The NHS is often described as the backbone of Britain: a vast, complex workforce that embodies the nation’s commitment to universal healthcare. Yet, beneath this proud image lies a persistent truth: not all NHS staff are treated equally when it comes to pay and career progression.
An ambitious 18-month review, led by the University of Surrey and commissioned by the NHS Race and Health Observatory, aims to confront this head-on. Running until December 2026, the review will examine disparities in earnings, promotion opportunities, pension contributions, and overall career trajectories for staff from different ethnic backgrounds.
It is work that could not be more urgent. Nearly one in three NHS staff come from Black, Asian, or minority ethnic backgrounds, yet research shows they are still less likely to secure higher-paid roles, even when shortlisted. Career progression, when it happens, is often slower. This is not simply a matter of perception, it’s an entrenched inequality backed by data.
Professor Carol Woodhams, co-leading the review alongside colleagues Dr Nicola Burton-Brown and Professor Giuseppe Moscelli, has spent years studying workplace pay gaps. She describes this project as “a chance to uncover the root causes of ethnic disparities in NHS pay and progression, and to help drive meaningful, evidence-based change.”
The involvement of leadership and inclusion consultancy Delta reflects a recognition that solutions must be both evidence-based and practically implementable. As Owen Chinembiri from the NHS Race and Health Observatory points out, progress so far has been “slow, patchy and frustrating” for staff affected by these inequalities. That frustration is more than personal. It erodes morale and drives talent away from a system already struggling to retain skilled professionals.
Trade unions have echoed this urgency. UNISON’s Helga Pile has warned that without understanding and addressing the root causes, “wiping out disadvantage” will remain out of reach. NHS Employers’ chief executive Danny Mortimer has gone further, linking equity directly to the quality of patient care: “The delivery of a better NHS and a healthier nation requires the best use of all the talents in our workforce.”
What’s striking is that ethnic pay gap reporting in the NHS is still not mandatory. Some trusts have voluntarily embraced transparency, but national accountability remains absent. This review could be the catalyst for change, if leaders are willing to implement its recommendations and confront the uncomfortable truths it will almost certainly reveal.
The stakes are clear: a fairer, more equitable NHS is not just about justice for its staff; it’s about building a stronger, more resilient health service for the millions who depend on it every day. When the final report arrives in 2026, the test will not be in the data it reveals, but in whether the system acts decisively to close the gaps it exposes.
Because equality in the NHS workforce is not a ‘nice-to-have.’ It is, quite simply, essential.
