NHS equality, diversity and inclusion (EDI) improvement plan

The NHS England EDI improvement plan aims to improve equality, diversity and inclusion and to enhance the sense of belonging for NHS staff.

23 June 2023

Published in June 2023, the EDI improvement plan sets out six targeted actions to address direct and indirect prejudice and discrimination, that exists through behaviour, policies, practices and cultures against certain groups and individuals across the NHS workforce. 

This plan aims to improve the outcomes, experience and culture for those with protected characteristics under the Equality Act 2010 (although it is not limited to these groups) and links to the NHS People Plan

The EDI improvement plan was developed through engagement with staff networks and senior leaders, including the Health and Care Women Leaders Network, the Race and Health Observatory, NHS Employers and NHS Confederation, reflecting the intersectional nature of this plan. 

Recognising the importance of staff networks in creating inclusive cultures, NHS England has released guidance on developing your NHS staff network alongside the EDI plan. This toolkit provides practical guidance to help develop or create staff networks. 

The NHS must welcome all, with a culture of belonging and trust. ​We must understand, encourage and celebrate ​diversity in all its forms.  NHS People Plan 2020 

    • Every board and executive team member must have EDI objectives that are specific, measurable, achievable, relevant, and timebound (SMART) and be assessed against these as part of their annual appraisal process (by March 2024). 

    • Board members should demonstrate how organisational data and lived experience have been used to improve culture (by March 2025). 

    • NHS boards must review relevant data to establish EDI areas of concern and prioritise actions. Progress will be tracked and monitored via the Board Assurance Framework (by March 2024). 

  • NHS organisations and integrated care boards (ICBs) are to complete the following actions: 

    • Create and implement a talent management plan to improve the diversity of executive and senior leadership teams (by June 2024) and evidence progress of implementation (by June 2025) 

    • Implement a plan to widen recruitment opportunities within local communities, aligned to the NHS Long Term Workforce Plan. This should include the creation of career pathways into the NHS such as apprenticeship programmes and graduate management training schemes (by October 2024). Impact should be measured in terms of social mobility across the integrated care system (ICS) footprint.  Read case studies from a range of organisations that share good practice around embedding inclusive recruitment. 

  • NHS organisations are to complete the following actions: 

    • Implement the Mend the Gap review recommendations for medical staff and develop a plan to apply those recommendations to senior non-medical workforce (by March 2024). 

    • Analyse data to understand pay gaps by protected characteristic and put in place an improvement plan. This will be tracked and monitored by NHS boards. Plans should be in place for sex and race by 2024, disability by 2025 and other protected characteristics by 2026. This article gives more information around pay gap reporting, useful resources and some tips.

    • Implement an effective flexible working policy including advertising flexible working options on organisations’ recruitment campaigns. (March 2024) 

  • Organisations are to complete the following actions: 

    • Line managers and supervisors should have regular effective wellbeing conversations with their teams, using resources such as the national NHS health and wellbeing framework. (by October 2023).  

    • Work in partnership with community organisations, facilitated by ICBs working with NHS organisations and arm’s length bodies, such as the NHS Race and Health Observatory. For example, local educational and voluntary sector partners can support social mobility and improve employment opportunities across healthcare (by April 2025). This NHS Confederation page has guidance and tools for tackling health inequalities

  • NHS organisations should complete the following actions: 

    • Before they join, ensure international recruits receive clear communication, guidance and support around their conditions of employment; including clear guidance on latest Home Office immigration policy, conditions for accompanying family members, financial commitment and future career options (by March 2024). 

    • Create comprehensive onboarding programmes for international recruits, drawing on best practice. The effectiveness of the welcome, pastoral support and induction can be measured rom, for example, turnover, staff survey results and cohort feedback (by March 2024). 

    • Line managers and teams who welcome international recruits must maintain their own cultural awareness to create inclusive team cultures that embed psychological safety (by March 2024). 

    • Give international recruits access to the same development opportunities as the wider workforce. Line managers must proactively support their teams, particularly international staff, to access training and development opportunities. They should ensure that personal development plans focus on fulfilling potential and opportunities for career progression (by March 2024). 

  • NHS organisations are to complete the following actions: 

    • Review data by protected characteristic on bullying, harassment, discrimination and violence. Reduction targets must be set (by March 2024) and plans implemented to improve staff experience year-on-year.

      Read our articles on the Workforce Race Equality Standard (WRES) and the Workforce Disability Equality Standard (WDES) to learn about two important measures of this experience and how action can be taken to improve it.

    • Review disciplinary and employee relations processes. This may involve obtaining insights on themes and trends from trust solicitors. There should be assurances that all staff who enter into formal processes are treated with compassion, equity and fairness, irrespective of any protected characteristics. Where the data shows inconsistency in approach, immediate steps must be taken to improve this (by March 2024). 

    • Ensure safe and effective policies and processes are in place to support staff affected by domestic abuse and sexual violence (DASV). Support should be available for those who need it, and staff should know how to access it (by June 2024) 

    • Create an environment where staff feel able to speak up and raise concerns, with steady year-on-year improvements. Boards should review this by protected characteristic and take steps to ensure parity for all staff (by March 2024).

      Read our top tips for supporting the psychological safety of staff and advice on how to embed a healthy speaking up culture to understand how you can do this.  

    • Provide comprehensive psychological support for all individuals who report that they have been a victim of bullying, harassment, discrimination or violence (by March 2024). 

    • Have mechanisms to ensure staff who raise concerns are protected by their organisation.