Why Diversity and Inclusion in the NHS Isn't Optional—It's Essential

henry9752
Oct 16
6 min read

16th October 2025

HR Field is a Wales based HR Services provider. The recent news articles with a negative view on EDI initiatives in the NHS have focused on England, so, we have as well.

The debate around diversity and inclusion roles in the NHS has heated up considerably in recent months. Headlines have been questioning the cost of EDI functions, with reports claiming "£70 million spent every year for 'diversity officers' in NHS, police, and town halls". Whilst some view these roles as unnecessary expenditure, the latest NHS data tells a very different story—one that reveals why diversity and inclusion functions aren't just important, they're absolutely critical to the NHS's ability to deliver quality care.

Let's look at what the evidence actually says.

The Current State: Progress and Persistent Problems

The 2024 WRES report, published by NHS England in June 2025, reveals a healthcare service in transition. On the surface, there's progress: 28.6% of the NHS workforce now comes from Black and minority ethnic (BME) backgrounds, an increase of 53,969 staff (14%) from the previous year. Within medicine specifically, 48.7% of doctors are from BME backgrounds, demonstrating just how much the NHS relies on diverse talent.

Yet beneath these encouraging numbers lies a troubling reality.

The Discrimination Data:

According to the 2024 WRES report, 15.5% of BME staff experienced discrimination from colleagues in the past year—more than double the 6.7% reported by white staff. This pattern has persisted year after year, revealing systemic issues that won't resolve themselves.

The disability data is equally concerning. The 2024 WDES report shows that only 36.9% of disabled NHS staff were satisfied with the extent to which their organisation values their work, compared to 47.8% of non-disabled staff—an 11-percentage-point gap that speaks volumes about workplace culture.

Perhaps most damning: when asked whether they believe their organisation provides equal opportunities for career progression, only 49.5% of ethnic minority staff agreed, compared to 58.9% of white staff.

Why This Matters: The Patient Care Connection

Critics of diversity and inclusion functions often frame them as "politically correct" box-ticking exercises divorced from frontline care. The research tells a completely different story.

Research published in the Journal of the American Medical Association (JAMA) found that diverse healthcare teams produce drastically improved patient outcomes. Study after study demonstrates that more diverse healthcare teams are better equipped to address the diverse needs of patient populations, leading to better overall care quality.

The evidence is clear:

Diverse teams bring varied perspectives that improve clinical decision-making
Patients from minority backgrounds report better experiences and outcomes when treated by diverse teams
Healthcare teams with greater diversity demonstrate enhanced problem-solving capabilities
Inclusive environments reduce medical errors through more comprehensive patient assessment

One peer-reviewed study noted: "Diversity improves performance and outcomes... More diverse healthcare teams and workplace environments have a positive component for enhancing patient outcomes, improving care."

This isn't about being nice. It's about delivering better healthcare.

The Business Case: Beyond Moral Imperatives

The NHS faces unprecedented workforce challenges. With over 100,000 vacancies and an ageing population demanding more complex care, the service simply can't afford to alienate or underutilise talent from any background.

Consider these realities:

Recruitment and Retention Crisis: The NHS is heavily dependent on international recruitment. Approximately 30% of NHS staff now come from ethnic minority backgrounds (up from 20% in 2019), with many recruited from overseas. Creating inclusive environments isn't optional when your workforce sustainability depends on attracting and retaining diverse talent.

The Cost of Discrimination: When 15.5% of BME staff experience discrimination from colleagues, the consequences extend far beyond individual wellbeing. Staff experiencing discrimination are more likely to:

Take sickness absence
Leave the organisation
Provide suboptimal patient care due to stress and disengagement
Discourage others from joining the NHS

The cost of replacing a single NHS nurse is estimated at £30,000. The cost of replacing a doctor can exceed £100,000. Poor workplace culture doesn't just harm staff—it devastates budgets.

Leadership Representation: The 2024 WRES data shows that whilst BME staff make up 28.6% of the overall workforce, they represent only 12.5% of senior leadership positions. This leadership gap means that decision-making tables lack the diverse perspectives needed to serve an increasingly diverse patient population effectively.

What Diversity and Inclusion Functions Actually Do

When critics question the value of EDI roles, they often misunderstand what these functions actually entail. Effective diversity and inclusion work in the NHS includes:

1. Data Analysis and Accountability The WRES and WDES frameworks don't compile themselves. EDI professionals analyse workforce data, identify disparities, and hold organisations accountable for progress. Without this function, the discrimination statistics we've cited would remain hidden.

2. Policy Development and Implementation Creating fair recruitment processes, equitable promotion pathways, and inclusive workplace policies requires expertise. As The King's Fund notes, white applicants to NHS positions are still more likely to be appointed than BME applicants with equivalent qualifications—a disparity that demands systematic intervention.

3. Training and Culture Change The 2024 data shows that discrimination remains prevalent. Changing organisational culture requires sustained effort, including training programmes that help staff recognise and address unconscious bias.

4. Support for Staff Networks BME and disabled staff networks provide crucial peer support and feed valuable insights to leadership. Facilitating these networks requires dedicated resource and expertise.

5. Patient-Facing Improvements EDI functions work to reduce health inequalities by ensuring services are accessible and culturally competent. The NHS recently launched its first-ever review to tackle LGBT+ health inequalities in July 2025—work that requires dedicated expertise to implement effectively.

The Real Question: Can We Afford Not To Invest?

Yes, the NHS spends money on diversity and inclusion functions. But let's consider the alternative.

Without systematic EDI work:

Discrimination would continue unchecked, driving away talented staff
Health inequalities would widen, leading to poorer population health outcomes
The NHS would struggle to recruit internationally, exacerbating workforce shortages
Legal challenges from discriminated staff would increase
Patient care quality would suffer from less diverse, less effective teams

The King's Fund, in its analysis of the 2024 WRES data, noted: "The latest WRES report shows fair and inclusive recruitment is far from embedded in the NHS—for example, white applicants are more likely to be appointed than BME applicants from shortlisting."

This isn't a problem that resolves itself. It requires dedicated, expert intervention.

Moving Forward: What Effective EDI Looks Like

The most effective NHS trusts don't treat diversity and inclusion as a standalone function—they embed it throughout organisational strategy. High-performing organisations:

Integrate EDI into Quality Improvement: Link diversity metrics directly to patient safety and care quality indicators, demonstrating the connection between inclusive workplaces and better outcomes.

Ensure Leadership Accountability: Make EDI performance a key component of executive and board-level objectives, with consequences for failure to progress.

Invest in Middle Management: Equip frontline managers with the skills to create inclusive teams, recognising that culture is built daily through countless small interactions.

Listen to Lived Experience: Actively seek input from staff networks and patient groups, using their insights to shape policy and practice.

Measure What Matters: Track not just representation statistics but also staff experience data, progression rates, and patient outcomes by demographic group.

The Path Ahead

The NHS stands at a crossroads. It can continue to employ a workforce where 15.5% of BME staff experience discrimination, where disabled staff feel significantly less valued than their non-disabled colleagues, and where leadership remains overwhelmingly white despite a highly diverse frontline—or it can invest properly in the diversity and inclusion functions that drive meaningful change.

The 2024 WRES and WDES data make clear that progress is possible. Some trusts have shown significant improvements across multiple metrics. But this progress doesn't happen by accident—it happens because dedicated professionals analyse data, develop interventions, challenge discriminatory practices, and hold organisations accountable.

In a healthcare service that depends on diverse talent to function and serves an increasingly diverse population, diversity and inclusion isn't a luxury. It's fundamental to the NHS's ability to deliver its core mission: providing excellent care to all who need it.

The question isn't whether we can afford diversity and inclusion functions in the NHS. It's whether we can afford to be without them.

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