NHS staff report a rise in racist abuse as UK workplace discrimination persists, with new evidence revealing racial slurs, patients refusing treatment from Black and Asian healthcare workers and continuing inequalities across the wider labour market. The findings are prompting fresh questions about employer accountability, active allyship and whether Britain needs a national anti-racism strategy.
Racist abuse against NHS workers has become more overt over the past 18 months, according to new evidence from the Society of Radiographers, with staff reporting racial slurs, anti-immigrant comments and patients refusing treatment from Black and Asian healthcare professionals.
A survey of 381 Society of Radiographers members found what the union described as a “noticeable” rise in overt racism experienced or witnessed across the health service. Reported incidents included complaints about workers’ skin colour, racist comments about immigration and patients refusing to be treated by staff from ethnically diverse backgrounds.
The findings come amid wider evidence showing significant racial disparities across the NHS and growing concerns about racism throughout UK workplaces. The official 2025 NHS Staff Survey found that 9.26% of NHS staff overall experienced discrimination from patients, service users, relatives or members of the public during the previous 12 months – the highest level in five years, up from 7.91% in 2021.
But those headline figures mask stark differences by ethnicity. The King’s Fund highlighted that one in five Black and minority ethnic NHS staff reported discrimination from patients or the public, compared with just 5% of white staff. A further 14% reported discrimination from colleagues, managers or team leaders – twice the 7% reported by white staff.
WIDESPREAD HARASSMENT AND DISCRIMINATION
And the problem does not stop at healthcare. New Trades Union Congress (TUC) research suggests racism, unfair treatment and harassment remain widespread across the British labour market, while Fair Play Talks reporting over several years has documented discrimination affecting Black professionals, women of colour, technology workers and employees across multiple sectors.
At the same time, more than 100 civil society organisations coordinated by the Runnymede Trust have called for a cross-government anti-racism strategy addressing racial inequality across employment, healthcare, education, housing, policing and other areas of society.
The developments raise an urgent question for employers: If racial hostility is becoming more visible in society, are organisations doing enough to stop it entering – or flourishing within – the workplace?
NHS STAFF REPORT RISE IN OVERT RACIST ABUSE
The latest concerns emerged after radiographers described patients openly making racist and anti-immigrant comments, questioning accents and refusing treatment from Black and Asian staff. One worker reported patients questioning whether they could understand him despite English being his first language. Other accounts included comments about immigrants “taking jobs” and complaints about healthcare workers’ skin colour.
The findings sit against a longer-term pattern. The official NHS Staff Survey shows discrimination from patients and members of the public has increased from 7.91% of staff in 2021 to 9.26% in 2025, reaching a five-year high.
Sarah Woolnough, Chief Executive of The King’s Fund, described racism in the NHS as “deeply entrenched” and “disturbingly normalised”. “You can’t run a health service on hostility,” she warned. Woolnough said anti-racism needed to move beyond a label and become part of NHS culture and leadership, including challenging overt discrimination and tackling less visible behaviours and structural barriers affecting ethnic minority staff.
The issue extends beyond how employees are treated. Fair Play Talks has previously reported research warning that structural racism continues to fuel health inequities, demonstrating how racial inequality can influence both the experience of working within healthcare and the outcomes experienced by patients.
RACISM AT WORK IS NOT JUST AN NHS PROBLEM
The visibility of racist incidents involving NHS workers risks creating the impression that this is primarily a healthcare or public-sector issue. The wider evidence suggests otherwise. The TUC’s No Worker Left Behind research, published in April 2026, found that racism, discrimination and harassment remain widespread and that several measures have worsened since 2020.
The research was based on a nationally representative survey of 1,590 workers aged 16 and over in Great Britain, including 1,044 Black workers and 509 white workers. Among Black workers:
- 41% had experienced racist jokes or “banter”
- 36% had experienced racist remarks directed at them or made in their presence
- 35% reported verbal abuse
- 35% had experienced offensive or humiliating questioning about their culture or religion
- 31% had had their ability to speak English questioned
- 28% had experienced racist material being circulated through workplace social media
- 26% had experienced physical violence, threats or intimidation, up from 19% in 2020
The increase in questioning employees’ ability to speak English was particularly marked, rising from 20% in 2020 to 31% in 2026. Unfair treatment affected working conditions and career opportunity too. The TUC found 45% of Black workers had been given harder or less popular tasks, 43% had received unfair criticism and 41% had been kept on temporary or fixed-term contracts. Black workers were also more likely than white workers to report being denied training or development, receiving insufficient hours and remaining on insecure contracts.
RACISM IN UK’S EMPLOYMENT MARKET
These findings build on evidence Fair Play Talks has documented for years. In 2023, TUC research found racism continued to play a “huge part” in the UK employment market, while research among technology professionals highlighted rising racial discrimination as a major workplace concern.
Separate global research found that two-thirds of employees from marginalised racial and ethnic groups had experienced racism at work. Broader UK evidence has also found almost half of workers experienced unfair discrimination at work or while looking for a job.
Taken together, the evidence makes clear that racism at work cannot be dismissed as an issue confined to one sector or type of organisation.
RACISM IS NOT ALWAYS VISIBLE
The incidents described by NHS workers involve some of racism’s most recognisable forms: racial slurs, xenophobic comments and refusing service from someone because of their ethnicity. But racism at work can be considerably less visible. It can influence who gets hired, whose mistakes are scrutinised most closely, who receives development opportunities, who gains access to influential assignments, who is sponsored and who is ultimately considered leadership material.
Fair Play Talks reported in 2022 that racism, microaggressions and unfair treatment remained commonplace for Black professionals. That distinction matters. An organisation can prohibit explicitly racist language while still producing unequal outcomes through recruitment, pay, promotion, performance management, disciplinary processes or access to career-enhancing networks.
CUSTOMERS, PATIENTS AND CLIENTS ARE PART OF THE PROBLEM
The NHS evidence also highlights a challenge relevant to almost every customer-facing employer. Racism does not necessarily come from colleagues. When the TUC examined Black workers’ most recent incident of unfair treatment, racism or harassment overall, the most common perpetrators were direct managers or people with authority at 28%, followed by colleagues at 22%, other managers at 16% and customers, clients or patients at 12%.
But when researchers looked specifically at explicit racism, customers, clients or patients were responsible for 22% of incidents, second only to colleagues at 33%. That has important implications for employers. A company cannot reasonably describe itself as anti-racist if its policies protect employees only from other employees.
Workers in healthcare, retail, hospitality, transport, professional services and other customer-facing sectors can all experience racism from the people they serve. Organisations need clear policies explaining when workers can end an interaction, how an incident should be escalated, what support should follow and what consequences a customer or client may face.
Some industries have already attempted collective approaches. Fair Play Talks previously reported how 28 major brands launched a charter aimed at stopping racism in retail. Similar collective action has taken place elsewhere, including efforts where gamers and organisations joined forces to tackle racism in gaming.
WHY RACISM OFTEN GOES UNREPORTED
Recorded incidents are also likely to represent only part of employees’ experience. The TUC found that just 21% of Black workers who experienced unfair treatment, racism or harassment reported their most recent incident to their employer. Almost one-quarter – 23% – did nothing. Employees who did speak up experienced very different outcomes. Among those who reported an incident, 69% said their employer took the matter seriously, but 31% said it was not taken seriously.
While 63% said their treatment improved afterwards, 15% said it became worse. Some complainants faced consequences themselves: 16% were transferred to another department or workplace, 13% became isolated from colleagues and 7% were disciplined or subjected to a counter-complaint.
That helps explain why simply having a grievance process is not enough. Workers need confidence that reporting racism will result in an impartial investigation rather than retaliation, career damage or the complainant themselves being moved while the underlying behaviour remains.
The problem forms part of a wider workplace safety issue. Fair Play Talks recently reported that eight in 10 UK workers had faced abuse at work during the previous year. That normalisation is particularly concerning. Whether the abuse is racist, sexist, ableist or takes another form, workers are less likely to speak up if previous experience tells them reporting will change little.
NEW STANDARDS TO TACKLE RACISM AND VIOLENCE
The NHS is now attempting to address those concerns through a significant change in workforce accountability. On 6 July 2026, NHS England and the Department of Health and Social Care introduced new national NHS staff standards covering line management, health and wellbeing, violence prevention and reduction, tackling racism, sexual safety and flexible working.
The standards apply to secondary care organisations and will feed into the NHS Oversight Framework, making staff experience a more formal part of organisational assessment. The anti-racism standard says staff should expect their organisation to take “sustained and meaningful action” to prevent and root out racism and discrimination from colleagues, patients, service users, relatives and members of the public.
Employers must establish clear consequences for misconduct, ensure staff can speak up safely, improve recruitment and career progression processes, monitor incidents and create clearer accountability at board level. Every NHS board member is expected to have a specific measurable objective on tackling racism, while either the chief executive or chief operating officer must act as senior responsible officer. The standards even allow for the possibility of refusing non-emergency care where patients engage in certain forms of racist misconduct.
Professor Habib Naqvi, Chief Executive of the NHS Race and Health Observatory, welcomed the introduction of the standard and its focus on “leadership, accountability, transparency and structural change”. But he warned that it would need to be backed by systemic action, evidence-based intervention and genuine leadership accountability. That is an important distinction: a policy is not the same as progress.
REVIEW ADDS PRESSURE FOR CHANGE
The new standards follow the publication of Lord John Mann’s review into antisemitism and other forms of racism across the NHS and healthcare regulatory system. Published in June, the review called for stronger accountability, better reporting and investigation processes and the embedding of an anti-racist culture across the health service. The government accepted the recommendations directed at the Department of Health and Social Care and NHS England.
The government said NHS employers should become a first line of defence against racism and discrimination affecting staff and patients. NHS England has subsequently committed to strengthening anti-racism accountability through staff standards, appraisal systems, board training and improved support for workers experiencing racism.
CAN THE NHS MODEL WORK?
The significance of the new standards is that they attempt to turn racism from something primarily handled through HR policies into an organisational performance and leadership issue. That could provide a useful model for other employers. The NHS is effectively asking: What does the data show? Who is responsible? What changed? And what happens when it does not?
But implementation will determine whether the reforms make a meaningful difference. The NHS has collected race equality data for years and substantial disparities remain. Standards will achieve little if employees still fear reporting racism, if different organisations respond inconsistently or if leaders face few consequences when disparities persist.
The broader lesson for employers is therefore not simply to copy NHS policies. It is to connect measurement with responsibility – and responsibility with consequences.
GROWING CALLS FOR NATIONAL ANTI-RACISM STRATEGY
The workplace debate is unfolding against wider concerns about racial hostility across Britain. A coalition of more than 100 racial justice, migrant rights, faith, human rights and civil society organisations, coordinated by the Runnymede Trust, has written to Prime Minister Andy Burnham calling for a comprehensive cross-government anti-racism strategy.
The coalition argues that racism continues to shape people’s experiences and outcomes across employment, healthcare, education, housing, policing, the legal system and immigration, and wants clearer race equality targets, departmental delivery plans, aligned budgets, public reporting and independent scrutiny.
The call comes amid wider concerns about racial hostility and the impact of increasingly divisive rhetoric surrounding race and migration. Dr Shabna Begum, CEO of the Runnymede Trust, has warned separately that political and media narratives that stereotype racialised communities can contribute to a wider climate of fear, hostility and division. She has argued that the sense of safety and belonging experienced by many people of colour has been eroded since the racist riots of 2025 and has called on the government to take decisive action on its narrative, policy and direction.
Against that backdrop, the coalition argues that recent racist and religiously motivated violence should not be treated as a collection of isolated events, but as part of a wider pattern of racial inequality and hostility requiring coordinated action. The new government now faces calls to turn commitments on racial equality into a sustained national plan involving government, civil society and affected communities.
CORPORATE BRITAIN CANNOT WAIT FOR GOVERNMENT
Whatever happens nationally, employers do not need to wait for legislation or another government strategy before taking action. The evidence has been accumulating for years.
Fair Play Talks has documented racism affecting Black professionals, women of colour, technology professionals and employees across the broader UK employment market. The challenge is no longer a lack of evidence. It is turning evidence into sustained action.
WHAT EMPLOYERS SHOULD DO NEXT
Employers should make anti-racism a leadership accountability issue, not simply an HR or diversity initiative. Boards and executive teams should understand racial disparities across recruitment, pay, promotion, performance ratings, disciplinary action, grievances and employee exits – and leaders should be expected to explain persistent gaps and what is being done about them.
Organisations should also examine employee experience by ethnicity. Headline engagement scores can hide significant differences in belonging, psychological safety, confidence in managers and experiences of bullying or discrimination.
Reporting mechanisms must be safe and credible. Workers should have routes that allow them to bypass their immediate manager, and employers should monitor whether people who complain subsequently experience isolation, transfers, counter-complaints or disadvantage.
Employers also need explicit policies covering racism from customers, patients, suppliers and clients. Employees should know when they can end an interaction, who will support them and what consequences a perpetrator may face. And “zero tolerance” must mean something. Policies need clear behavioural standards and consequences, while managers need the confidence and authority to intervene.
Employers should also examine progression, not simply representation. A company can recruit an ethnically diverse workforce while retaining substantial racial inequality at senior levels. Promotion, sponsorship, succession planning, leadership development and access to influential assignments all need scrutiny.
TURN BYSTANDERS INTO ACTIVE ALLIES
Formal accountability is only part of the solution. Workplace culture is also shaped by what colleagues do when they witness racism.
Employers should help people move from passive bystanders to active allies by giving them practical tools to challenge inappropriate comments, interrupt discriminatory behaviour and support colleagues experiencing racism.
As Fair Play Talks highlighted for International Allyship Day, meaningful allyship requires more than statements of support. It means challenging discrimination, listening to experiences different from our own, questioning unfair decisions and using influence to create fairer outcomes. Responsibility for confronting racism should not fall solely on the person experiencing it.
RACISM DOES NOT EXIST IN ISOLATION
Employers also need to recognise that an employee’s experience of racism may intersect with other forms of discrimination. Gender and disability provide particularly clear examples. Fair Play Talks previously reported that three out of four women of colour had experienced racism at work, while TUC research revealed “shockingly high” levels of workplace bullying, discrimination and harassment affecting disabled workers.
Other evidence has highlighted rising Islamophobia and antisemitism affecting UK employees and age discrimination driving older workers out of the workforce. These studies examine different populations and forms of discrimination and should not be interpreted as proving that everyone with multiple underrepresented identities will experience greater discrimination. But they demonstrate why employers need an intersectional approach.
A Black disabled employee, for example, may encounter barriers shaped by both race and disability. An older Asian woman may face assumptions associated with ethnicity, gender and age. A Muslim worker from an ethnic minority background may experience racialised and religious prejudice simultaneously.
Where workforce size and privacy safeguards allow, organisations should therefore consider how outcomes differ across intersecting groups rather than relying solely on organisation-wide averages.
WHY THIS MATTERS: A WIDER WORKPLACE CHALLENGE
The rise in overt racist behaviour being reported by NHS workers cannot simply be dismissed as a problem caused by a small number of abusive patients. It forms part of a much wider workplace challenge.
The latest TUC evidence shows racism and harassment remain widespread, with several measures worsening since 2020 – from racist remarks and questioning employees’ English to physical violence, threats and intimidation. And racism sits within a broader problem of workplace mistreatment. Fair Play Talks recently reported that eight in 10 UK workers had faced workplace abuse in the previous year.
There are significant organisational consequences too. Among Black workers who had experienced unfair treatment, racism or harassment in the TUC study, 17% said their most recent experience led them to leave their job, while a further 23% wanted to leave but felt unable to do so.
TIME FOR ACTION AND ACCOUNTABILITY
Racism therefore affects much more than reputation or corporate diversity commitments. It influences retention, wellbeing, psychological safety, progression, trust and employers’ ability to attract and make full use of talent.
The NHS’s new staff standards represent an important attempt to move from aspiration towards measurable accountability. Sector-wide initiatives demonstrate that employers can collaborate. And active allyship can help ensure responsibility for confronting racism does not fall solely on those experiencing it.
Other employers should pay attention. Because whether racism comes from a manager, colleague, patient, customer or client – and whether it is experienced alone or alongside other forms of discrimination – every organisation ultimately faces the same questions: Who will speak up? Who will be held accountable? And what will the employer actually do about it?
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