This is a practical guide to support NHS trust board members to address health inequalities as part of their core business. It outlines why trusts should act on health inequalities, includes a vision for what good looks like, a self-assessment tool for trusts to use to determine where they are in their journey and a list of suggested objectives for board members. It covers a wide range of trust work, from operational and clinical delivery of services, to the trust’s role as an anchor institution and as an employer of NHS staff. The suggested objectives are drawn from NHS England (NHSE) policy, guidance, and good practice from the sector.

This guide is specifically designed for NHS trusts and does not cover the roles and responsibilities for addressing health inequalities at the wider system level. We recognise that tackling health inequalities often requires system-level solutions, by working in partnership with local authorities, integrated care systems (ICSs) and voluntary, community and social enterprise (VCSE) sector organisations. Collaborative working needs to be embedded across the work of NHS trusts to deliver on this agenda. Commissioners could also make use of the guide within planning discussions and are encouraged to share it with colleagues in trusts and wider systems.