The NHS will now evaluate trusts based on their effectiveness in addressing racism, violence, and sexual misconduct against staff, as announced by the government. Starting in July, all NHS acute, ambulance, and mental health trusts in England will be assessed and ranked in public league tables using six key wellbeing metrics, impacting over 1.5 million employees. Secondary care trusts are included, while primary care providers such as GP practices are excluded for now, though expansion to these sectors is planned in subsequent years.
The new performance standards will measure hospitals and ambulance services on their efforts to tackle racism, prevent violence, enhance sexual safety, support flexible working, improve line management, and provide health and wellbeing resources. Each trust will receive a score from one to four for these measures, contributing to an overall rating. For the first time, progress on workforce wellbeing—assessed through the NHS staff survey—will be a factor in overall performance ratings alongside waiting lists and A&E metrics.
Karin Smyth, the minister for secondary care, emphasized that NHS staff are essential to the health service and deserve dignity and respect. She stated, “The levels of racism, violence, and sexual harassment reported by staff are unacceptable. These new standards, part of a 10-year health plan commitment, introduce accountability where it has been lacking. Measuring and publishing how trusts treat employees is crucial because supporting staff ensures better patient care.”
According to the latest NHS staff survey, hundreds of thousands of healthcare workers have faced attacks, harassment, bullying, or discrimination. Nearly one in 10 staff, 30% of ambulance personnel, and over 10% of nurses and midwives reported experiencing unwanted sexual behavior in the past year. A Guardian investigation also revealed a sharp increase in violence and sexual misconduct over the past three years.
Experts support the new measures but raised concerns about the speed of tangible change. Suzie Bailey, director of leadership and organisational development at the King’s Fund, noted, “The NHS cannot deliver high-quality care if staff and managers do not feel safe, valued, and supported.” Nicola Ranger, general secretary of the Royal College of Nursing, warned that zero-tolerance policies alone are insufficient. “Robust enforcement mechanisms are needed for meaningful change. Without addressing abuse, nurses will leave the NHS—a devastating outcome.” Tim Mitchell, outgoing president of the Royal College of Surgeons of England, called for a national, independent, and anonymous reporting system to protect staff who raise concerns without fear of retaliation.