Managers will be given a target on the proportion of trust board members coming from black and minority ethnic backgrounds under plans being drawn up by the Department of Health.

DH director for equality and human rights Surinder Sharma told HSJ the issue was being treated as a priority to make boards more representative of their local populations.

He said: "We're working with the Cabinet Office to set a target for a public service agreement... and looking at how they'll be set locally."

It would not be treated as a centrally imposed quota, he said.

Responding to HSJ's survey of NHS trusts and primary care trusts, he said: "The figures speak for themselves. We have got some work to do but we're going down the right road and we need to work together with our BME staff and managers to find the solutions together."

The issue would be addressed by the new diversity and equality board being set up, which will be chaired by NHS chief executive David Nicholson.

Mr Sharma said the number of BME managers had leapt by 67 per cent since 2006-07, disproving the "myth" that non-white senior managers had disproportionately lost out as a result of reconfigurations.

In fact, the number of BME executive directors dropped by 7 per cent, compared with 9 per cent of those who were white.

Overall, the NHS is the largest employer of BME communities in Europe, he said, and 30 per cent of medical students come from non-white backgrounds.

Mr Sharma called on strategic health authorities to hold trust managers to account over their race equality duties, and praised NHS North West for sending strategic plans back to PCTs if they lack equality impact assessments.

Monitor also has a role to play, he said, by ensuring foundation trusts comply with race equality legislation.

"It's just as important as any other duty that trusts have," he said. "It's not just a 'to do' list, it's the responsibility of the whole board. It's part of world-class commissioning and should be part of everything we do."