Equality, Diversity and Inclusion Annual Report 2025/26

Contents

Foreword

We are proud to publish our 2025/26 Public Sector Equality Duty Annual Report, highlighting our successes over the last year and the measures we will take into 2026/27 to improve equality, diversity and inclusion.

Chelsea and Westminster Hospital NHS Foundation Trust (CWFT) is one of the top-performing hospital trusts in the UK. We employ over 7,000 staff across our two main hospital sites, Chelsea and Westminster Hospital and West Middlesex Hospital, alongside community services. Both hospitals have major A&E departments and the Trust provides one of the largest maternity services in England.

We are part of the Acute Provider Group, which formed on 1 April 2026, along with Imperial College Healthcare NHS Trust, The Hillingdon Hospitals NHS Foundation Trust and London North West University Healthcare NHS Trust. The group is focused on reducing inequalities for patients accessing acute care across North West London by developing joint clinical pathways and providing mutual aid.

Introduction to the report

Purpose and scope

In line with the Equality Act 2010, the Trust is legally required to publish equality information annually to show how it has complied with the Public Sector Equality Duty. This annual report covers 1 April 2025 to 31 March 2026 and focuses on our workforce and our patient population, providing the Trust with valuable insights into our workforce equality performance and the demographics of our patients and service users. It identifies priority areas for improvement. In addition, this report incorporates information required by the Workforce Race Equality Standard (WRES) and Workforce Disability Equality Standard (WDES), as mandated in the NHS Standard Contract. We report separately on other NHS requirements such as the Equality Delivery System 2022.

Use of data and information

Within this report, we refer to important equality monitoring information about our workforce. When staff join our organisation as employees, we ask questions about personal details, including protected characteristics such as age and sexual orientation. This is known as equality monitoring information. Any information provided is held securely and confidentially on our Electronic Staff Record system (known as ESR). The data, when extracted for analysis in reports such as this one, is anonymised.

We must comply with strict rules in managing and using people’s personal information. We analyse the anonymised information to identify and respond to any issues affecting groups that share certain protected characteristics. We use data and information in relation to a range of national standards relating to workforce equality that we are required to meet annually, as outlined in this report. Staff can update their personal data via employee self-service at any time.

Terminology

Throughout this report, we use the term Black, Asian and Minority Ethnic (BAME) to refer to those members of the NHS workforce who are not white. As set out in the Workforce Race Equality Standard (WRES) technical guidance, the definitions of “Black, Asian and minority ethnic” and “white” used in the WRES have followed the national reporting requirements for ethnic categories in the NHS Data Model and Dictionary and NHS Digital data. We are aware that terminology is being reviewed and we will follow NHS guidance as it is produced.

This report serves to assure compliance with the Public Sector Equality Duty (PSED) for 2025/26 for Chelsea and Westminster Hospital NHS Foundation Trust. In accordance with legal obligations, the Trust is required to monitor, analyse and annually publish data related to equality, diversity and inclusion, aligning with its commitment to the Public Sector Equality Duty. The data encompasses protected characteristics outlined in the Equality Act 2010, including age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race (ethnicity), religion and belief, sex and sexual orientation.

Highlights 2025/26

The annual report provides an overview of highlights from April 2025 to March 2026. Some of these highlights are listed below:

• Positive and improved scores in the NHS Staff Survey 2025 for “We are compassionate and inclusive”. Our score increased for four consecutive years and, at 7.46, is above the acute trust average of 7.28.
• A reduction in the proportion of staff who experienced discrimination from a manager, team leader or other colleagues, from 11.53% in 2024 to 10.04% in 2025. The figure has fallen year on year over five years, from 12.31% in 2021.
• Continued development of our “Belonging” steering group, driving our equality, diversity and inclusion programmes.
• Secured commitment to and launched our Cultural Intelligence training programme in 2026.
• Continued growth of our staff networks.
• Signed up to the Sexual Safety Charter and launched a new policy with more reporting routes and increased training for managers responding to reports of sexual misconduct.
• The Trust is in its seventh year of Project SEARCH, providing internships for individuals with autism and/or learning disabilities to gain work experience.
• Sustained high levels of patient satisfaction across inpatient, outpatient and birthing services, performing broadly in line with or above London and national benchmarks.
• Enhanced real-time insight through targeted Friends and Family Test questions, improving monitoring of known pressure points.
• Used patient feedback to inform service improvements, including changes to environments, information, communication and care pathways.
• Continued delivery of engagement, volunteering and chaplaincy services, supporting patient dignity, access, wellbeing and compassionate care.
• More than 15 external patient representatives supported the national PLACE assessment programme, providing valuable independent feedback on the patient environment and experience.
• Continued engagement with Healthwatch throughout the year on key projects.

Looking forward: priorities for 2026/27

This report provides an update on many of the activities and actions that have taken place across the Trust in 2025/26. Chelsea and Westminster Hospital NHS Foundation Trust is committed to delivering national and local priorities, including the six high-impact areas of the NHS EDI Improvement Plan and the NHS Staff Standards. Our work will also continue to focus on anti-racism, sexual safety, reducing health inequalities and disability inclusion. The areas of work below form a high-level set of actions which we will continue to progress in 2026/27.

Workforce

Career progression and development

• Embed inclusive recruitment for Band 7+ and medical leaders. We are addressing workforce representation through further implementation of our inclusive recruitment approach. Trained Diversity and Inclusion representatives on panels help us seek to ensure a fair recruitment process. In 2027/28, this process will be enhanced through standardisation of processes across the Acute Provider Group and the implementation of best practice from all four trusts in the group.
• Grow and develop leaders from underrepresented groups. Recruit to the Healthcare Leaders Fellowship.
• Develop and embed a just and learning culture.
• Focus on employee voice and grow staff networks.
• Launch and implement a programme of Cultural Intelligence training.
• Streamline and improve access to reasonable adjustments.
• Focus on cultural improvements, reinforcing values and behaviours and addressing inclusion and discrimination, bullying and harassment, violence and aggression and sexual safety.

Patients and our communities

• Embed co-production in service redesign and improvement.
• Increase engagement with underserved and seldom-heard communities.
• Improve patient involvement in care, treatment and discharge decisions.
• Strengthen the use of patient feedback, complaints and experience data to drive improvement.
• Improve access to inclusive, accessible and culturally responsive information and communication.
• Reduce inequalities in access, experience and outcomes through targeted improvement programmes.
• Strengthen community partnerships to improve trust, engagement and health outcomes.

Our workforce

Equality, diversity and inclusion 2025/26

In this section, we highlight our strategic priority areas for workforce development, focusing on creating an inclusive, diverse and supportive environment where all staff can thrive and contribute to the delivery of high-quality care.

We agree a set of People Priorities each year, setting out a wide range of programmes and improvements which respond to staff feedback, our data and other drivers for change.

People Priorities 2026–29

The framework for our people priorities will be similar across the Acute Provider Group (APG), with four pillars. There will be shared people priorities across the Group, alongside Trust-specific priorities linked to local data and intelligence.

1. Looking after our people: Health, wellbeing and workplace safety

We aim to continuously improve the health, wellbeing and workplace safety of our diverse workforce and increase awareness of the support available to them.

APG shared priorities

1. Design and deliver a targeted health and attendance programme.
2. Focus on cultural improvements, reinforcing values and behaviours, and addressing:
   • Inclusion and discrimination
   • Bullying and harassment
   • Violence and aggression
   • Sexual safety
3. Deliver the 10-point plan aimed at improving the lives of resident doctors.

CWFT priority

• Embed team-based rostering to support flexible working.

2. Belonging in the NHS: Valuing and including our diverse workforce

We aim to create and embed a culture where everyone feels they belong and are included, recognised and rewarded for their contribution.

APG shared priorities

1. Deliver an engagement programme across the Group.
2. Streamline and improve access to reasonable adjustments.
3. Develop and embed a just and learning culture.
4. Grow and develop leaders from underrepresented groups.
5. Embed inclusive recruitment for Band 7+ and medical leaders.
6. Focus on employee voice and grow staff networks.
7. Invest in developing leadership and line management practices.

CWFT priority

• Roll out Cultural Intelligence training.

3. Growing for the future: Attract and retain

Develop agile resourcing and retention strategies that are inclusive, responsive and future-proofed to meet the needs of our people, patients and services.

APG shared priorities

1. Create the APG shared recruitment hub.
2. Widen access to quality employment for local communities.
3. Streamline and simplify cross-group working and mobility.
4. Implement solutions to manage high-volume recruitment.
5. Improve access to career development opportunities across the Group.

CWFT priority

• Design and deliver targeted improvements in flexible working.

4. New ways of working and delivering care: Productive and sustainable workforce

Through effective workforce planning, create a productive and sustainable workforce model for the future that can respond to the needs of our people, patients and services.

APG shared priorities

1. Deliver the workforce plan and bank, agency and sickness targets.
2. Deliver the workforce deployment systems programme.
3. Implement the outcomes of the national review of mandatory training.
4. Deliver the Band 4–9 N&M job profile review.
5. Develop APG new operating models, including digital skills.

CWFT priority

• Deliver the rostering efficiency programme.

Summary from 2025/26

1. Inclusive culture

Sexual safety: The Trust signed the Sexual Safety Charter in 2024 and has since worked to make tangible improvements in preventing sexual misconduct and sexual harassment and supporting staff who experience it. We launched a new policy in 2025, which put in place wider measures to encourage reporting, including anonymous reporting, to ensure that reports are managed quickly and fairly and to improve access to support. It also offers the same support to staff who are victims of domestic abuse. We have launched training for staff who may be “first responders” to colleagues raising complaints and will provide specialist training to our HR teams who investigate and manage cases.

Freedom to Speak Up: The Trust has continued to promote a wide range of ways to provide feedback or raise concerns, including conversations about negative behaviours or experiences of our staff, including those with protected characteristics. Our Freedom to Speak Up team has relaunched with new channels of communication and promotion across the Trust.

Project SEARCH: We continue to offer one-year internships for young people with learning disabilities and autism in roles across the Trust. This not only provides pathways to long-term employment for interns but also brings cultural change, giving staff the opportunity to mentor, manage and work alongside them.

Cultural Intelligence training: In 2025/26, the Trust agreed funding for significant investment in a programme of Cultural Intelligence training. Cultural Intelligence is the ability to function and relate effectively in culturally diverse situations. We have trained a faculty of 20 internal trainers to deliver this training. It will have an impact on staff interactions and culture as well as on patients. This will form a major part of our Equality, Diversity and Inclusion programme in 2026/27 and respond to many of the issues identified in our Staff Survey data, including discrimination, bullying and harassment and patient experience.

Cultural Intelligence (CQ) is the capability to function and relate effectively in culturally diverse situations or contexts.

• CQ Drive: Level of interest, persistence and confidence during multicultural interactions.
• CQ Knowledge: Understanding of how cultures are similar and different.
• CQ Strategy: Awareness and ability to plan for multicultural interactions.
• CQ Action: Ability to adapt when relating and working in multicultural contexts.

Just and Learning culture: In 2025/26, we redesigned our employee relations pathway to help remove bias from processes linked to staff entering disciplinary procedures. A new triage panel with EDI and BAME representation will seek to oversee decision-making and identify alternative solutions.

Inclusive recruitment for leaders at Band 7+ and medical leaders: We have continued to roll out inclusive recruitment practice with the aim of increasing appointments from underrepresented groups. We have a network of 70 Diversity and Inclusion representatives who support the programme.

Participation in the Healthcare Leaders’ Fellowship regional leadership development programme: The Healthcare Leaders Fellowship is a positive action programme for clinical leaders at Band 7 and above. Cohort 1, “Get On”, and Cohort 2, “Go Further”, are designed as a strategic talent management and succession-planning initiative to help address underrepresentation at senior levels. Delegates take part in a structured development programme with a leadership apprenticeship, bespoke workshops, career-planning support and mentorship alongside colleagues from other trusts across the ICS.

Menopause: Our work to support staff affected by menopause symptoms continues with a monthly network session covering a range of menopause-related topics, supported by subject-matter experts from across the Trust. Our Menopause Team continues to support the network and has introduced a referral pathway for staff to see a menopause clinical nurse specialist within the Trust for support and advice. We host an annual conference with our APG partners featuring a range of expert speakers to celebrate World Menopause Day in October.

Staff networks and events

The Trust has five staff networks, helping every member of staff feel respected, represented and able to thrive. Our staff networks bring colleagues together from across the organisation, providing safe and supportive spaces for connection, collaboration and change. Each staff network has an executive sponsor and either a chair or co-chairs who organise network priorities and annual work plans. Each network is open to all staff, including allies, recognising the intersectionality of staff members who want to learn, share experiences and support others.

Our maternity cultural safety champions facilitate and accelerate organisational change within maternity services, helping to embed and sustain culturally safe practice for all women, birthing people, their families and staff. They also support staff to provide excellent care and work in an environment that provides equal treatment and opportunities to staff from all backgrounds.

The five staff networks represented in the report are:

• Equality Network for Race, Inclusion and Cultural Heritage (ENRICH) Staff Network
• Disability Network
• Women’s Network
• LGBTQ+ Network
• Armed Forces Network

International Women’s Day

The Women’s Network celebrates International Women’s Day each year.

London Pride march—June 2025

Armed Forces Family Network—June 2025

Black History Month—October 2025

The Trust celebrated Black History Month under the theme “Standing Firm in Power and Pride”.

Disability History Month—November 2025

Scrubs to Sequins fashion show—April 2026

In 2026, we launched a fashion show which showcased fashions from a wide range of cultures and both represented and celebrated the diversity of our workforce.

Career progression

Apprenticeships

The Trust continues to expand its apprenticeship offerings through partnerships with training providers, ensuring a diverse range of opportunities and high-quality delivery. During the financial year 2025/26, the Trust delivered 48 distinct apprenticeship programmes, with an average of 4.1% of its workforce participating as apprentices.

There were 111 completions across 22 different apprenticeship programmes this year, compared with 94 completions last year. As a main provider, the Trust continues to deliver the Healthcare Support Worker Apprenticeship and is actively exploring further expansion of its provision as an Apprenticeship Main Provider. The Trust’s achievement rate is 84%, higher than the national average of 64%.

In November 2025, during the Capital Clinical Support Workers (CSW) Awards, the Trust was recognised as the winner in the Widening Access and Supporting Diversity category. Additionally, the Head of Apprenticeships received a high commendation in the CSW Lead of the Year category, reflecting the Trust’s commitment to inclusion and leadership in the sector.

This programme provides significant opportunities for career development and progression. Of those on an apprenticeship programme, 61% in 2025/26 were from BAME groups.

Our patients and communities

Health inequalities programmes

During 2025/26, we have continued to work towards addressing health inequalities and improving the health of the population we serve. Below is a brief summary of some of our ongoing programmes to improve the health and care of our local population.

Hospital Discharge Pilot: Facilitating timely discharge and preventing avoidable social readmissions through a person-centred, targeted approach that bridges hospital and community services. This work involves collaboration with partners to address root causes such as housing stability, health and lifestyle and income maximisation, while supporting long-term sustainable outcomes in the community.

Improving access to outpatient services: Patients in our most deprived cohort have the highest did-not-attend (DNA) rates for outpatient appointments. We are testing solutions including better text reminders, an AI system to flag patients at risk of missing appointments and using volunteers to provide appointment reminders.

Health literacy: Exploring the implementation of Trust-wide health literacy training to reduce unwarranted variation in patient experience and outcomes, ensuring health information is consistently communicated in an accessible way aligned to a universal reading age of approximately nine years.

Improving maternity outcomes: A targeted case-loading model was piloted at West Middlesex for Black women under the age of 25 to improve access and outcomes, resulting in reduced DNA rates, enhanced engagement with services and demonstrable improvements in measured maternity outcomes.

Right Patient, Right Scan, Right Time: Ongoing improvement work in diagnostic imaging focused on appropriate testing, safer pathways, digital decision-support tools and more inclusive practice.

Smokeless Programme

Smoking cessation support continues to be delivered across both acute and maternity settings. Efforts have focused on improving the recording of smoking status and ensuring patients are routinely advised on the risks associated with smoking.

Where appropriate, patients are offered referral to the smoking cessation service, including access to nicotine replacement therapy.

Alcohol care

Building on the demonstrated benefits of the alcohol care service at West Middlesex, work is underway to extend the hospital liaison model to Chelsea and Westminster. This includes strengthening partnerships with borough teams and community providers to enhance continuity of care and support patients following discharge.

Neighbourhood approach

We are working closely with local integrated neighbourhood teams to improve outcomes for our population through targeted, joined-up initiatives, for example, a local holistic multidisciplinary team (MDT) bringing together clinical teams, local authorities, voluntary, community and social enterprise organisations and primary care.

Appendix 1: Workforce profile

Age

The workforce age profile shows no significant change from last year. The largest age group is 25–34, followed by 35–44. The number of staff aged under 25 has fallen from 550 last year to 290 this year, while the number aged 65 and over has increased from 158 to 227.

Disability

As at 31 March 2026, 4.1% of staff had declared a disability on our ESR system, up from 3.2% in 2025. Of staff, 85% had not declared a disability and the status of 11% was unknown.

The number of staff who have declared a disability on our ESR system is shown by pay band for clinical and non-clinical groups.

Gender

As at 31 March 2026, the Trust had a total workforce of 7,912, excluding bank staff. The workforce gender split has remained largely unchanged over many years, at 75% female and 25% male.

By band, the proportion of male colleagues varies from 16% in Band 6 to 50% in Band 9 and among very senior managers.

Ethnicity

As at 31 March 2026, the Trust had a total workforce of 7,912, excluding bank staff. Overall, 56% were from a BAME background, compared with 36% who were white; 8% had an unknown ethnicity.

This is an increase of 1.1 percentage points from 2025, when 54.9% were from a BAME group.

According to the Office for National Statistics 2021 Census, 53.8% of the London population were white and 46.2% were from a BAME background.

When broken down by pay band, the proportion of BAME colleagues varies from 75% in Band 5 to 27% in Band 8d.

Sexual orientation

The majority of staff were heterosexual (77.1%), with 10.1% recorded as unspecified and 3.3% as gay or lesbian. Some staff choose not to disclose their sexual orientation and are recorded as either unspecified or not stated on our ESR records.

There has been a small increase in the number of staff who have declared that they are gay or lesbian or bisexual since last year.

Sexual orientation counts

Sexual orientation category	Previous year	Current year
Unspecified	850	802
Undecided	11	11
Other sexual orientation not listed	14	17
Not stated (person asked but declined to provide a response)	608	594
Heterosexual or straight	5,948	6,102
Gay or lesbian	237	260
Bisexual	115	126

Religious profile

As at 31 March 2026, the Trust had a total workforce of 7,912, excluding bank staff. Overall, 45.93% declared Christianity as their religion, followed by similar proportions (9–10%) in the groups atheism, Islam, unspecified and those who do not wish to disclose.

Compared with the previous year, there has been a small increase in the number of staff in the categories of Christianity, Islam, Hinduism and atheism.

Marriage and civil partnership

The majority of staff have declared that they are single (53.53%) and 37.42% are married.

Marriage and civil partnership counts

Category	Number of staff
Civil partnership	79
Divorced	204
Legally separated	50
Married	2,961
Single	4,235
Unknown	353
Widowed	30

Appendix 2: Patient profile

Inpatient demographics by gender and age

The largest female age group accessing inpatient services is 30–39. For males, the largest age group is 60–69.

Note: Each patient is counted as a unique individual within the financial year, regardless of the number of visits or activities.

Outpatient demographics by gender and age

The largest female age group accessing outpatient services is 30–39. For males, the largest age group is 50–59.

Note: Each patient is counted as a unique individual within the financial year, regardless of the number of visits or activities.

A&E demographics by gender and age

Among females accessing A&E services, the largest age group is 20–29. For males, the largest age group is also 20–29.

Maternity: mothers’ age at delivery and baby’s gender

Patient demographics by ethnicity

Patient ethnicity percentages

Ethnicity	Trust level	Chelsea	West Middlesex
Mixed	4.0%	4.3%	3.5%
Black	8.2%	9.4%	6.7%
Not stated	8.6%	9.8%	7.2%
Other	11.3%	13.5%	8.7%
Asian	21.5%	11.3%	33.8%
White	46.4%	51.7%	40.1%

Note: Each patient is counted as a unique individual within the financial year, regardless of the number of visits or activities.

Patients’ religious beliefs

Patients’ first language

Patients by deprivation index

Deprivation index: 1 is most deprived and 10 is least deprived.

Deprivation decile percentages

Deprivation decile	Percentage
1	2%
2	10%
3	12%
4	18%
5	15%
6	14%
7	9%
8	9%
9	7%
10	4%

Appendix 3: Governance

The table below shows the Trust’s internal governance structure from 1 April 2026. It has several groups or committees, as set out below. Externally, we have governance meetings through the North West London Acute Provider Group, NHS London Region (including Pan-London and London Workforce Race Strategy), NHS England and NHS WRES and WDES teams, among others.

Governance structure from 1 April 2026

Meeting	Purpose	Frequency	Chair	Membership
Belonging Committee	Provides direction and oversight for delivery of the Trust workforce EDI delivery plan.	Monthly	Chief Nurse	Representatives from our People Division senior management team, divisions, staff-side representatives and staff network chairs.
Workforce Development Committee	Oversees all people and workforce topics and programmes of work.	Monthly	Chief People Officer	Representatives from People and Organisational Development, senior management, divisions and staff-side representatives.
CEO Cabinet	A weekly executive meeting for strategic oversight ahead of Executive Management Board discussions on all topics, including people and workforce.	Weekly	Trust Chief Executive Officer	Trust executive directors and directors.
Trust Standing Committee	Oversees delivery of the Trust strategy and strategic priorities, achievement of constitutional and regulatory standards and provides assurance that related Trust risks and issues are being managed.	Quarterly	Trust Vice Chair	All non-executive directors (voting and designate), except the Chair in Common who will attend ad hoc ex officio; voting executive directors of the Board.
Executive Management Board	Provides strategic oversight of all key workforce business decisions.	Twice a month	Members of the Senior Leadership Team on a rotating basis	Executive and non-executive directors, senior directors.
Group People in Common Committee	A non-statutory committee of the Board in Common to support the boards of the four acute trusts in fulfilling their people-related responsibilities. It oversees and provides assurance on Trust- and Group-level people performance, ensures compliance with statutory and regulatory requirements, identifies variation and risks requiring collective action and oversees the delivery and development of strategic people priorities and programmes to drive improvement across the Group.	Quarterly	Vice Chair of the Board in Common	A non-executive director from the trusts within the North West London Acute Provider Group; Group Chief People Officer.
Board in Common	Provides a forum for the four North West London acute provider trusts to work collectively to improve outcomes, performance and efficiency. It brings together all Trust Board members to set strategic direction, oversee performance and ensure public accountability.	Quarterly	Chair of the NWL Acute Provider Group	Executive and non-executive directors, senior directors.