Health, Wellbeing & Social Care

Background / Overview – Scotland

Background / Overview – UK

Health

Child and infant mortality in England and Wales states that mothers in the Pakistani ethnic group had the highest rate of newborn deaths out of all ethnic groups (7.8 deaths for every 1,000 live births). Mothers in the White Other ethnic group had the lowest rate (2.6 deaths for every 1,000 live births). Mothers in the combined Black Caribbean and Black Other ethnic group had the highest percentage of newborn deaths from immaturity-related conditions out of all ethnic groups (52%) – they also had the highest percentage of newborn deaths from antepartum infections (8%).

According to 4b Patient experience of hospital care, patients who stayed in hospitals in England in November 2020 had an average satisfaction score of 77.1 out of 100. White Gypsy or Irish Traveller patients were the most satisfied out of all ethnic groups (82.9). Patients from the Pakistani ethnic group were the least satisfied (69.3). The 2022 British Social Attitudes survey provides more recent data, including reasons why people are satisfied or dissatisfied with NHS care. It is important to note that the achieved sample size for this survey was 3,360 compared with around 78,000 for the Adult Inpatient Survey 2020. Inpatient Experience During the COVID-19 Pandemic

Mental Health

The Mental Health Services Data Set highlights that in the year to March 2023, black people were 3.5 times as likely as white people to be detained under the Mental Health Act – 228 detentions for every 100,000 black people, compared with 64 for every 100,000 white people. The black ‘other’ group had the highest rate of detention out of all ethnic groups (715 detentions for every 100,000 people).

A 2019 study on disparities in the use of Mental Health Act among ethnic groups found either no explanation for the variation in risk of detention, or inadequate evidence to support explanations such as “higher comorbid drug use in ethnic groups, language barriers, poorer detection of mental illness and greater stigma of mental health issues”.

In response to the Independent Review of the Mental Health Act, the National Institute of Health Research (NIHR) awarded grants for research to reduce detention rates and readmission particularly for people from ethnic minorities as well as research to improve the experiences of black African and black Caribbean patients if they are detained.

Social Care

According to Children looked after in England including adoptions, Reporting year 2023, there were 83,840 looked-after children in England on 31 March 2023. Black children made up 7% of looked-after children, 2% of looked-under children who were adopted, and 5% of all under-18s. Asian children made up 5% of looked-after children, 1% of looked-after children who were adopted, and 12% of all under-18s.

A report from the Adoption and Special Guardianship Leadership Board 2022 looked at ending racial disparity in adoption.

According to Short and Long Term (SALT) data collection, between 2016 and 2021, the number of adults receiving long term support went down from 653,070 to 620,960. The percentage of adults receiving long term support who were from Asian ethnic groups went up from 4.4% to 5.1%. The percentage of adults receiving long term support who were from black ethnic groups went up from 3.8% to 4.5%.

Social workers for children and families Workforce

According to data from the Children’s Social Work Workforce for England and Wales, in September 2024, local authorities in England employed 36,400 social workers for children and families – ethnicity was known for 81.4% of them. 73.8% of social workers were White and 15.2% were Black (where ethnicity was known). by comparison, 80.0% of working age people (16 to 64 year olds) in England were White and 4.6% were Black (2021 Census). in the 7 years to September 2024, the percentage of social workers who were White went down, and the percentage who were Black went up.

NHS Workforce, Experience and Pay

According to the NHS Workforce Statistics – June 2022 for England and Wales, in June 2022, over 1.3 million people were employed by the NHS. out of NHS staff whose ethnicity was known, 74.3% were white and 25.7% were from ethnic minority groups (not including white minority groups). 68.7% of professionally qualified clinical staff were white, and 15.9% were Asian. Ethnic minority staff made up 15.0% of people in managerial level positions, and 11.3% of senior managerial level positions. Ethnic minority staff made up 49.9% of hospital and community health services (HCHS) doctors. Asian staff made up the highest percentage of HCHS doctors working in staff grade, specialty doctor, and associate specialist positions.

According to NHS Workforce Race Equality Standard (2022) for England and Wales, the total number of BME staff at very senior manager level has increased by 69.7% since 2018 from 201 to 341. In 93.5% trusts, there was a higher proportion of BME staff compared to white staff experienced harassment, bullying or abuse from staff in the last 12 months. The number of BME board members in NHS trusts increased by 128 (38.1%) between 2020 and 2022. BME staff were 1.14 times more likely to enter the formal disciplinary process compared to white staff. This is the same as in 2021. There is a significant improvement from 2016, when the likelihood ratio was 1.56. BME staff were more than 1.25 times more likely to enter the formal disciplinary process at just under half of trusts. Abuse or harassment from other staff is mostly a problem of harassment for BME staff (and is seen in all regions). White applicants were 1.54 times more likely to be appointed from shortlisting compared to BME applicants; this is lower than 2021. There has been year-on-year fluctuation but no overall improvement over the past seven years. 42.8% of women from a white Gypsy or Irish Traveller background experienced harassment, bullying or abuse from patients, relatives or the public in the last 12 months. Women from a black background (19.8%) and women from an Arabic background (18.4%), experienced high levels of discrimination from a manager/team leader or other colleagues in the last 12 months. 35.4% of staff from a black background believed their trust provides equal opportunities for career progression or promotion, with levels below those of other ethnic groups since at least 2015, irrespective of gender.

According to NHS Staff Earnings Estimates June 2020 for England and Wales, in May 2020 the average (mean) monthly basic pay for all NHS staff was £3,406 for men and £2,644 for women. Only staff from the Black ethnic group had lower monthly basic pay than White staff – Black men were paid 84p for every £1 paid to White men, and Black women were paid 93p for every £1 paid to White women. Monthly basic pay for medical staff was highest for the White ethnic group (£6,329 for men and £5,580 for women) and was lowest for the Black ethnic group (£5,041 for men and £4,465 for women). Monthly basic pay for non-medical staff was highest for the White ethnic group (£2,721 for men and £2,503 for women) and lowest for the Black ethnic group (£2,324 for men and £2,361 for women). Women from each ethnic group were paid less than their male counterparts among medical staff. This was also true for non-medical staff, apart from for the Black and Other groups, where women were paid more than their male counterparts.

Strategy Policy, Legislation

Listed Authorities

Race Equality Framework (REF)

Link	Description
REF 26: Health & Home – Minority Ethnic People Experience Better Health & Well-Being Outcomes	Minority ethnic communities and individuals experience better health and wellbeing outcomes
REF 26a: promote Preventative Approaches and Health Literacy	Promote preventative approaches through tackling unhealthy behaviours and health and wellbeing 'myths,' and encourage healthy living in ways that appeal to minority ethnic communities (including through partnership working with statutory and mainstream services, peer education and advocacy); and improve health literacy through alignment with Making it Easy, A Health Literacy Action Plan for Scotland
REF 26b: Improved Engagement in the Healthier Scotland Engagement Programme	Ensure effective engagement of minority ethnic communities in the Healthier Scotland engagement programme to ensure issues relevant to race equality are considered as part of this wider review
REF 26c: Effective Engagement in the Developing Our Voice Framework	Ensure effective engagement with minority ethnic communities in the development of the Scottish Government Mental Health Strategy to ensure issues relevant to race equality are considered as part of this wider review
REF 27: Health & Home – Improved Access to Health and Social Care	Minority ethnic communities and individuals experience improved access to health and social care services at a local and national level to support their needs
REF 27a: Embed Race Equality in Partnership Integrated Model	Promote the embedding of race equality in new health and social care partnership integrated models
REF 27b: Work with Partners to Improve Data Gathering	Work with Health and Social Care Partnerships, NHSScotland's Information Services Division ( ISD) and other stakeholders to develop cohesive, effective practice on improving approaches to gathering, collating and publishing ethnicity data on health and social care at a national level
REF 27c: Work with Partners to Develop Guidance	Work with EHRC, Health and Social Care Partnerships and race equality stakeholders to develop recommendations around: Promoting race equality from prevention to treatment and aftercare, with respect for intersectionality and individual needs (including cultural and linguistic needs) Involving minority ethnic communities in developing holistic, user friendly health and social care services which recognise specific needs
REF 28: Health & Home – Health and Social Care Workers Improved Ability to Tackle Racism and Promote Equality	Scotland’s health and social care workers are better able to tackle racism and promote equality and community cohesion in delivery of health and social care services
REF 28a: NHS Board Training	Ensure that every NHS Board can demonstrate that it requires all staff to participate in training on equality, diversity and human rights, including race equality and intercultural competency training
REF 28b: Encourage Social Services to Provide Staff Training	Encourage social services employers to provide opportunities for their staff to participate in training on equality, diversity and human rights, including race equality and intercultural competency training
REF 29: Health & Home – Diversity of Workforce	Scotland's health and social care workforce better reflects the diversity of its communities
REF 29a: Work with Partners to Take Positive Action to Improve Workforce Diversity	Work with relevant bodies to take positive action to encourage a greater representation of the minority ethnic population within the workforce of NHSScotland
REF 29b: Work with Relevant Bodies to Improve Workforce Diversity	Ensure that relevant bodies who will be able to contribute to future work to encourage a greater representation of the minority ethnic population within the social services workforce are identified and engaged with

Immediate Priorities Plan (IPP)

Link	Description
IPP – IDE 01: Improving Ethnicity Coding Through Improved Data Infrastructure – Make Ethnicity a Mandatory Field for Health Databases	This is an immediate action that should be done for one or more systems E.g. primary care databases, Scottish Morbidity Records and others. We recognise that making a field mandatory at the national level is not necessarily a panacea but in our view it is essential to improving the data in the short and longer terms. It means a valid code has to be submitted for each record in Board data submissions. ‘Refused’ and ‘Unknown’ are valid codes so even if then it does not mean it is available for all patients. At present, data held by PHS does not discriminate between these two concepts and only includes a single code for ‘refused’/’unknown’, likely including many instances when the patient was never asked. Further work is needed to understand if it is possible to create more refined categories for unknown ethnicity, requiring an improved understanding of the source data within health boards and whether the current computer systems used by health boards allow for more detailed information to be collated. In addition, mandatory does not mean accurate, any code will be accepted, and so data needs to be good quality and this needs data quality monitoring at local and national levels. Given the ownership of much data collection lies with NHS Boards, they should make it mandatory on local systems as well but this would need to go hand in hand with leadership and training initiatives described in the Lothian study and others as described above to ensure quality.
IPP – IDE 02: Improving Ethnicity Coding Through Improved Data Infrastructure – Linkage to the Census	The census currently provides the most robust information on ethnicity for the population of Scotland. Data linkage to the census should be immediately pursued by the Scottish Government to monitor the equity of the COVID-19 response in relation to ethnicity. This should not only include the immediate infectious consequences of COVID-19 (such as risks of infection, hospitalisation and death), but also secondary health harms arising from the pandemic response (such as reductions in the use of appropriate healthcare for other health conditions). If a vaccination becomes available, monitoring of its uptake by ethnicity should also be pursued using data linkage. Under the principle of collecting data once but making use of it many times, linkage to the census should be pursued to allow long-term monitoring and research of ethnic inequalities in health. At present, linkage is done for the purposes of a specific project and for this reason such analyses are often not conducted in a timely manner and are resource intensive. The ERG recommends the addition of an ethnicity field derived from the census is added to an appropriate population spine (such as the Community Health Index, CHI) which would be available for routine analyses without requiring approval from multiple organisations. This recommendation should be considered an important priority which could substantially improve data quality and facilitate timely and responsive analysis.
IPP – IDE 03: Improving Ethnicity Coding Through Improved Data Infrastructure – Develop a CHI field	Allow information to be accessible if provided to any health database only once. This will need maintenance/integration within the Community Health Index (CHI) system and a way to decide on conflicts in classification between databases over time. Similarly, some process for updating the information on an occasional basis will likely be necessary. The CHI is due to be substantially revised within the next 1-2 years, providing an opportunity to embed ethnicity within the system. This single change could make a major impact on the potential 7 for conducting analyses of health data by ethnicity, since this information would then be readily available within many health datasets. There would be considerable synergies if combined with recommendation 2.
IPP – IDE 04: Improving Ethnicity Coding Through Improved Data Infrastructure – Ethnic Group populations	Monitoring of health outcomes by ethnic group should be updated regularly and more frequently than the decennial census, as it is difficult to monitor without up-to-date populations on which to base rates. This is particularly the case in Scotland with the relatively small numbers of many minority ethnic groups and also the fact that many minority ethnic groups have relatively young populations compared to White Scottish/British and so risks can be masked by generally better outcomes in younger people if looking at outcomes at an aggregate level (Note, this was case with recent PHS Ethnicity analysis where the raised risk in South Asians was only apparent after adjustment for underlying age and sex in general population). Attempts have been made previously by NRS and ONS to look at inter-census estimates, but they appear to have stalled. A group at Leeds University have produced broad population projections for ethnic groups based on a number of assumptions (ETHPOP12). Similar work to produce inter-census estimates should be taken forward by the Scottish Government and the NRS within the next six months.
IPP – IDE 05: Improving Ethnicity Coding Through Improved Data Infrastructure – Social Care Data	At present, the provision of social care is highly varied across local authorities and data is not collected in a harmonised manner to facilitate robust analysis. There are considerable efforts to improve the quality and harmonisation of data ongoing and the inclusion of ethnicity within such efforts is important. The need for social care provision that is tailored to an ethnically diverse population is likely to increase substantially in coming years, as the proportion of older people who are minority ethnic increases. The Scottish Government and local authorities must make a clear commitment to address data deficits on ethnicity within the social care system.
IPP – IDE 06: Improving Ethnicity Coding Through Improved Data Infrastructure – Flexibility in Data Collection	The analysis of administrative data provides a number of advantages for monitoring ethnic inequalities, including the large size of datasets (which allows minority ethnic groups to be analysed) and its relative efficiency and affordability. However, administrative data will not always be appropriate and there will continue to be a need for bespoke data collection for specific purposes, including monitoring the needs of particularly vulnerable groups or when administrative data does not capture the required information. For example, migrants who have no recourse to public funds are a particularly vulnerable group and specific data collection efforts may be required to respond to their needs. Sufficient resources will need to be made available for data collection for these specific purposes. Furthermore, existing survey datasets often do not include large enough groups of minority ethnic people to allow analyses by ethnicity. Consideration should be given to the need for boosting samples of ethnic minority participants. Often there will be a strong case for collecting qualitative data to supplement the quantitative data that has been the focus of this paper.
IPP – IDE 07: Improving Ethnicity Data Collection at Source – Co-ordinated Action	A co-ordinated set of initiatives must be put in place by the Scottish Government and NHS Scotland as soon as possible building on the lessons from past successes to improve recording of ethnicity within health databases. The COVID-19 pandemic provides a clear illustration of the importance of collecting this data, so such action has a greater chance of success than in the past. These initiatives cannot be one-off projects but rather a sustained plan of action that embeds the process of ethnicity data collection in the culture of the NHS in Scotland.
IPP – IDE 08: Improving Ethnicity Data Collection at Source – Primary Care Health Ethnicity Data Collection	Collection of ethnicity information at the time of GP registration provides an opportunity for substantial improvements to health ethnicity data. The current level of completeness is low, so mandating ethnicity data collection within general practice must be taken forward by the Scottish Government. However, the pressures on general practice are considerable at this time, so there is a need to ensure partnership with GPs, the Royal College of General Practitioners and other primary care staff to explore how best to take this work forward.
IPP – IDE 09: Improving Ethnicity Data Collection at Source – Participation by Minority Ethnic People and Communities	Minority ethnic people and communities must be at the heart of any initiatives to improve ethnicity recording and closely involved in driving forward such initiatives. Minority ethnic communities racialised by the data process need to be involved to make sure it is worthwhile and not just another tick box exercise. This will help ensure the work meets the needs of Scotland’s diverse communities and also facilitate success. It should be noted that not being willing to provide ethnicity information is rare when the reason for its collection is appropriately explained. The perspectives of minority ethnic people and communities should also be brought into the data collection process to ensure greater understanding in relation to the importance of safeguarding data. Caldicott guardians should be supported to understand how racism and racialisation plays out in the systems of data collection and analysis in order to inform their responsibilities regarding the lawful and ethical processing of information. This should include awareness of the risks of both use and non-use of data.
IPP – IDE 10: Improving Workforce Data – Monitoring Workforce Data	COVID-19 has highlighted the issue of racism experienced by many of those working in the health and social care sector. While overt racism is relatively uncommon, evidence of institutional discrimination has accumulated. For example, minority ethnic groups have been more likely to report inadequate or needing to re-use personal and protective equipment. More generally and before the COVID-19 pandemic, a special series within the BMJ medical journal highlighted the systemic nature of racism within Medicine, with minority ethnic groups less likely to be promoted and occupy positions of prestige. Monitoring of the minority ethnic diversity of frontline NHS and social care staff is required urgently by NHS Scotland to be able to appropriately respond to concerns raised by employee representative bodies such as the Unison and STUC Black workers committees. In respect of COVID-19, unions identified that Black workers were disproportionately exposed to COVID risks. The experience of Black workers and others highlights both the legal duty to respond to these minority ethnic workers and also instigate transformative consultations with workers and others to respond to the experience of racialisation in our institutions and systems. NHS Scotland and public service organisations should put in place effective and sustained systems to record ethnicity of the workforce and analyse workforce data and surveys to show the variation in experience of employment by ethnic group.
IPP – IDE 11: Improving Workforce Data – NHS Workforce Data	NHS Education for Scotland (NES) are responsible for collecting, analysing and publishing NHS workforce data, and high-level ethnicity data is published annually. NES must address data quality issues and regularly report on progress in achieving equity in relation to NHS workforce issues for minority ethnic staff. This includes information on pay, promotion and recruitment. We would expect NES to monitor the quality and completeness of the data and report regularly on any gaps within that data. We would also expect the Scottish Government to provide oversight of progress on improvement.
IPP – IDE 12: Improving Workforce Data – Social Care Workforce Data	At present, no national workforce data for social care is available for Scotland, with individual local authorities responsible for its provision. Data does not appear to be regularly collated or reported and this may mean that monitoring by ethnicity is not possible within much of Scotland due to the relatively small numbers of minority ethnic people in many individual local authorities. Given the integration of health and social care, joint work by Scottish Government and local authorities is needed to ensure that minority ethnic workers are treated equitably within social care. This may require data specifications to be included within contracting processes made between commissioners and providers, informed by nationally agreed data standards. This would allow minority ethnic groups to be studied at a national level.
IPP – IDE 13: Reporting, Accountability and Governance – Reporting Data by Ethnicity	a) The COVID-19 pandemic has highlighted the need for ongoing monitoring of health (and other) data by ethnicity. The lack of reporting of datasets that are available by ethnicity can serve to make ethnic inequalities in health hidden and threatens the case for maintaining data quality. It is therefore crucial that data when available and robust enough for analysis are published and disseminated to policymakers, practitioners and communities. We recommend that: A dashboard is created by the Scottish Government to report regularly on the impact of decisions made by the public bodies on minority ethnic people and communities during the COVID-19 pandemic, this should also include data from the disruption to health and social care (second-order effects), and financial poverty (third-order effects). b) Public Health Scotland must publish an annual monitoring report on ethnic group health inequalities in Scotland. c) The National Performance Framework must include specific indicators on the impact of racialised inequalities or the impact of systemic racism on minority ethnic people to supplement the current 81 National Indicators.
IPP – IDE 14: Reporting, Accountability and Governance – Accountability and Governance	a) In order to ensure that issues on racism and ethnicity are taken seriously then people within Scottish Government, the NHS, local authorities and other public sector organisations need to be accountable for taking forward this advice and recommendations with speed and commitment. Putting a measurable racism and ethnicity objective in every Scottish Government Health Director and NHS Chief Executive’s performance objectives would provide some motivation and personal incentive to drive this forward. The ERG would be happy to discuss what these objectives could be. b) Each public body that has duties under the Equality Act should publish its scheme of governance to ensure adequate data recording, analysis and presentation of information to demonstrate their commitment to monitoring and tackling inequalities. Public bodies should do this in the interests of access, experience and outcome for services to minority ethnic groups that it provides, providing specific analysis of conditions of interest such as COVID-19, and the fair employment of staff by ethnic group using agreed indicators. In line with the reporting recommendation in relation to the National Performance Framework above, actions taken to improve indicators contained within the National Performance Framework should be publicly reported, with designated Scottish Government leads for responding to each indicator.
IPP – SIR 03: COVID-19 Immediate Action – Test and Protect and Future Health Measures	a) There must be Minority Ethnic participation at all levels of the COVID response. It is also important to ensure that communication with individuals from minority ethnic communities by Test and Protect teams is effective and that Test and Protect teams have incorporated processes and expertise which reflect the diversity of the communities they serve and the intersectional framing of their experiences. b) Scottish Government must ensure that the needs of minority ethnic communities are considered and acted upon. There is a risk of undermining the broader zero COVID-19 community transmission approach if this is not done. c) Culturally competent health promotion and disease prevention programmes, relating to issues such as the higher risk of diabetes and Cardio-Vascular Disease among South Asians, is well known but efforts to tackle it may have diminished recently and it is important that such efforts are reinvigorated. Further, the Independent Race Equality Framework Advisor had previously made a recommendation involving funding the implementation of a low cost community intervention project with the aim of bringing about lifestyle changes that would a) prevent and b) improve management, of these diseases.
IPP – SIR 04: COVID-19 Immediate Action – Fair Work Practices	The Scottish Government, NHS Scotland and other partners must demonstrate how they will ensure that fair work practices are in place in health and social care settings, particularly in relation to PPE, and other workplaces.
IPP – SIR 05: COVID-19 Immediate Action – Investment in Minority Ethnic Organisations and Hental Health Services	a)In the event of enhanced lockdown, the Scottish Government will need to invest in NHS Scotland Mental Health provision. b) Further, there should be support for minority ethnic led sector organisations to provide the service required to Scotland’s diverse demographics. c) In addition, the Scottish Government and NHS Scotland should deploy culturally competent and multi-lingual psychotherapists and counsellors as there are ethnic inequalities in accessing mental health services. d) More broadly, the Scottish Government should commission research to identify barriers and put in place a plan to address the unmet need and persistent ethnic inequalities in mental health care.
IPP – SIR 06: COVID-19 Immediate Action – Public Health Messaging	a) The Scottish Government must take action to ensure the inclusivity of public health messaging around COVID-19 minority ethnic communities and migrants. This should take into account language barriers, literacy levels, cultural factors, religious beliefs and differential access to health-related information among diverse communities. Translation is necessary, but not sufficient. Co-production and pre-testing of messaging with communities is essential for tailoring to specific cultural contexts. b) Local authorities need to have appropriately experienced staff or access to sources of advice so they can actively engage with ethnic communities to understand local issues and act as trusted sources of communication with the community. Messages should be tailored to reflect local realities and consider cultural norms, accessibility of services, and financial disadvantage. c) Messaging and engagement needs to understand that groups are not homogenous. d) Work needs done at a local level – it is essential to work with trusted 3rd parties in the relevant communities.” There is concern that public communication around the higher proportion of cases in minority ethnic communities’ could risk creating a blame-game that would lead to negative repercussions for these groups e) The Scottish Government should be clear and resolute in standing up to this danger,
IPP – SIR 08: Short-Term Actions – Functions	a) The functions of the infrastructure should include: Collection, analysis and publication of government, local authority, public body ethnic, and private sector ethnic minority data and evidence – Helping Directorates within Scottish Government to develop, monitor, implement and evaluate policies to reduce ethnic disparities – providing leadership to improve the quality of Scottish Government, local authority and other public bodies in their collection, analysis and reporting of data on minority ethnic groups, as well as actions to address these inequalities. Reporting regularly on the impact of policies on racialised inequality in Scotland. Creating an open data source which is kept updated in order to monitor and act on the impact of Scottish Government plans and expenditure on minority ethnic people and communities. Highlighting priority areas for investment to boost progress in affected communities across Scotland. Reporting and sharing best practice. b) As a priority, the Scottish Government should conduct an inequalities audit across the Scottish Government and other public bodies' functions. Government should work with the NHS, local authorities and other public service partners to ensure that data relating to workforce and the use of public services is accurate, comprehensive, accessible, can be ethnically disaggregated and is regularly monitored and reviewed. That work should include the investigation of any ethnic disparities. Where data disaggregated by ethnicity is not available, the Scottish Government must make the necessary investments or policy changes to address this. Any Scottish infrastructure should be multi-disciplinary, seek international guidance and expertise, especially in relation to understanding how systemic, structural/ institutional racism manifests and is sustained, as well as learn lessons from the experiences of the UK Racial Disparities Unit.
IPP – SIR 15: Short-Term Actions – Employment	All public bodies should develop action plans with annual progressive targets for public sector employment at all levels of seniority in relation to minority ethnic groups – workplaces must reflect the diversity of the communities they serve and also set a positive leadership example. These targets should support the achievement of the existing commitment to fair representation for minority ethnic people in the Scottish Government and public bodies' workforce. Appropriate levers to encourage similar actions from the private sector should also be explored, including the potential to support community and activist-led programmes, such as "Pull Up or Shut Up,” a campaign that calls on companies to release the total number of Black employees at their companies and to identify their employment levels.

Other Accountability Mechanisms

Equity Reports

Mainstreaming Report

Link	Description
Equality Outcomes 2023 to 2025: Health	In September 2024, the Cabinet Secretary for Health and Social Care made a clear commitment to applying an anti-racism lens to improving services. In his anti-racism statement Mr Gray identified racism as a key driver of racialised health inequalities, and a significant public health challenge and called on everyone in the NHS in Scotland and in social care to become leading anti-racism organisations. We asked all 22 NHS Health Boards to develop and deliver against anti-racism plans, covering workforce and service delivery. Anti-racism planning guidance has been developed in collaboration with stakeholders including the NHS Ethnic Minority Forum (EMF) to support this work. Some boards have already made good progress on anti-racism, and some of the improvement we expect to see will come from sharing good practice. The 2023 report references the Community of Practice on Racialised Inequalities in Health & Social Care. The community continues to grow from strength to strength, membership continues to expand. We have received positive feedback that the sessions are thought provoking and useful in helping embed anti-racism approaches with a focus on equity in service delivery and policy making.
Equality Outcomes 2023 to 2025: Leadership, Culture Wellbeing – Embedding Anti-Racism	We are working with NHS Scotland to embed anti-racism practice within the workplace. Following recommendations from the Expert Reference Group on Covid-19 and ethnicity and the EHRC we began to develop a programme of systemic change that will lead to improved recruitment, retention, and progression outcomes for ethnic minority staff. More diverse staff alongside improved training on diverse health needs will lead to improved outcomes for patients

Link

Description

Equality Outcomes 2023 to 2025: Health

In September 2024, the Cabinet Secretary for Health and Social Care made a clear commitment to applying an anti-racism lens to improving services. In his anti-racism statement Mr Gray identified racism as a key driver of racialised health inequalities, and a significant public health challenge and called on everyone in the NHS in Scotland and in social care to become leading anti-racism organisations. We asked all 22 NHS Health Boards to develop and deliver against anti-racism plans, covering workforce and service delivery. Anti-racism planning guidance has been developed in collaboration with stakeholders including the NHS Ethnic Minority Forum (EMF) to support this work. Some boards have already made good progress on anti-racism, and some of the improvement we expect to see will come from sharing good practice. The 2023 report references the Community of Practice on Racialised Inequalities in Health & Social Care. The community continues to grow from strength to strength, membership continues to expand. We have received positive feedback that the sessions are thought provoking and useful in helping embed anti-racism approaches with a focus on equity in service delivery and policy making.

Equality Outcomes 2023 to 2025: Leadership, Culture Wellbeing – Embedding Anti-Racism

We are working with NHS Scotland to embed anti-racism practice within the workplace. Following recommendations from the Expert Reference Group on Covid-19 and ethnicity and the EHRC we began to develop a programme of systemic change that will lead to improved recruitment, retention, and progression outcomes for ethnic minority staff. More diverse staff alongside improved training on diverse health needs will lead to improved outcomes for patients

Periodic Report Recommendations

Link	Description
Periodic Report Recommendation 19: Health	Health: Recalling its previous concluding observations, 9 the Committee recommends that the State party: (a) Take effective measures to address structural inequalities and discriminatory barriers in the context of the social determinants of health, including climate change and environmental health hazards, improve health outcomes and ensure the accessibility and availability of culturally acceptable and gender-responsive quality health-care services for persons belonging to ethnic minorities, throughout its jurisdiction; (b) Develop and implement further measures to protect ethnic minorities on the basis of the lessons learned from the coronavirus disease (COVID-19) pandemic. The Committee reiterates the calls that it made in its statement and decision on the lack of equitable and non-discriminatory access to COVID-19 vaccines, under its early warning and urgent action procedures;10 (c) Take further and effective steps to decrease infant and maternal mortality rates among ethnic minorities; (d) Strengthen its measures to effectively address racial discrimination in the use of compulsory detention and community treatment orders, notably by amending the relevant legislation, including the Mental Health Act 1983.

Link

Description

Periodic Report Recommendation 19: Health

Health: Recalling its previous concluding observations, 9 the Committee recommends that the State party: (a) Take effective measures to address structural inequalities and discriminatory barriers in the context of the social determinants of health, including climate change and environmental health hazards, improve health outcomes and ensure the accessibility and availability of culturally acceptable and gender-responsive quality health-care services for persons belonging to ethnic minorities, throughout its jurisdiction; (b) Develop and implement further measures to protect ethnic minorities on the basis of the lessons learned from the coronavirus disease (COVID-19) pandemic. The Committee reiterates the calls that it made in its statement and decision on the lack of equitable and non-discriminatory access to COVID-19 vaccines, under its early warning and urgent action procedures;10 (c) Take further and effective steps to decrease infant and maternal mortality rates among ethnic minorities; (d) Strengthen its measures to effectively address racial discrimination in the use of compulsory detention and community treatment orders, notably by amending the relevant legislation, including the Mental Health Act 1983.

Dr Addy's – Scottish Anti-Racism Resource Library (ARRL)