Race equity, inclusive leadership and the future of the NHS

It reflects not only the depth and breadth of talent across the NHS and wider health sector, but also the increasing influence of Black, Asian and minority ethnic leaders in shaping policy, delivery, innovation, and culture.

Our goal in celebrating these figures is not simply rooted in morality but in evidence: diversity and inclusion drive greater staff engagement, stronger productivity, and better outcomes for patients. Surely, it is an obvious and critical agenda for all senior leaders to invest in.

Yet despite the significant and ever-growing evidence base, senior leaders are often still nervous about committing to tackle the underlying causes of inequality.

The 10-Year Health Plan sets out an ambitious vision for reform: shifting care from hospital to community, from analogue to digital, and from treatment to prevention. But that vision will only be delivered if equity and inclusion are treated as core conditions for success, not as peripheral considerations.

A neighbourhood NHS, more preventative care, improved digital access, and better outcomes for patients will depend on the contribution, leadership, and experience of the whole workforce – including Black, Asian, and minority ethnic staff who make up nearly 30 per cent of NHS staff. It is for that reason that race equity is not, and cannot be, divorced from the delivery of the government’s core missions on health.

At the same time, we know that tackling race inequality is not simple work. It is among the most complex, sensitive, and enduring challenges in healthcare, precisely because it requires us to confront the deeper structural, cultural, and institutional factors that shape the experiences of staff, patients, and communities.

Racism exists across society, and an NHS workforce of almost 1.6 million people is not immune from its effects. Meaningful progress, therefore, requires honesty, skill, patience, and sustained investment: the courage to acknowledge what needs to change; the capability to turn evidence into action; and the persistence to stay the course even when progress feels difficult, uncomfortable or slow.

That is exactly why the NHS Race and Health Observatory developed its Seven Principles of Anti-Racism. This framework is designed to help leaders, organisations, and systems move beyond acknowledgement and towards practical, evidence-based action.

Encouragingly, the seven principles now sit at the heart of national efforts to tackle racism in the NHS: they feature prominently in the recently published Lord Mann Review, including recommendations for adoption by the Department of Health and Social Care, NHS boards, senior leaders, and regulators; and they underpin the NHS Staff Standard for tackling racism, providing a foundation for local action, shared learning, accountability, and sustained improvement.

This is where the work of the NHS Race and Health Observatory remains so vital. Through independent evidence, practical tools, and national convening power, the Observatory is helping the system move from commitment to measurable change, including in the critical area of workforce equity.

Our work to identify and address ethnicity pay and progression gaps, reduce bullying and harassment, and support evidence-based approaches to anti-racism is about creating workplaces where all staff can thrive and deliver their best for patients.

At the same time, we know inclusion is not only national bodies’ or senior leaders’ responsibility. Every NHS staff member has a role to play in: listening to and acting upon the experiences of colleagues and patients; challenging discriminatory behaviour when it occurs; using data and evidence to understand unequal outcomes; building inclusive teams; and ensuring that dignity, respect, and fairness are reflected in every interaction, every decision, and every pathway of care.

My sincere thanks and gratitude to both the HSJ team and to our expert panel of judges for their support, input, and insight.