Last reviewed 14 June 2022

A major review of NHS leadership has concluded that all NHS staff in England should tackle discrimination against disadvantaged groups, not just leaders and specialist equality, diversity and inclusion (EDI) teams.

The independent report, Leadership for a Collaborative and Inclusive Future, identified the point of entry into health and care employment as a “critical opportunity to set cultural and behavioural expectations”, and emphasised that “how one behaves is as much a component of professional acumen as what one does”.

The inquiry, undertaken by General Sir Gordon Messenger and Dame Linda Pollard, proposed a locally delivered mid-career development event, designed to bring together professionals from all parts of health and social care around the “triple lens” of “collaborative leadership, broader cross-sector awareness and understanding, and behavioural expectations”.

It said the NHS should adopt a different approach to equality issues to overcome the widely recognised disadvantages faced by certain groups of its own staff, including lower pay and chances of promotion among Black, Asian and ethnic minority (BAME) doctors compared with white medics, and low BAME representation in senior managerial ranks.

The report focused on the current absence of accepted standards and structures for the managerial cohort within the NHS, which it said has long been a profession that “compares unfavourably” to the clinical careers in the way it is trained, structured and perceived.

However, the report concluded: “Most critically, we advocate a step-change in the way the principles of equality, diversity and inclusion are embedded as the personal responsibility of every leader and every member of staff.

“The only way to tackle (inequity in experience and opportunity) effectively is to mainstream it as the responsibility of all, to demand from everyone awareness of its realities and to sanction those that don’t meet expectations.”

The inquiry said NHS trusts would need fewer EDI teams if action against discrimination became the responsibility of all. Health and Social Care Secretary Sajid Javid welcomed the report and accepted its recommendations in full to ensure best possible leadership across the country.

NHS Race and Health Observatory Director Dr Habib Naqvi welcomed the report, saying: “Equality, diversity and inclusion isn’t about more automated mandatory training that’s carried out once a year. It’s about hardwiring equity and fairness into the everyday behaviours and experiences of all staff, and the culture of the organisation.”

He added: “These principles must be embedded and mainstreamed as the responsibility of all regardless of role. This is a fundamental condition for recognising and acting upon the stark inequalities experienced in the workplace.”

The report is available on the GOV.UK website.