Classification: Official
Publication reference: PRN02538

To:

• NHS chief executives

cc.

• Chief people officers
• Chief nursing officers
• Medical directors
• Communications directors
• NHS England regional directors

Dear colleagues,

Lord Mann Review

Today Lord Mann has published his review into tackling racism and antisemitism within the NHS with recommendations to support our shared goal of making our services safe for all patients, communities and colleagues.

Some of the events we see at home and abroad – not least of all the distressing events surrounding the death of Henry Nowak – can polarise opinions and harden division, going against the values that make the NHS what it is.

As the NHS, we can – and often do – create an environment where every person, patient or colleague feels treated with dignity, compassion and respect.

Today’s review demonstrates that we are not achieving that consistently and as effectively as we should be. Just like wider society, the NHS is not immune to the persistent and systemic challenges of all forms of racism (including antisemitism and Islamophobia), discrimination and inequality, and we all have much more to do.

These recommendations will help us strengthen the way we drive change, and our focus should be ensuring that we are a place of compassion, care and unity – not conflict or discrimination, every day, on every site, in every home we visit, in every shift. Achieving this requires us all to be honest about the challenges we face and take strong action to address them.

Lord Mann’s review set out a range of recommendations for NHS England, NHS organisations and leaders, the Department of Health and Social Care, as well as arm’s-length-bodies (ALBs) and regulators. Collectively, these measures aim to:

• strengthen leadership and accountability
• improve understanding and capability through training and development
• set clear expectations regarding political identifiers and inclusive practice
• improve and standardise support and protection for staff who experience racism
• improve the consistency, quality and application of data relating to racism.

As NHS England, we welcome the recommendations and we accept the recommendations for us in full. As an immediate set of actions, we will:

• sign up to the NHS Race and Health Observatory Seven Anti-Racism Principles
• set clear Staff Standards relating to experience of racism
• support NHS improvement and assurance through the NHS Oversight Framework
• strengthen accountability for racial inclusion through our appraisals
• consult on adding Jewish and Sikh to NHS protected characteristic datasets
• develop bespoke eLearning for NHS PALS and complaints handlers
• ensure all NHS boards and system leaders complete regular anti-racism training.

We also know the display of politicised badges and symbols has been a matter of debate and concern for staff and patients. We will complete engagement and publish the long-awaited national uniform guidance in short order.

Tackling all forms of racism within the NHS will require a joined-up, concerted effort at every level – we should all be acutely aware of the racial abuse and harassment our colleagues and patients are subject to. Our own staff surveys give clear voice to some of the unacceptable discrimination and abuse faced within our organisations. In addition, it is just as concerning when we see evidence of discrimination in our services or hear testimony from patients who have experienced unequal treatment or antisemitic or racial abuse when interacting with the NHS. We also know that we must better support staff when they experience racism in their interactions with the public.

We have set out a series of immediate actions we are asking you to take within your own organisations:

• To join NHS England in signing up to the NHS Race and Health Observatory Seven Anti-Racism Principles
• Ensure implementation of the Violence Prevention and Reduction Standard, including data capture and use to target improvement with affected groups, this will be monitored via the NHS Oversight Framework
• Prepare to implement the forthcoming NHS Staff Standards
• Adopt the new government definition of anti-Muslim hostility
• Ensure all staff have completed the NHS Core Skills Framework module on Equality, Diversity and Human Rights (EDHR), which includes content on antisemitism and Islamophobia
• Ensure all staff complete the new bitesize module co-created with faith leaders in the NHS when it becomes available (with the exception of those who have completed EDHR mandatory training in the last 6 months)
• Ensure Board agreement to undertake new anti-racism training when it becomes available.
• Ensure colleagues, staff representatives, patients and communities are aware of your actions through your internal and external communications channels and are appropriately engaged in further developments to address antisemitism and all forms of racism locally
• Ensure your Board and its relevant committees fully understand your staff survey data on the experience of racism in your organisation and are taking appropriate action on key problem areas related to this issue and monitoring progress.

In addition, following on from our communications in October 2025, please can you confirm whether your organisation has adopted the International Holocaust Remembrance Alliance (IHRA) definition of antisemitism and the Government definition of anti-Muslim hostility. Please respond to this request, once for each organisation, by Friday 31 July 2026.

We know many organisations are already taking clear action, working in partnership with patients, community, trade unions and colleagues with lived experience – acknowledging and seeking to understand that experience is crucial to making the improvements we all want to see.

There are some fantastic examples of the work you are doing to tackle issues of racism and unequal access to services, and we’ll work with you to share these widely across the system whilst encouraging you to use and support the delivery of the NHS equality, diversity and inclusion improvement plan.

Antisemitism and all forms of racism have no place in the NHS. Patients should never feel anxious when receiving care and no member of staff should ever feel isolated, intimidated or unwelcome in their workplace. The Lord Mann review gives us the opportunity to raise our standards and expectations about what we will accept and put our professional values – care, compassion and clinical excellence first. It is part of every leader’s role to actively begin to dismantle the structural discrimination which exists. We are grateful for your support in delivering the actions set out.

Yours sincerely,

Sir Jim Mackey, Chief Executive, NHS England
Danny Mortimer, Director General for People, NHS England