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Equality and diversity in the NHS

  • Equality and diversity

What the Equality Act 2010 means for you

Laws under the Equality Act 2010 give the NHS opportunities to work towards eliminating discrimination and reducing inequalities in care. Most of the provisions came into force on October 1 2010, with other parts to be phased in by 2013.

Since October 1 2012, it is unlawful for NHS and social care service providers and professsionals to discriminate, victimise, or harass a person because of their age. 

The NHS already has clear values and principles about equality and fairness, as set out in the NHS Constitution, and the laws under the Equality Act 2010 reinforce many of these.

What does this mean for you?

Most of us need to visit a doctor or dentist from time to time, and may need hospital treatment on occasions. Others may rely on the NHS and social care services for help with long-term health conditions or disabilities. Whenever you need healthcare, medical treatment or social care, you have the right to be treated fairly and not to be discriminated against, regardless of your ‘protected characteristics' (you can see a list of protected characteristics below). Laws under the Equality Act set out that every patient should be treated as an individual and with respect and dignity.

The laws mean that all NHS organisations will be required to make sure health and social care services are fair and meet the needs of everyone, whatever their background or circumstances.

Who is protected?

The Equality Act 2010 offers protection to nine characteristics. These are:

  • age
  • race
  • sex
  • gender reassignment status
  • disability
  • religion or belief
  • sexual orientation
  • marriage and civil partnership status
  • pregnancy and maternity

For the first time the law also protects people who are at risk of discrimination by association or perception. This could include, for example, a carer who looks after a disabled person.

Also read the section for carers about stigma and discrimination.

Which services are covered?

Health and social care services covered by the laws under the Equality Act 2010 include:

  • all NHS providers (e.g. hospitals)
  • all NHS commissioners (e.g. GP practices)
  • those supporting elderly and disabled people in their homes
  • care in day centres, and residential or nursing homes
  • those caring for children who cannot live with their parents

It doesn’t matter whether the service is provided by a public authority or an independent provider.

You also have rights under the European Convention on Human Rights (included in the Human Rights Act 1998 in the UK), which are relevant to health and social care. These rights include:

  • the right to life
  • the right not to be subjected to torture, inhuman or degrading treatment or punishment
  • the right to liberty
  • the right to respect for private and family life

What is discrimination?

Discrimination can be direct or indirect.

Direct discrimination is when one person receives less favourable treatment than another person because of a protected characteristic. For example, if a clinic refuses to offer fertility services to a lesbian couple because they are not heterosexual, this constitutes direct discrimination on grounds of sexual orientation.

Indirect discrimination is when there is a condition, rule, policy or practice that applies to everyone, but which particularly disadvantages people who share a protected characteristic. For example, a social care provider that runs a day centre decides to apply a ‘no hats or other headgear’ rule to its service users. If this rule is applied to every service user, then Sikhs, Jews, Muslims and Rastafarians, who may cover their heads as part of their religion, will not be allowed to use the drop-in centre. Unless the social care provider can objectively justify using the rule, this is indirect discrimination.

The Equality and Human Rights Commission has developed guidance for users of health and social care.

Follow the links below to find out more about health issues relevant to these groups:

Age discrimination

Age discrimination is unfairly treating people differently because of their age.

It is unlawful for NHS and social care services, and professionals to discriminate against, victimise, or harass a person because of their age.

Professionals must not base decisions about care and treatment on age instead of a proper assessment of an individual's needs. For example, a doctor should not refuse to refer a patient for surgery based on their age alone, but must also consider their individual needs and physical condition.

The ban on age discrimination only applies to harmful uses of age. NHS and social care organisations and professionals can still take account of someone's age when it is right and beneficial to do so, for example by ensuring services:

  • are targeted at those who most need them
  • meet patients' requirements, such as allowing them to mix with their own age group

Positive use of age in decisions about providing health and social care services is allowed, as long as it is 'objectively justified'. For example, the Department of Health invites women aged 25-49 for a cervical screening test every three years, whereas women aged 50-64 are invited every five years. This is because statistics show that the younger group are more susceptible to the disease than the older group.

What to do if you experience age discrimination

If you believe you have been treated less favourably because of your age and you are aged 18 or over then you can take action. You can use the NHS complaints procedure to raise your concerns and you also have the right to take organisations or individuals to court.

Find out more about the ban on age discrimination.

Page last reviewed: 25/09/2012

Next review due: 25/09/2014

NHS complaints

If you're not happy with the care you've received, you have the right to complain. Find out how

Care Quality Commission

Find out how the CQC ensures all care services in England provide people with safe, effective, compassionate and high quality care

Caring and discrimination

Find out why carers need to have access to support and advice about their rights.

Media last reviewed: 17/04/2014

Next review due: 17/04/2016

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