affect access to opportunity and influence. These frameworks helped us understand the structural barriers faced by Black, Asian and minority ethnic AHPs, including limited access to leadership roles, lack of mentorship, and workplace bias. Our advocacy focused on dismantling these barriers through inclusive recruitment, equity-focused policy advice, and development pathways for underrepresented colleagues.

The relationships we built through this work were invaluable. We connected with professionals across the NHS who shared a commitment to inclusion and justice. These networks became platforms for collaboration, innovation, and mutual support. They also reinforced the idea that leadership is not about having all the answers, it’s about enabling others to be seen, heard, and valued (Nembhard and Edmondson, 2006).

One of the most powerful aspects of this journey was learning how change happens in large, complex systems. We gained insight into navigating institutional politics, identifying leverage points, and sustaining momentum even when progress felt slow. These lessons have made us more resilient, more strategic, and more focused on long-term impact.

A call to others

For those considering stepping into voluntary leadership roles, we offer this reflection: these positions may not come with titles or financial reward, but they offer something far more valuable. They are real-world laboratories for developing leadership, advocacy, and strategic influence. They stretch you, challenge you, and prepare you for roles that demand courage and clarity.

As we look ahead, we remain hopeful. The work is far from finished, but we’ve seen what’s possible when people come together with purpose. Whether it’s shaping leadership development, influencing recruitment, or building culturally competent pathways, our efforts are making a difference. And we’re excited to see how others will take up the baton and continue to move the system forward.

References 

• The Allied Health Professions (AHPs) Strategy for England:2022-2027 AHPs Deliver. Available at: https://www.england.nhs.uk/long-read/the-allied-health-professions-ahps-strategy-for-england-ahps-deliver/
• Bourke, J. and Dillon, B., 2018. The diversity and inclusion revolution: Eight powerful truths. Deloitte Insights.
• Cooper, S. and Wheeler, L., 2025. Leadership for Impact: Developing Leadership Agency of Senior AHPs to Transform Quality and Safety Across Systems. BMJ Leader. Available at: https://blogs.bmj.com/bmjleader/2025/06/23/leadership-for-impact-developing-leadership-agency-of-senior-ahps-to-transform-quality-and-safety-across-systems-by-sarah-cooper/ [Accessed 15 Aug 2025].
• Crenshaw, K., 1989. Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(1), pp.139–167.
• Heifetz, R., Grashow, A. and Linsky, M., 2009. The practice of adaptive leadership: Tools and tactics for changing your organization and the world. Harvard Business Press.
• Mhlanga, R. and Rastrick, S., 2022. Actions not words: The Chief AHP Officer Black, Asian and Minority Ethnic Strategic Advisory Group (CAHPO BAME SAG). NHS England Blog. Available at: https://www.england.nhs.uk/blog/actions-not-words-the-chief-ahp-officer-black-asian-and-minority-ethnic-strategic-advisory-group-cahpo-bame-sag/ [Accessed 15 Aug 2025].
• Nembhard, I. and Edmondson, A.  Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams Journal of Organizational Behaviour 27, 941–966

Authors

Nomalanga Makhanda (Noma), Deputy Chief Allied Health Professional & Professional Lead Occupational Therapist, Outgoing Chair Chief Allied Health Professional Office BAME SAG  (2023-2025)

Noma is the outgoing chairperson for the Chief Allied Health Professional Office Black Asian Minority and Ethnic (BAME) Strategic Advisory Group (NHS England) having served for 2yrs (2023-2025). Noma is an Occupational Therapist that has worked in clinical settings and in strategic roles within the NHS in the last 15 years.  Noma has worked within inpatient and community mental health and learning disability settings and her roles have included the provision of specialist clinical assessment and treatment for adults and older adults. Noma currently works at Rotherham Doncaster and South Humber NHS Foundation Trust, as Deputy chief AHP and Professional Lead for Occupational Therapy.

Malany Kalicharan, Work and Health Integration Program Manager, Outgoing Deputy Chair of Chief Allied Health Professional Office BAME SAG  (2024-2025)

Malany Kalicharan is the outgoing Deputy Chair of the Chief Allied Health Professions Office (CAHPO) Black, Asian Minority Ethnic Strategic Advisory Group, contributing to national Allied Health Professions leadership and direction. She is an experienced diagnostic radiographer with over 20 years in the NHS. Having qualified in South Africa, her career spans a wide range of imaging services, gradually stepping into strategic and leadership roles. Her diverse portfolio includes Superintendent Radiographer, Project Lead, Workforce Planning and Development Manager and International Recruitment Lead. Malany currently works as the Work and Health Integration Programme Manager at Leicestershire, Leicester and Rutland Integrated Care Board (ICB).

Declaration of interests

We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.