Both NHS Employers and The Royal College of Nursing say that the fight against the catastrophic rise in racism must go beyond tick-boxing and superficial compliance

Dean Royles, interim chief executive of NHS Employers, has urged HR leaders to prioritise education around different forms of prejudice, to move beyond “superficial compliance”. He was writing after the government laid out a plan to fight against antisemitism and other forms of racism in the NHS.

A rapid review by John Mann, Baron Mann, the government’s independent advisor on antisemitism, found in November that the current system is “too slow and cumbersome” to tackle racism.

Royles, in a post on the NHS Employers website, laid out how chief people officers (CPOs) can play their part in protecting patients and staff against such discrimination.

He said: “Hesitation, or any suggestion that some racism is more acceptable than others, risks normalising behaviour that damages staff wellbeing, patient care, and public trust.”

HR executives should advise boards to issue clear zero-tolerance statements that name antisemitism, Islamophobia and racism explicitly, staying clear of “vague language” that can obscure specific prejudices, Royles said.

He also argued that effective reporting routes need to be in place for staff experiencing racism, with protection from retaliation and access to wellbeing support.

Speaking about a “deeper cultural change”, the interim chief executive said: “Mandatory training is important, but it must move beyond tick-box exercises. Effective education addresses the distinct drivers and expressions of different prejudices while reinforcing shared NHS values. Great chief people officers champion evidence-based approaches that build genuine understanding rather than superficial compliance.”

Following Mann’s initial recommendations, published in March, Wes Streeting, the then health secretary, announced reforms to the General Medical Council (GMC) to ensure doctors who use “intolerably racist and antisemitic language” are struck off from the medical register.

Mann called for the GMC to receive greater powers to challenge the rulings of the Medical Practitioners Tribunal Service, which decides whether doctors should be suspended or not.

Rise in racism

The scale of the problem should not be underestimated. Freedom of Information (FOI) requests made by the Royal College of Nursing to NHS trusts and health boards across the UK show a 78% increase in the number of reports of racism by nursing staff in the past four years.

In 2025, nursing staff reported 6,812 incidents of racial abuse while working in NHS trusts and health boards across the UK, rising from 3,652 in 2022. Racist incidents became so frequent last year that a member of nursing staff was reporting a new case of racist abuse every 77 minutes across the UK.

“These findings show a catastrophic rise in the racist abuse faced by nursing staff. It is a disgrace, and perhaps just as bad is the fact that many NHS trusts and health boards cannot even tell us how many staff have been on the receiving end. It amounts to a policy of ‘don’t know, don’t care’,” said the College’s general secretary and chief executive Nicola Ranger.

The Royal College is calling on NHS trusts and health boards to develop far more comprehensive protocols on what action will be taken upon receiving reports of racial abuse. From October, under the Employment Rights Act 2025, NHS trusts will be liable for harassment of their own staff by patients or their families, unless they have taken all reasonable steps to prevent it from happening.

It is also urging health leaders and governments across the UK to deliver standardised and streamlined incident reporting across NHS employers, recording staff role, work area and ethnicity of the person reporting the racist abuse. “This would allow NHS trusts to spot patterns, areas of risk and implement prevention measures to stop future cases,” the College said in a statement.