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Evidence-based approach to understanding and addressing health inequality
Evidence-based approach to understanding and addressing health inequality
Purpose of the Ethnicity & Health Unit
Purpose of the Ethnicity & Health Unit
Meet the Team
Meet the Team
The Ethnicity and Health Unit was formed at NIHR ARC NWL and Imperial College London in 2021 to address challenges and act as a beacon of real-life change, with the vision of advancing health equality for ethnically diverse communities through cutting-edge research.
Working with our local network of community-facing organisations that support people from ethnically diverse backgrounds, we aim to generate new research findings leading to real-world health improvements for people from ethnically diverse backgrounds.
We exist to apply an evidence-based approach to addressing health inequality
We exist to apply an evidence-based approach to addressing health inequality
Why is it important?
Health inequality is a complex and pressing public health challenge.
The COVID-19 pandemic has thrown into even sharper focus the health inequalities affecting the UK’s ethnic minority communities. These issues existed previously but the pandemic has exacerbated and highlighted them. A similar story emerges around common health conditions such as cardiovascular disease and diabetes.
Much more evidence is required to fully understand and address these inequalities. We employ the best research design and methodology to enhance the scientific evidence which can inform policy, practice, and decision-making for a more equal world.
What do we hope to achieve?
What do we hope to achieve?
To convene a community of researchers focused on understanding health issues relevant to ethnic minority communities.
To create opportunities for ethnically diverse individuals to progress in academia and education through scholarships and mentoring.
To produce data and intelligence to enhance the evidence base on health inequalities in ethnic minority communities.
To support policy, practice and strategy which would enable equity in health and healthcare across ethnic minority communities.
What is the benefit?
What is the benefit?
Reduce variation in quality of care received
Improve access to the NHS services
Improve care experience, quality of life
Promote equality
Working with NHS England
Working with NHS England
The publication of the Medical Workforce Race Equality Standard report in 2021 identified the racial disparity experienced by BME doctors in terms of recruitment, promotion, pay, experience of bullying and harassment, and representation in senior positions. This was especially evident for international medical graduates and specialty and associate specialist doctors.
The NHS England Medical Workforce Race Equality Standard will focus on five domains:
To reduce disproportionality of entry into local disciplinary processes and referrals to the GMC for BME and international medical graduate (IMG) doctors.
To improve diversity in senior medical leadership appointments.
To increase BME representation amongst the Councils of Royal Colleges to proportionately reflect their memberships.
To ensure there are meaningful local arrangements for initial and ongoing support for IMG doctors.
To support SAS doctors to make progress in leadership roles and by review of the contract.
The International Medical Graduates NHS Induction Programme is included in the NHSE plan of five actions within Medical Workforce Race Equality Standard under Domain 4. NIHR ARC Northwest London and the Ethnicity and Health unit lead the development and launch of the International Medical Graduates NHS Induction Programme including the assessment of the IMG Induction Pilot which informed the programme. This evaluation confirmed the benefits of the induction in the early settling down phase as well as confirming its effectiveness.
You can view a copy of the Medical Workforce Race Equality Standard and a copy of the Assessment the IMG Induction Pilot Report below.
MWRES The First Five 2023.pdfAssessing the IMG Induction Pilot Report 31 December 2022.docxThe Medical Workforce Race Equality Standard Five Years On
The Medical Workforce Race Equality Standard Five Years On
MWRES_Digital_2025.pdfThe Medical Workforce Race Equality Standard (MWRES) and its indicators were first published by NHS England in 2020 , followed by the full data report in July 2021 . Using data available in 2020 and collected by NHS England and a number of its partner organisations, the report was the world’s first to document differences in the experience of White and Black and minority ethnic (BME) medical staff at a national level. Five years on, these data have been revisited.
The Standard had 11 indicators and was developed by a working group drawn from across NHS England and other institutions with influence over medical careers. The indicators included dimensions ranging from training opportunities and career progression to complaints, treatment by patients and employers, and representation in leadership roles. The majority of the indicators were based on routinely collected data, to facilitate their publication annually and ensure action to address inequalities exposed by the data.
Building on the inaugural MWRES, an action plan entitled ‘Medical Workforce Race Equality Standard - A commitment to collaborate; the First Five’ was launched in February 2023 . The plan focused on five specific areas of improvement and co-designed by representatives from key health sector organisations, including NHS England, Health Education England (reorganised into NHS England Workforce Training & Education), NHS Employers, General Medical Council (GMC), British Medical Association, NHS Resolution, Academy of Medical Royal Colleges, and NHS Employers.
The intention was to commit the full range of national organisations to a united programme of action.
The purpose of this report
The purpose of this report
The MWRES data report stated that the intention was to publish the indicators on an annual basis, with a view to monitoring change and developing and modifying interventions as the learning grows in terms of actions most effective in addressing inequalities. However, contrary to expectation, no further updates have been published by NHS England.
Meanwhile, programmes of work have been developed to close the racial/ethnic gaps highlighted by the 2021 report. Medical staff, managers and leaders in national institutions as well as in NHS Trusts and in other organisations in NHS England are investing time and resources, often in the face of significant clinical workloads, to implement these programmes . Five years on, there is a strong imperative to assess whether the 11 indicators demonstrate an improvement. There is a need to assess whether interventions designed to eliminate discrimination and disadvantage have been effective or whether they require refinement.
This unfunded and independent report, launched 8th September 2025, entitled MWRES Five Years On, aims to fill this lacuna. In the absence of any funding or formal authority to commission or request data extraction or analysis, the information presented is limited mainly to that which has been published by NHS England, the GMC, Medical Schools Council and other organisations.
Despite this limitation, this report offers the first cohesive update of progress since the publication of the MWRES 2020 data report. Each MWRES Indicator is listed, together with the corresponding action plan domain in ‘Commitment to Collaborate’, where appropriate, Table 1. Data published in the MWRES 2020 data report and more recent data, if available, are shown for each indicator to illustrate change. The report concludes with recommendations for action.
Ethnicity and Health Unit News and Events
Ethnicity and Health Unit News and Events
Publications and Relevant Documents
Publications and Relevant Documents
Ethnicity and Health, Postnote, Parliamentary Office Science and Technology, UK Parliament: https://www.parliament.uk/globalassets/documents/post/postpn276.pdf
Medical Workforce Race Equality Standard (MWRES) WRES indicators for the medical workforce 2020:
https://www.england.nhs.uk/wp-content/uploads/2021/07/MWRES-DIGITAL-2020_FINAL.pdf
London Workforce Race Strategy Race equality. A better NHS for us all. Executive Summary: https://mcusercontent.com/ec5dea9536bde16d5a3153530/files/697d8cc5-cf5d-479f-ab8f-73567888b16d/LWRSES.pdf
Now is the time for radical action on racial health inequalities:
DOI: https://doi.org/10.1136/bmj.o424
Equality and diversity in health governance systems: are we getting it right and are there lessons from COVID-19?
DOI: https//doi.org/10.4997/JRCPE.2021.421
Re-thinking the inclusion of race in British hypertension guidance:
https://doi.org/10.1038/s41371-021-00601-9
Now is the time for radical action on racial health inequalities:
DOI: https://doi.org/10.1136/bmj.o424
Tackling racism in UK health research:
DOI: https://doi.org/10.1136/bmj-2021-065574
Racial and ethnic health disparities in healthcare settings:
DOI: https://doi.org/10.1136/bmj.n605
Playing hide and seek with structural racism:
DOI: https://doi.org/10.1136/bmj.n988
'We weren't checked in on, nobody spoke to us': An exploratory qualitative analysis of two focus groups on the concerns of ethnic minority NHS staff during COVID-19:
DOI: http://dx.doi.org/10.1136/bmjopen-2021-053396
Bereavement care for ethnic minority communities: A systematic review of access to, models of, outcomes from, and satisfaction with, service provision:
DOI: https://doi.org/10.1371/journal.pone.0252188
External Links
External Links
The Centre for Ethnic Health Research - NIHR ARC East Midlands
Promoting equality, diversity and inclusion in research - nihr.ac.uk
Blog: Race equity in health research: Good for the public and the workforce by Prof. Mala Roa - nihr.ac.uk
Blogs by Dr Bola Owolabi, Director, Health Inequalities at NHS England and NHS Improvement
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