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NHS workforce race and disability equality standard - 2024

26 June 2025

This briefing outlines the workforce race equality standard (WRES) and the workforce disability equality standard (WDES) reports’ key findings and NHS Providers’ view.

  • Workforce

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On 25 June 2025, NHS England (NHSE) published the annual Workforce Race Equality Standard (WRES) and the Workforce Disability Equality Standard (WDES) data reports. These reports continue to support trusts’ work to achieve the goals of NHSE’s 2023 equality, diversity and inclusion improvement plan

With changes underway at NHS England and DHSC, it is vital that this data continues to be collected and published so that trusts can continue to make much needed and long overdue progress to support their ethnic minority and disabled staff.

We remain of the view that it would be useful for national WRES and WDES reports to be published closer to the period of data collection to allow alignment with the latest NHS Staff Survey results and to maximise the breadth of data available to trusts and other stakeholders as they work to tackle inequities experienced by their staff. 

In March, NHSE published the results of the NHS Staff Survey 2024. The WRES and WDES reports draw largely on staff survey data from 2023, so where possible, we have included the more recent 2024 staff survey data in this briefing. 

This briefing outlines the WRES and WDES reports’ key findings and NHS Providers’ view. If you have any questions about this briefing, please email Sarah White, senior policy manager (workforce) at Sarah.White@nhsproviders.org.

WRES: 2024 data report

Key findings

  • The overall percentage of ethnic minority staff [1] across the NHS workforce has increased year-on-year and now stands at 28.6% in 2024 (26.4% in 2023; 17.7% in 2016).
  • The number of very senior managers in the NHS from an ethnic minority background has increased by 85% since 2018, from 201 to 372.
  • At board level, the percentage of ethnic minority staff has also increased year-on-year, with 11.8% of staff from an ethnic minority, compared to 10.8% in 2023 and 5.4% in 2016. However, the report notes for the third consecutive year that increasing diversity in the overall workforce has resulted in the mean gap between overall workforce and board diversity increasing, particularly among executives (increase from 14.5% to 16.8%).
  • It is concerning that white applicants remain “significantly” more likely than ethnic minority applicants to be appointed from shortlisting at 80% of trusts (up from 76% last year). The national likelihood ratio has remained broadly unchanged since the inception of the WRES in 2016, meaning that this metric is proving the most difficult to change.
  • The relative likelihood of ethnic minority staff entering the formal disciplinary process compared to white staff has increased to 1.09 compared to 1.03 in 2023, and 1.14 in 2022.  It is disappointing to see this increase following a period of improvement.
  • It is concerning to see that abuse, bullying and harassment from patients remains high, alongside the continued gap in experience of these behaviours between ethnic minority and white staff.
  • The percentage of ethnic minority staff experiencing harassment, bullying or abuse from staff decreased to 24.9% in 2023 (from 27.7% in 2022). This compares to 20.7% of white staff experiencing the same. There is a key role for trust leaders in ensuring that this metric continues to improve.

[1]  The WRES report uses the term “Black and minority ethnic” to describe ethnic minority staff. However, this briefing will not use this term, the acronym “BME”, or “BAME”. Instead, NHS Providers uses the full description “Black, Asian and minority ethnic” or “ethnic minority” as preferred descriptions to denote the same aggregation where disaggregation into more appropriate, distinct categorisations of ethnicity is not possible.

Representation

The overall percentage of ethnic minority staff across the NHS workforce has increased year-on-year and now stands at 28.6% in 2024. This is an 84.4% increase since 2018, compared to an 8.1% increase in white staff across the same period. At VSM level, the percentage of ethnic minority staff has also increased year-on-year, with 12.7% of VSMs now from an ethnic minority, compared to 11.2% in 2023 and 5.4% in 2016. However, there is a non-disclosure rate of 4.8% among VSMs, regarding ethnicity.

By region, London is again the most diverse with 53.9% of the workforce from an ethnic minority (52.1% in 2023) compared to the South West, again the lowest, with 17.3% of staff from an ethnic minority (15.0% in 2023). When considered by Agenda for Change (AfC) band, band 5 continues to see the highest percentage of staff from an ethnic minority (42.3%, compared to 38.5% in 2023), while band 9 (12%) again sees the lowest. Ethnic minority staff at VSM level represent 11.2% of the workforce (10.3% in 2022).

Band 6 remains the most diverse AfC band for non-clinical staff, with 20.9% of staff from an ethnic minority (19.8% in 2023). In clinical roles, band 5 (the base grade for registered nurses) remains the most diverse band, with 45.7% of staff from an ethnic minority background (41.6% in 2023). Overall ethnic minority representation among doctors is 48.7% (46.8% in 2023). This is highest in non-consultant specialist grades at 64.3%, falling to 41.0% amongst consultants, and falling further to 44.6% among senior medical managers.

Indicator 9 looks at representation at board level and shows an increase in overall board diversity at a national level – 16.5%, up from 15.6% in 2023 and 7.1% in 2016). It is worth noting that this compares to 28.6% of staff across the whole NHS workforce being from ethnic minority groups, but there are welcome findings that the number of very senior managers in the NHS from an ethnic minority background has increased by 85% since 2018, from 201 to 372.

Executive board member diversity has increased to 11.8%, compared to 10.8% in 2023 – though this is lower than the current 21.1% for non-executive directors. While there has been an increase in the diversity of board members, the report again notes that increasing diversity in the overall workforce has resulted in the mean gap between overall workforce and board diversity increasing, particularly among executives (increase from 14.5% to 16.8%). 

 

NHSE EDI improvement plan

High Impact Action (HIA) 2 calls for trusts and NHS organisations to embed fair and inclusive recruitment processes and talent management strategies, targeted at under-represented groups. A success metric for this HIA is year-on-year improvement on WRES indicators 1 and 9, which has been achieved since 2016.

Equal opportunity and recruitment

Indicator 2 considers the relative likelihood of white applicants being appointed from shortlisting compared to ethnic minority applicants. It shows that white staff are “significantly” more likely to be appointed than ethnic minority candidates in 80% of trusts nationally – a worsening position compared to 76% last year and 71% in 2022.

However, by region, there have been year on year improvements in London, year on year deterioration in the Midlands, and sharp deterioration in the North West. The national relative likelihood has remained broadly unchanged since the inception of the WRES in 2016, meaning that this metric is proving the most difficult to improve on.

 

NHSE EDI improvement plan

High Impact Action (HIA) 2 calls for trusts and NHS organisations to embed fair and inclusive recruitment processes and talent management strategies, targeted at under-represented groups. A success metric for this HIA is year-on-year improvement on WRES indicator 2. The metric has been broadly unchanged since 2016, meaning little progress nationally.

Indicator 3 examines the relative likelihood of ethnic minority staff entering the formal disciplinary process compared to white staff, which increased to 1.09 compared to 1.03 in 2023, and 1.14 in 2022.  It is disappointing to see this increase following a period of improvement.

Just over half (51%) of trusts reported ethnic minority staff were over 1.25 times more likely than white staff to enter the formal disciplinary process, an increase on 46% saying the same last year. London continues to be the worst performing region on this indicator.

Indicator 7 considers the percentage of staff who believe their organisation provides access to equal opportunities for career progression or promotion.

Using 2024 NHS Staff Survey data, 49.5% of ethnic minority staff agreed (an increase from 48.9% last year), compared to 58.9.% of white staff. This compares to 44.0% of ethnic minority staff and 59.6% of white staff in 2020.

Discrimination and harassment

Indicators 5, 6 and 8 utilise data from the 2023 NHS staff survey data published in 2024. NHSE recently published 2024 data on 13 March 2025. Our briefing on these results is available here and we have utilised 2024 data where possible.  

Experiences of harassment, bullying or abuse from patients, their relatives or the public are measured in Indicator 5. In 2024, ethnic minority staff remain more likely to experience harassment, bullying or abuse from patients, their families and the public (28.6%), compared to their white colleagues (23.5%). This represents a gap of 5.1 percentage points and this has widened compared to 2023 (3.6 percentage points.

This is also the case regarding these behaviours from a manager, with 10.1% of ethnic minority staff reporting experience of bulling, abuse or harassment (10.8% in 2023), compared to 9% of their white colleagues (9.4% in 2023). 

The WRES report includes breakdowns by gender and role, and data from 2023 shows that women (25.1%) and men (24.2%) were similarly likely to have experienced these behaviours, though in 2022 women were slightly more likely to. Men (41.2%) and – for the second consecutive year – women (37.7%) from a White Gypsy or Irish Traveller background experienced the highest levels these behaviours.

Indicator 6 shows the percentage of ethnic minority staff experiencing harassment, bullying or abuse from staff decreased to 24.9% in 2023 (from 27.7% in 2022). This compares to 20.7% of white staff experiencing the same. We hope that this metric continues to improve, as almost a quarter of ethnic minority staff experiencing these behaviours from colleagues is unacceptable.

Using 2024 NHS Staff Survey data, the percentage of staff experiencing discrimination from a manager, team leader or other colleague (Indicator 8) has increased to 9.2% - the highest level since 2020. Figures remain highest among ethnic minority staff. According to the survey, the gap in experiences of discrimination between ethnic minority and white staff from patients, their families and the general public has grown compared to last year.

NHS Providers view 

As with previous national WRES reports, it is positive to see improvements on some metrics this year, but it remains clear that there is much to be done to improve the experience of ethnic minority staff in the NHS.

Over a quarter of ethnic minority staff continue to experience bullying, abuse and harassment at work. White Gypsy or Irish Traveller staff experienced the highest levels of harassment, bullying or abuse, which requires targeted intervention to address.

Ethnic diversity among senior NHS managers has increased significantly since the inception of WRES in 2016. This is welcome, but it must be noted that this increase has, once again, not kept pace with the overall diversity of the NHS workforce.

80% of trusts reported that white applicants were significantly more likely than ethnic minority candidates to be appointed from shortlisting. The national likelihood of white vs ethnic minority staff being appointed from shortlisting has remained broadly unchanged since the inception of the WRES in 2016, meaning that this metric is proving the most difficult to improve on. Sustained focus is now needed on providing equal opportunities for career progression and promotion for staff from ethnic minority backgrounds.

The relative likelihood of ethnic minority staff entering the formal disciplinary process compared to white staff has increased compared to 2023.  It is disappointing to see this increase following a period of improvement.

Our race equality programme has published a wide range of resources to help trusts tackle racial disparity and inequality, aligned with the ambitions of the EDI improvement plan. Most recent examples include: 

  • Insights on accountability and action for board members in leading EDI transformation.
  • A peer learning event on data-driven approaches to tackling workforce inequalities.
  • A guide on understanding organisational ethnicity pay gaps, co-produced with leading healthcare law firm, Hempsons.

View details of our upcoming events.

WDES: 2024 data report

Key findings

  • The percentage of NHS staff declaring a disability via ESR has increased to 5.7% in 2024, and 25.2% of staff now identify as disabled through the anonymous NHS Staff Survey (2024). Despite progress, the significant gap between ESR and survey data remains a concern.
  • Disabled representation on NHS trust boards has grown, with 6.5% of board members declaring a disability—exceeding workforce levels. Non-executive board members (6.8%) are more likely to declare a disability than executive members (6.2%).
  • Nationally, disabled and non-disabled applicants are equally likely to be appointed after shortlisting, suggesting improvements in inclusive hiring practices.
  • Disabled staff remain more than twice as likely to enter a formal capability process than non-disabled staff.
  • Disabled staff consistently report higher levels of harassment and abuse from patients, service users, and the public compared to non-disabled staff. This pattern has not improved over time and remains broadly unchanged from 2023.
  • Bullying among staff or by managers has continued to decrease year-on-year. However, disabled staff are still more likely than their non-disabled colleagues to experience this behaviour. Positively, disabled and non-disabled staff are increasingly likely to report harassment or abuse when it takes place.
  • Progression and career development opportunities for disabled staff have deteriorated for disabled staff, with a lower percentage of disabled staff (51.5%) than non-disabled staff (58.1%) reporting that their trust acts fairly regarding career progression or promotion.
  • Fewer disabled staff now feel pressured to work when unwell, but they still experience this more often than their non-disabled peers. This is referred to as ‘presenteeism’ in the report and has reached its lowest level in six years.
  • Concerningly, over a third (36.3%) of disabled staff report feeling that their work is valued compared to 47.4% of non-disabled staff. 

Visibility and representation 

  • The overall percentage of NHS staff declaring a disability via ESR has risen to 5.7% in 2024, up from 3.1% in 2019. While this represents positive progress, a significant gap remains between the proportion of staff reporting a disability to their employer via ESR and those identifying as disabled in the anonymous NHS staff survey, which stood at 25.2% in 2024 – a difference of 19.5 percentage points.
  • Disability declaration rates in senior non-clinical roles have improved, rising from 2.2% in 2019 to 5.1% in 2024. However, this growth has largely mirrored the increase in the wider non-clinical workforce, where declarations rose from 3.6% to 6.7% over the same period. As a result, the representation gap at senior levels remains relatively unchanged and currently stands at -1.6%.
  • Disability representation at each AfC pay band was highest at band 3 and lowest at band 9, with no consistent pattern across pay bands. Despite slight increases in disability declaration at senior levels (band 8c to VSM), the gap between senior disabled representation and the overall non-clinical workforce has remained relatively steady. Non-disabled staff consistently outnumber disabled staff at every pay band.
  • Disability declaration is notably lower in medical roles, at 2.4% overall, with little variation by seniority level. The proportion of medical staff with an unknown disability status is 21%, which is higher than other staff groups. Disabled doctors are underrepresented compared to other staff groups.
  • This WDES report also highlights that the percentage of staff with an ‘unknown’ disability status in ESR has decreased to 14.3% in 2024, down from 25.4% in 2019, adding uncertainty to true representation levels.

Metric 10 considers board representation, with the data showing a larger percentage of board members identifying as disabled (6.5%) compared to the overall workforce (5.7%). Disabled board members are more likely to be non-executive directors (6.8%) than executive directors (6.2%).

The report notes a representation gap between board members and overall workforce disability (1.1 percentage points for non-executives and 0.5 percentage points for executives). While this indicates some progress in board-level inclusion, disability representation across the wider workforce still needs improvement. 

 

NHSE EDI improvement plan

High Impact Action (HIA) 2 calls for trusts and NHS organisations to embed fair and inclusive recruitment processes and talent management strategies, targeted at under-represented groups. A success metric for this HIA is year-on-year improvement on WDES indicators 1 and 10, which has been achieved since 2019.

Recruitment, progression and development

Metric 2 looks at the relative likelihood of a disabled applicant being appointed from shortlisting compared to a non-disabled applicant.

On average, there is no statistically significant difference between appointment rates for disabled and non-disabled candidates, with the relative likelihood having fallen from 1.18 in 2019 to 0.98 in 2024.

 

NHSE EDI improvement plan

High Impact Action (HIA) 2 calls for trusts and NHS organisations to embed fair and inclusive recruitment processes and talent management strategies, targeted at under-represented groups. A success metric for this HIA is year-on-year improvement on WDES indicator 2. This has been achieved between 2023 and 2024 and will need to be maintained in the years ahead.

Metric 3 looks at the relative likelihood of disabled staff entering a formal capability process compared to non-disabled staff. Disabled staff remain over twice as likely to enter a formal capability process compared to non-disabled staff. This disparity has widened over time, increasing from a ratio of 1.53 in 2020 to 2.04 in 2024, although there has been a slight improvement from 2.17 in 2023.

Metric 5 considers the percentage of disabled staff who feel their organisation provides equal opportunities for career progression or promotion.

Data from the NHS Staff Survey 2024 shows that just over half (51.5%) of disabled staff believe that their organisation acts fairly regarding promotion opportunities and career progression, down slightly from 52.2% in 2023. Only 36.3% of disabled staff feel valued for their work, compared to 47.4% of non-disabled staff, reflecting a gap of 11.1 percentage points.

Metric 8 looks at the percentage of disabled staff reporting their employer has made adequate reasonable adjustments. The proportion of disabled staff who report gaining the adjustments they need has increased from 74.5% in 2023 to 75.1% in 2024, showing modest progress.

That said, there is still some way to go to ensure that all disabled staff receive the adjustments they need to carry out their work. Across the regions, this ranged from 78.1% in the South West to 69.7% in London.

Bullying, harassment and abuse 

The WDES report draws on data from the 2023 NHS Staff Survey to highlight rates of harassment, bullying, and abuse experienced by disabled staff from patients, service users, and the public (metric 4a).

According to more recent 2024 data, 29.5% of disabled staff reported such experiences, compared to 23.3% of non-disabled staff. This gap has been a consistent finding in WDES reporting since 2019 and the 2024 data remains relatively unchanged compared to 2023.

Encouragingly, the overall level of reported harassment, bullying, or abuse in the last year fell to its lowest point since the WDES began. However, it remains concerning that almost a third of disabled staff and nearly a quarter of non-disabled staff continue to experience abuse from patients, service users, or the public.

Metric 4b reports on harassment, bullying or abuse from managers. The proportion of disabled staff experiencing this has seen a sustained fall, from 19.4% in 2018 to 14.1% in 2024. Disabled men (16.3%) were most likely to have experienced harassment, bullying or abuse from managers in the last 12 months, with high levels also reported for disabled women (13%).

Metric 4c examines the percentage of disabled staff experiencing harassment, bullying or abuse from other colleagues compared to non-disabled staff. According to the 2024 NHS Staff Survey, while the rate among disabled staff has decreased each year since 2019 (26.4%), it remains higher at 23.6% compared to 15.3% for non-disabled staff.

This indicates that, despite some progress, rates of abuse from colleagues remain unacceptably high - particularly for disabled staff.

Metric 4d shows the percentage of staff who reported harassment, bullying or abuse on the last occasion that it happened. Disabled staff are increasingly likely to report incidences of bullying and harassment, rising to 54.4% in 2024 from 52.5% in 2023. This is 0.7 percentage points higher than their non-disabled colleagues.

Morale

Data from the 2024 NHS Staff Survey shows that just over a quarter (25.4%) of disabled staff reported experiencing presenteeism (metric 6), defined as feeling pressure from their manager to attend work despite not feeling well enough.

This represents the lowest level in six years. However, disabled staff continue to report higher rates of presenteeism compared to their non-disabled colleagues (17.7%). 

In 2024, only 36.3% of disabled staff felt satisfied with the extent to which their organisation values their work (metric 7), compared to 47.4% for non-disabled staff, highlighting that disabled staff continue to feel less recognised and valued in the workplace than their non-disabled peers. 

Metric 9a considers engagement with the NHS Staff Survey. Since 2019, engagement among disabled staff has consistently remained around 0.5 percentage points lower than non-disabled staff. In 2024, the engagement score was 6.44 for disabled staff compared to 6.99 for non-disabled staff.

NHS Providers view 

It is positive that the WDES report found disabled people are increasingly represented on NHS boards, are just as likely to be appointed to NHS jobs as non-disabled candidates, and that trusts are making reasonable adjustments to enable them to carry out their work. It is also encouraging that presenteeism has reached its lowest level in six years.

But it is deeply concerning that disabled staff are more than twice as likely to be performance managed at work and are more likely to experience bullying, harassment or abuse from managers and colleagues – despite this metric decreasing since last year’s report.

It is also concerning that career development opportunities have deteriorated for disabled staff, with 51.5% reporting that their trust acts fairly with regard to career progression or promotion, compared to 58.1% of non-disabled staff.

While disability disclosure rates on ESR are improving, at 5.7% this remains far lower than the 25.2% of staff identifying as disabled in the anonymous NHS Staff Survey (2024). Improving disclosure rates will remain a priority for trusts.

Overall, with 36.3% of disabled staff feeling that their work is valued compared to 47.4% of non-disabled staff, it is clear that the NHS must do much more to show disabled staff that they are valued.