Date Published: 19 August 2006

Healthcare watchdog puts NHS trusts on notice over compliance with race relations law

The Healthcare Commission warns that it suspects the NHS of widespread non-compliance with legislation on race relations designed to promote equality. It will release the results of an audit suggesting most trusts have not met responsibilities to publish information under the Race Relations (Amendment) Act 2000.

Inspectors spent 30 minutes scanning each website of all 570 NHS trusts, looking for information that legislation has required public bodies to publish since May 2002.

In that half an hour, they could only find this information the websites of seven NHS trusts, around one per cent of the total.

As part of a duty to promote race equality, all NHS trusts should publish:

  • a race equality scheme and action plan setting out how the organisation will make race equality central to all its functions, reviewed every three years
  • annual employment monitoring statistics showing the ethnic profile of the workforce, including access to training and promotion, as well as numbers of job applicants and short-listed candidates
  • the outcome of race equality impact assessments demonstrating what action has been taken to address any adverse impact of an organisation's policies.

In the time allowed under the audit, Commission inspectors could find:

  • none of the information required on 31% of trust websites
  • an updated race equality scheme on 60% of trust websites
  • employment monitoring statistics on 6% of trust websites
  • race equality impact assessments on 2% of trust websites

The Commission stresses that the audit is not a definitive test of compliance, but says the findings do suggest a significant problem with the number of trusts meeting statutory codes of practice.

As a result, the inspectorate has this week written to NHS trusts urging them to check they meet their legal responsibilities. It plans to identify the apparent worst offenders and warn them that unless they demonstrate action they risk taking a hit in the annual performance ratings.

It has also passed the findings to the Commission for Racial Equality, which has powers to warn and prosecute organisations that fail to comply.

Jamie Rentoul, the Healthcare Commission's Head of Strategy, said:

" It is not unreasonable to expect legislation to take a little time to bed in. But we were surprised and disappointed by the apparent extent of the problem at this stage.

_ Trusts should take this seriously because NHS services have not always found it easy to reach all sections of the community. They employ a particularly large and diverse section of the workforce so it is important they demonstrate what they are doing.

_ This is why we are putting trusts on notice that they must put their houses in order. If they fail to do so then we, and the CRE, will have to take action. The duty to promote race equality is not an optional extra."

The Race Relations Act 2000 was part of the response to the public inquiry into the murder of Stephen Lawrence. The law instructs public sector bodies to actively seek to reduce inequalities between races, both in service provision and employment.

The NHS has long recognized that people from ethnic minority groups have poorer access to services and outcomes from treatment. The Commission's surveys of patients show these groups are more likely to be negative about their healthcare.

The inspectorate points out that the NHS is the biggest employer in the world with 1.4 million workers. It says that a relatively large number of these - almost 40% - are from black and minority ethnic groups.

Inspectors found a race equality scheme at 73% of trusts in the southeast, compared with 54% in the central region, 55% in the north and 63% in the southwest.

They found a race equality scheme most easily on the websites of primary care trusts followed by mental health, ambulance and learning disability trusts. They found a race equality scheme on the websites of fewer than half of acute hospital trusts.

Surinder Sharma, the National Director for Equality and Human Rights, said:

" The Department of Health takes these findings very seriously. All NHS organisations must ensure that they are fully compliant with the Race Relations Act and publicly set out how they are meeting their responsibilities.

_ Whilst the Healthcare Commission's audit is not a definitive test of co-operation, it does point to serious issues of concern. I am personally looking to every NHS Trust to give immediate attention to remedying this situation, not just to comply with legislation, but also because race equality remains a core element of our drive to improve access to healthcare, combat health inequalities and develop a diverse workforce."

The Department of Health says it will notify all NHS chief executives of the importance of responding to these findings in a prompt professional manner, and will be issuing new equality guidance to non-executive directors of NHS boards.

Source: The Healthcare Commission (England, UK),
formerly at - website no-longer live.

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