Executive summary

NHS England has produced a Specific Equality Duties (SED) Review Report to clearly demonstrate how NHS England met our statutory requirements under the Equality Act 2010’s Public Sector Equality Duty (PSED) and the associated SEDs between 1 April 2024 and 31 March 2025. Responsibility for compliance with these legal duties rests with the Board and is considered in a public Board meeting. The collective input from the Executive was sought prior to submission of these papers to the Board.  

Central to the statutory requirements is the duty, placed on NHS England, to publish equality information annually. The SED Review Report meets this annual publication requirement and is divided into five main parts and two appendices.

1. Part 1 provides an overview of the report and explains how it demonstrates that NHS England is meeting the PSED and the SEDs.
2. Part 2 summarises how NHS England met the existing SEDs on gender pay gap reporting and overviews work undertaken by HR OD in relation to non-statutory pay gap reporting.
3. Part 3 assesses progress, between April 2024 and March 2025, against the 8 equality objectives and targets approved by the Board in May 2024.
4. Part 4 provides information on strategic equality work undertaken by teams with a corporate responsibility for equality programmes and initiatives across NHS England.
5. Part 5 explains how planned major legislative and NHS reforms impact on NHS England’s 2025/26 equality objectives and targets. In light of the merger with the DHSC, part 5 also sets out 4 recommendations for the review of the equality objectives and targets in 2025/26 (see paragraph 10 below).
6. Appendix 1 sets out the proposed equality objectives and a reduced number of equality targets for 2025/26.
7. Appendix 2 explains the rationale for withdrawing a number of equality targets for 2025/26 which were approved by NHS England’s Board in May 2024.

Action required

The Board is asked:

1. To note the publication of NHS England’s pay gap reports, published in March 2025, in relation to statutory Gender Pay Gap reporting and non-statutory pay gap reporting in relation to disability, ethnicity and sexual orientation.
2. To note the progress assessment in furtherance of equality objectives 1 – 8 and the associated equality targets during 2024/25 (SED report: part 3).
3. To note the strategic work undertaken during 2024/25 by key teams to advance equality of opportunity (SED report: part 4).
4. To approve the recommendations for 2025/26 which balance meeting PSED/ SED requirements whilst taking a flexible approach and working in partnership with the DHSC (paragraph 10 below and SED report: part 5).
5. To approve the equality objectives and targets for 2025/26 (SED report: Appendix 1).

Background

1. The Board set equality objectives and associated equality targets in May 2024 for 2024/25 and 2025/26. The equality objectives and targets have been reviewed in light of progress made during 2024/25 and planned changes.

2. The central changes considered include the incoporation of NHS England into the DHSC over the coming two years, the wider NHS reform programme and anticipated major legislative changes on the equalities front (SED report: part 5). Four recommendations in the SED report seek to address these major changes (see paragraph 10 below).

3. The national directors responsible for the programmes and equality objectives and targets have signed off on the report and on the targets in appendix 1 of the SED report. The overall SED Review Report was considered by the CNO and the CWTEO. It was also submitted to the Executive on 22 May 2025. Legal and publication approval clearance have also been secured.

4. Compliance with the PSED and SEDs are statutory obligations. Part 5 of the SED Review Report proposes how NHS England should navigate the challenges in relation to setting strategic equality objectives and targets for 2025/26, working in partnership with the DHSC. There have been initial discussions with the DHSC teams responsible for the DHSC’s compliance with the PSED and the SEDs about the recommendations and they are content (paragraph 10).

Considerations and recommendations

5. The Equality and Human Rights Commission (EHRC) as the regulatory body for the Equality Act 2010, has highlighted the importance PSED compliance as part of the development of the NHS 10 Year Health Plan and NHS England’s wider strategic work. The approach proposed in the report demonstrates NHS England’s continued commitment to meeting our PSED and SED statutory obligations. The SED report contains the following recommendations:

Recommendation 1: Equality objective 8 [system landscape] should be amended to include consideration of the forthcoming major legislative and policy reforms.

Recommendation 2: The equality objectives and targets for 2025/26 should be the subject of a joint review by NHS England working in partnership with the DHSC during 2025/26 to facilitate recommendation 1.

Recommendation 3: Given the merger programme, the equality objectives and targets in appendix 1 should be regarded as provisional unless reviewed in accordance with recommendation 2. However, the equality objectives and targets must be worked towards unless the review recommends changes at which time the rationale for any changes will be properly documented and a decision made by the appropriate governance body.

Recommendation 4: NHS England will work towards making our equality objectives and targets more performance and outcome driven in 2025/26. This will involve the identification of suitable equality focused performance measures, appropriate statistics and data for relevant equality objectives and targets. This work will inform the joint review identified in recommendation 2.

6. There are no additional financial costs for the proposed equality objectives and targets, as relevant costs have been addressed as part of existing programmes.

7. In terms of legal compliance, governance and risk, meeting the statutory obligations set out in the PSED and the associated statutory regulations are legal obligations. Meeting these legal obligations is wholly consistent with the principles of good governance and the principles and requirements set out in the NHS Standard Contract (SC 13). Publication of this report, by the end of May 2025, will address the statutory obligation to publish equality information within 12 months of the last publication date.

Interdependencies and wider implications

8. The equality targets, set out in section 2 of the SED Review Report, have been set by relevant programmes and are designed to make a specific and measurable impact contributing to addressing each of the 8 equality objectives.

9. The equality objectives, targets and work in the SED Review Report will continue to make a strategic contribution to advancing equalities and reducing health inequalities, supporting the 10 Year Health Plan and a range of wider NHS strategies. The recommendations on closer working with the DHSC, the revisions to equality objective 8 and the reduced number of focused equality targets are designed to enable NHS England to respond to developments during 2025/26 which will significantly engage the PSED (SED report: part 5).