- HSJ-Equal Recruitment worst in a decade, according to NHSE data
An article with the above title and published by the HSJ on 14 April 2026, by Nick Kituno reads as follows:
> Absence of data analysis report is a “disgrace”, says WRES founder
>Disability declarations improved
The relative chance of minority ethnic applicants being recruited from an NHS job shortlist compared to others has fallen to the lowest level in the decade it has been monitored.
The latest NHS Workforce Race Equality Standard figures report that white applicants are 1.77 times more likely to be recruited than their colleagues from minority ethnic backgrounds. The difference has increased each year since 2022, and the previous high was 1.61 in 2021.
NHS England has previously acknowledged that this measure “remains the most difficult to change” and has “remained broadly unchanged” since the WRES’s inception in 2016. It fell to as low as 1.45 in 2018.
NHSE published the annual data on 7 April, but for the first time did not issue its own summary analysis of the findings, nor any media alert about it.
Roger Kline, who founded the WRES, told HSJ this downgrading was “disgraceful”. He warned in HSJ last month that national leaders were “deliberately downplaying” the NHS’s racism problem by weakening transparency and accountability.
Some findings in the data were more positive.
Representation of Black and minority ethnic people on boards has continued to rise. It reached 17.3 per cent in 2025, up from 7.1 per cent in 2016. However, it has not kept pace with rapid growth in wider staff with a minority ethnic background, meaning the gap has grown (see chart below).
One of the clearest improvements across 10 annual WRES reports is in disciplinary fairness. BME staff were 1.6 times more likely than white colleagues to enter formal disciplinary proceedings in 2016; by 2025, this fell to 1.1, approaching parity. It has risen from 1.03 in 2023, however.
The absence of a full NHSE data analysis report has made it more difficult to compare to previous years and disaggregate by region and profession.
Mr Kline, a research fellow at Middlesex University Business School, told HSJ: “The only good reason for this is to hide the data, and I am afraid it has happened at the same time as leadership at NHSE and the Department of Health and Social Care is astonishingly white for a health service in which 30 per cent of staff are of [Black and minority ethnic] heritage.
“The NHSE board and Wes Streeting may say they want diverse leadership, but at the moment, their actions speak louder than their words. Many NHS staff will undoubtedly conclude this is intentional, not accidental.”
NHSE also published figures for the annual NHS Workforce Disability Equality Standard, which found that one in 15 trust staff have now declared a disability, increasing from 5.7 per cent to 6.7 per cent this year.
The relative likelihood of non-disabled applicants being appointed from shortlisting remains close to equity, and declined from 0.98 the previous year to 0.95 – meaning disabled applicants were slightly more likely to be appointed. NHSE did not publish figures on disabled staff entering disciplinary proceedings due to “volatility and small numbers”.
The 2024 data showed disabled staff were twice as likely to enter these processes than their non-disabled colleagues.
The percentage of board members with a declared disability continues to rise, increasing from 6.5 per cent to 7.3 per cent this year, which is above the wider workforce.
HSJ has approached NHSE for comment.
Chart not included
The 2025 WRES data can be found here
- NHS England-The future of Freedom to Speak Up
On 16 April 2026 NHS England published a document, with the above title, on its Website detailing the future of Freedom to Speak up. The Summary of the document reads as follows:
“From 1 July 2026 , following a recommendation in July 2025 by the Dash review of patient safety across health and care, NHS England will deliver some activities previously undertaken by the National Guardian’s Office (NGO). Trusts, primary care organisations, integrated care boards (ICBs) and independent providers will be taking on greater responsibility and accountability for embedding effective Freedom to Speak Up arrangements”.
- HSJ-Cultural differences in British society are being ignored by NHS reform
An article with the above title and published by the HSJ on 14 April 2026, by Raza Rahman reads as follows:
Structural reforms ignore how to handle cultural differences within the population, leaving clinicians without frameworks for making complex decisions, risking inequity, unsafe care, and weak accountability
The NHS 10-Year Health Plan outlines the most significant structural reform of the health service in a generation. It proposes three shifts: hospital to community, analogue to digital, and treatment to prevention. These changes aim to rebuild care around neighbourhoods, prioritise prevention, and enhance workforce capability.
The plan reaffirms its commitment to addressing healthcare inequalities in the most underserved communities. All of this is welcome, but a crucial element is missing. The plan, along with the workforce strategy due this spring, lacks a structured methodology for handling culturally complex decisions faced by clinicians and frontline workers without adequate governance frameworks.
This isn’t about diversity awareness sessions or unconscious bias modules; it’s about a governance methodology – a structured, auditable, decision-support process similar to what we expect for clinical safety safeguarding and information governance. Culturally complex patient care is often treated as a soft skill, when it’s actually a governance risk.
Consider these two anonymised real-world scenarios.
Firstly, a community mental health team assesses a young man whose family has raised concerns about his behaviour. They interpret this as spiritual disturbance. Unsure how to weigh this with their own assessment, the team defaults to the Mental Health Act framework, leading to the patient’s detention.
The case record includes clinical indicators but lacks documentation on how the family’s interpretation was considered, its weight or why it was disregarded. While the decision might have been clinically sound, the absence of documented reasoning about cultural and faith-based context prevents the family or trust from demonstrating fairness.
Secondly, a health visitor identifies concerns about a mother presenting with signs of coercive control. However, she doesn’t disclose information in the way the referral pathway expects. Instead, she speaks about family obligations, community reputation and pressure from her extended family.
The practitioner, unsure how to interpret these dynamics within the risk assessment, records the concerns but frames the case as “cultural complexity” without specifying its implications for risk level or intervention.
Consequently, the case doesn’t escalate. Months later, a serious incident triggers a review. The file reveals a practitioner who noticed something was wrong but lacks structured reasoning for how cultural context influenced the decision not to act.
A problem of decision-making
Both situations share common features: skilled practitioners with genuine intent and the lack of a structured process for making culturally informed reasoning visible and auditable. While the decisions may or may not have been correct, the key issue is that neither could be defended under scrutiny because the thinking wasn’t recorded in a way that demonstrated how cultural context shaped the professional judgement.
The 10YHP calls for the NHS to become a neighbourhood
service, and the workforce strategy will address staffing. However, neither has yet considered how to govern the
cultural complexity inherent in neighbourhood care
These aren’t awareness problems; they’re decision-making problems. Evidence shows that people from racialised communities are significantly more likely to be detained under the Mental Health Act and detained for longer periods. The Patient and Carer Race Equality Framework exists precisely because mental health services haven’t provided culturally competent care at the point of contact.
Research published as recently as this year found that public services often reproduce trauma rather than alleviating it for racialised communities. Furthermore, the NHS’s own work on ethnicity data acknowledges that without understanding cultural and linguistic barriers to access, services become unresponsive to the communities they serve.
The 10YHP’s focus on neighbourhood care heightens its urgency rather than diminishing it. For the model to effectively shift care into communities – environments defined by cultural, linguistic, and faith-based dynamics – the workforce entering these neighbourhoods requires more than clinical competence.
They need cultural governance – not just sensitivity or awareness – a structured repeatable methodology for navigating complexity and making defensible decisions. This same rigour applies to medicines management consent and data protection.
The 10YHP calls for the NHS to become a neighbourhood service, and the workforce strategy will address staffing. However, neither has yet considered how to govern the cultural complexity inherent in neighbourhood care. This is the missing element.
Until cultural governance is treated as infrastructure – embedded in training, reflected in inspection and expected with the same seriousness as clinical governance – the plan’s promise of equitable community-rooted care will remain structurally incomplete. The question isn’t whether the NHS needs this; the evidence is clear. The question is who will build it
- RCN Foundation-Apply for an education grant
Please find below an email from the RCN Foundation concerning the education grants available notably:
| Hi
Are you or a colleague thinking about taking a course to support your educational and professional development? Great news – our education grants are now available! You could be awarded funding between £500 and £2,500, and you don’t need to be an RCN member to apply. We welcome applications from nurses, midwives, nursing associates, maternity assistants, and healthcare support workers. We’re pleased to launch the RCN Foundation Adult Social Care Nursing Fund, delivered in partnership with the Rayne Foundation, which will support the professional development of registered nurses, care and support workers/assistants working in adult social care settings across the UK. Applications close at 5pm on 13 May 2026. |
| Apply for an education grant |
| What grants can I apply for?
· RCN Foundation Professional Bursary Scheme (PBS): grants of up to £1,600 available for registered nurses, midwives, healthcare support workers, nursing associates and maternity assistants wishing to undertake a course or module to enhance their professional development · RCN Foundation Adult Social Care Nursing Fund: grants of up to £1,600 for registered nurses, care and support workers/assistants working in adult social care settings and seeking development opportunities · RCN Foundation Next Generation Grant: up to £1,000 available to support graduates wishing to become a nurse or midwife, and for direct entry nursing associate students undertaking a foundation degree. The grant will support with living costs whilst studying · RCN Foundation Marcia Mackie and Rae Bequest Grants: eligible to nurses registered in the UK and working in Northern Ireland in any sector wanting to undertake a course or programme that will improve patient care and develop practice. Grants of up to £1,600 (Rae) and £1,000 (Marcia Mackie) are available · RCN Foundation Mair Scholarship: open to nurses working in occupational health in Scotland only. Grants of up to £500 available for continuous professional development · RCN Foundation Kershaw Grant: grants of up to £500 available for healthcare support workers seeking continuous professional development opportunities · RCN Foundation Monica Baly Grant: open to nurses, midwives and student nurses/midwives for research projects or activities related to the history of nursing and midwifery. Funding of up to £2,500 available……….. |
| Apply for an education grant |