HSJ's nationwide survey on the experiences of black and minority ethnic staff in the NHS shows the service has a long way to go to make its worthy platitudes on equality and diversity a reality.

The data on issues such as appointments and grievances mirrors that from the South East Coast region that we revealed in the summer.

In an effort to overcome inertia on equalities, the Department of Health is planning to set targets for the proportion of trust board members coming from black and minority ethnic backgrounds.

This is well intentioned but misses the point. It is the diversity equivalent of trickle down economics, assuming better representation at the board will - eventually - drive changes further down the organisation.

That will take too long to achieve too little.

Senior managers need to get a grip on this issue now, on everything from diversity training for interviewers to the handling of grievances. As so often, the solution can only be found locally, not in the Department of Health.