This research report examines whether NHS Boards in Scotland are meeting their legal duties under the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012 to publish equality-related reports in a manner accessible to the public. Despite the legislative aim of fostering transparency, accountability, and public engagement, the findings reveal widespread shortcomings. The bulk of Scotland’s NHS Boards do not systematically collect or report data on whether the public accesses downloads of the key reports—such as Mainstreaming Equality, Gender Pay Gap, and Workforce Monitoring reports—and all of them had no records of requests for paper or alternative formats of the reports. Where data was provided, the number of downloads was strikingly low and highly concentrated in a small number of Boards, suggesting minimal public reach.
The study concludes that accountability is largely illusory: NHS Boards fail to promote their reports to the public, websites are difficult to navigate, and there are no linked and traceable mechanisms to encourage feedback, challenge, or dialogue and construct a virtuous circle to the accountability concept inherent in the legislation. This culture of passive compliance undermines the original policy objectives of the Equality Act 2010 (Specific Duties) (Scotland) Regulations 2012, leaving both Boards and the Scottish Government open to criticism for failing to demonstrate leadership or embed accessibility and accountability.
To address these failures, the report recommends systemic reforms, including the creation of a centralised, Audit Scotland–hosted database of all equality reports published by the public sector; automatic compliance monitoring for the Equality & Human Rights Commission; mandatory Plain English standards; and requirements for Boards to actively promote their reports, track readership, and respond to public feedback. Without such measures, Scotland’s NHS cannot credibly claim to be accountable to the communities it serves in advancing equality.