Making the difference: Diversity and inclusion in the NHS

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Recent research demonstrates that very little progress has been made in the past 20 years to address discrimination against black and minority ethnic (BME) staff in the NHS.

NHS England commissioned The King’s Fund to produce a report assessing the scale of this problem; the research analysed data from the 2014 NHS Staff Survey and drew on wider work on climates of inclusion to suggest strategies for lasting and pervasive change. The report for NHS England also addresses the question of how to make a difference at individual, team, organisational and national levels.

The King's Fund has produced a summary of the NHS England-commissioned report.

Key findings

  • Overall, levels of reported discrimination vary significantly by type of trust, location, gender, age, ethnicity, sexual orientation, religion and disability status. 
  • Reported levels of discrimination are highest in ambulance trusts.
  • Overall, women are less likely to report experiencing discrimination than men (except in the case of ambulance trusts).
  • Older staff are less likely to report experiencing discrimination than younger staff.
  • Reported levels of discrimination are highest for black employees and lowest for white employees; all other non-white groups are far more likely to report experiencing discrimination than white employees.
  • People from all religions report experiencing discrimination on the basis of their faith, but this is by far the highest among Muslims.
  • Disabled staff report very high levels of discrimination; levels of reported discrimination are higher for this category than for any other (gender, age, etc).

Implications for NHS organisations

  • Diversity training for individuals can be helpful, but some strategies are more effective than others in bringing about wider positive changes.
  • Opportunities to bring about change are most likely to be effective at team level, as this is where most discrimination occurs.
  • Teams are more inclusive when they are well-structured and have effective processes that include: clear vision and values; shared team leadership; valuing diversity as a positive element of the team; and a pattern of listening to and valuing all voices within the team.
  • Within organisations, effective diversity management policies, practices and procedures that can shape and reinforce equal employment are vital.
  • Organisations must take a strategic approach to creating a culture of inclusion. The key elements necessary for cultures of inclusion are also associated with high-quality health care.
  • Nationally, there should be clear guidance on how to develop climates for inclusion and the NHS should exercise its power to set national standards around developing cultures of diversity and inclusion.



nhs trust
Comment date
18 December 2019

seems the united kingdom still sees colour and not professionals. no matter how great a practitioner you are as long as you are not white there is a risk of racial abuse and discrimination. all non white are at risk of job loss or worse deportation... why speak up and loose a job … rather keep quiet and take care of our families

Novelette Childs

MENTAL HEALTH support worker,
Powys Local Health board nhs former
Comment date
29 March 2017
why you always put out comment about trying to help eliminated discrimination however when I tried to contact various Equality group they are decline to least make any investigation on my behave . I am now left isolate lost my job unfairly although I have apologies several times for been racial abuse by the local health board nhs why cant you help


NHS Trust
Comment date
14 October 2016
Regardless of your qualifications, drive and desire to lead and manage barriers are put in place and a culture that import talent than nurture it and that does not recognise past race exists. Once you show ambition the establishment targets you like a pariah hence its best not to attempt. I agree with Penny, there is nothing that can be done any time soon and its only going to get worse


Comment date
26 May 2016
Of course racism exists but the real problem is that once you have complained, you can kiss your career goodbye hence most of us choose to let it go. It won't change anytime soon because when you go for leadership roles usually there will not be one single BEM face!!

Robert farey

old age
Comment date
12 May 2016
there is more discrimination against disabled people now than when i was employed some 15 years ago why?.

Judith Thomsson

Senior Care Assistant,
Risedale Residential Home
Comment date
29 March 2016
As much training,and information on this wide and varied topic,as possible please

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