Equality, Diversity and Inclusion in the NHS: The Equality Act 2010 for Medicine Interviews

Equality, diversity and inclusion (EDI) means treating people fairly, valuing their differences and making sure everyone can take part. In the NHS it rests on the Equality Act 2010, which protects nine characteristics, and on the duty to treat patients and colleagues fairly. In medicine interviews it's a common topic, usually as a run of short questions.

I'm Dr Akash Gandhi, an NHS GP and the founder of TheUKCATPeople, and I've helped students prepare for medicine interviews since 2012. Equality questions ask for definitions, law and a personal view in the same breath, so this guide covers all three. It sits alongside the other topics in our NHS hot topics guide.

What does equality, diversity and inclusion mean?

Equality, diversity and inclusion are three linked ideas about how people are treated, and interviewers like to hear them separated. The key facts:

• Equality: everyone has the same rights and opportunities, and nobody's treated worse because of who they are
• Diversity: the mix of people in a team or a patient population, including ethnicity, sex, age, disability, religion, sexual orientation and background
• Inclusion: the culture that lets everyone in that mix take part fully, speak up and feel they belong

A team can be diverse without being inclusive: you can hire a wide range of people and still run meetings where only the senior consultants speak. Diversity is who's in the room, inclusion is whether they can contribute.

Does equality mean treating everyone exactly the same?

No. Equality means fair treatment, and fair treatment sometimes means doing something different for one person. A deaf patient needs a British Sign Language interpreter that other patients do not. The aim is an equal chance of a good outcome.

Key Takeaway: Define all three words separately, then say that equal treatment and fair treatment are different things.

What is the Equality Act 2010?

The Equality Act 2010 is the law that protects people in England, Scotland and Wales from discrimination, replacing earlier laws such as the Sex Discrimination Act 1975, the Race Relations Act 1976 and the Disability Discrimination Act 1995.

Most of it took effect on 1 October 2010, and it lists nine protected characteristics in section 4. The table below is most of what you need.

A useful point of accuracy for interviews: marriage and civil partnership is protected at work only, so it doesn't apply to patients using NHS services. Northern Ireland has its own equality laws.

Most students who try to recite the nine from memory forget two. Group them as who you are (age, sex, race, disability, sexual orientation), what you believe (religion or belief) and life events (pregnancy and maternity, marriage and civil partnership, gender reassignment).

What would you add to the Equality Act?

Any reasoned answer works, because the question is asking you to think. Socioeconomic background is the usual suggestion: deprivation shapes health more than almost anything else, and the socioeconomic duty in section 1 of the Act has been brought into force in Scotland and Wales but never in England.

Key Takeaway: Name the Act, say it protects nine characteristics, and be able to list them without looking down.

What counts as discrimination under the Equality Act?

The Act bans several kinds of unfair treatment, and the words matter because each describes a different situation. The five that come up in healthcare are in the table below.

Reasonable adjustments are the one duty that requires action rather than restraint. Section 20 says that where a rule, a physical feature or the lack of an aid puts a disabled person at a substantial disadvantage, reasonable steps must be taken to remove it, and the disabled person can never be asked to pay.

In general practice the most common adjustment is time: a patient with a learning disability gets a double appointment, a carer in the room if they want one and an easy-read letter. None of that is special treatment, it's what the law expects.

Is positive discrimination allowed?

Positive discrimination, meaning choosing someone because of a protected characteristic, isn't lawful. Positive action is allowed: encouraging under-represented groups to apply, targeted outreach, and choosing the under-represented candidate in a tie between two equally qualified people. Widening participation sits on the lawful side of that line.

Key Takeaway: Know direct, indirect, harassment and victimisation, and give reasonable adjustments its own example.

What is the public sector equality duty?

The public sector equality duty is the part of the Act that asks public bodies, including NHS trusts and GP practices, to think about equality before they decide rather than after a complaint. Section 149 says they must have due regard to the need to:

1. Eliminate discrimination, harassment and victimisation
2. Advance equality of opportunity between people who share a protected characteristic and people who do not
3. Foster good relations between those groups

The duty came into force on 5 April 2011. It's why trusts carry out equality impact assessments before changing a service, and why the Accessible Information Standard requires NHS organisations to record how a disabled patient needs information given to them.

The phrase to use is due regard: the duty doesn't force a decision, but a trust that closes a clinic without asking who will struggle to reach the next one has broken it.

Key Takeaway: Say the three limbs, eliminate, advance and foster, and that the duty is about considering equality before deciding.

Why does diversity matter in a medical workforce?

Diversity in the NHS workforce matters because patients get better care from a service that understands them, and because the NHS can only run if it recruits and keeps staff from every part of society. The reasons worth having ready:

• Trust and disclosure: patients tell more to clinicians they feel understand them, and a history taken in full is safer than one taken in part
• Health inequalities: between 2022 and 2024 the maternal death rate was 2.7 times as high for Black women as for White women, which the national maternity investigation linked partly to stereotypes about pain
• Workforce: in March 2025, 30.7 per cent of NHS trust staff and half of medical and dental staff were from Black, Asian and minority ethnic backgrounds, so an NHS that treated them unfairly couldn't staff itself

The disclosure point is visible in any GP surgery. A patient who gives a two-word answer about their drinking will sometimes give the whole story to a healthcare assistant who shares their language, because the question arrived from someone who understood its cost.

👉 Read More: BAME Staff and Racism in the NHS

👉 Read More: Health Inequalities and the Marmot Review

Key Takeaway: Go beyond fairness to staff: say that diversity changes what patients disclose and what teams notice.

What are the Workforce Race Equality Standard and the Workforce Disability Equality Standard?

The Workforce Race Equality Standard (WRES) and the Workforce Disability Equality Standard (WDES) are the NHS measures that compare the experience of staff from different backgrounds, published every year. The 2025 WRES report, published on 7 April 2026, uses workforce data from 31 March 2025. Its headline figures:

• Recruitment: white applicants were 1.77 times as likely as Black, Asian and minority ethnic applicants to be appointed after being shortlisted
• Discrimination: 15.0 per cent of minority ethnic staff reported discrimination from a manager or colleague in the previous year, against 6.7 per cent of white staff
• Leadership: 17.3 per cent of trust board members were from minority ethnic backgrounds, against 30.7 per cent of the workforce

The WRES was introduced in 2015 and has nine indicators. The WDES followed in 2019 with ten metrics and tells a similar story: in the 2025 report, 6.7 per cent of staff had declared a disability, 13.9 per cent of disabled staff reported harassment, bullying or abuse from a manager against 7.6 per cent of non-disabled staff, and 75.3 per cent said their employer had made reasonable adjustments.

Key Takeaway: Quote one WRES figure accurately, such as white applicants being 1.77 times as likely to be appointed from shortlisting in 2025.

What is widening participation in medicine?

Widening participation means the schemes that help students from under-represented backgrounds into medical school. The Medical Schools Council reported in April 2025 on ten years of its Selecting for Excellence work:

• Deprivation: entrants from the most deprived fifth of areas rose from 6 per cent to 14 per cent of the intake since 2013
• Target: a third of medical students from disadvantaged backgrounds by 2032

The tools are contextual admissions, which judge grades against the school and area they were earned in, gateway years and outreach such as summer schools. Independent school entrants fell from 29 to 24 per cent over the same period.

If you're asked whether this is fair to applicants who did not qualify for help, connect it to the workforce argument: a profession drawn from one kind of school is less likely to understand all of its patients.

Key Takeaway: Widening participation is positive action, and the reason for it is the same as the reason diversity matters for patients.

How should I answer questions about transgender patients?

Answer with the person in front of you: dignity, privacy, the name and pronouns they ask for, and confidentiality, then show that you know the law is contested without taking a side. Interviewers are testing whether you can care for a vulnerable patient calmly while the argument carries on around you.

On 16 April 2025 the UK Supreme Court ruled in For Women Scotland Ltd v The Scottish Ministers that sex, man and woman in the Equality Act 2010 refer to biological sex, and that a gender recognition certificate does not change that for the purposes of the Act.

Gender reassignment stays a protected characteristic, so trans people remain protected from discrimination and harassment.

Guidance on single-sex spaces has been under review since. The Equality and Human Rights Commission's updated code of practice for services came into force on 5 August 2026, and in November 2025 the health minister told Parliament that NHS England was reviewing its guidance on same-sex hospital accommodation to reflect the ruling.

Ward placement therefore follows current guidance, local policy and a conversation with the patient.

If you're asked directly, say that you'd follow the trust's current policy, involve a senior colleague and keep the patient's privacy and dignity whatever the placement. Stay measured, because heat in either direction is what gets marked down.

Key Takeaway: Lead with dignity, privacy and the patient's chosen name and pronouns, know the April 2025 ruling, and say placement follows current guidance.

What does Good Medical Practice say about treating people fairly?

Good Medical Practice, the GMC standard every UK doctor is held to, took effect on 30 January 2024 and made the duty of fairness towards patients and colleagues more explicit than before. Our summary of the changes in Good Medical Practice 2024 covers the whole document. The paragraphs that matter here:

• Paragraph 48: you must treat colleagues with kindness, courtesy and respect
• Paragraph 56: you must not abuse, discriminate against, bully or harass anyone based on their personal characteristics, or for any other reason
• Speaking up: the 2024 version expects doctors to act on bullying, harassment and discrimination they witness, with a firmer duty on those in leadership roles

The same ideas run through the six NHS core values, in particular respect and dignity and everyone counts.

A workplace racism scenario is where these meet: the student who overhears a racist remark about a colleague is expected to support that colleague and to raise it with someone senior, because the duty to act applies to witnesses as well as to the person who spoke.

Key Takeaway: Paragraph 56 of Good Medical Practice 2024 bans discrimination, bullying and harassment on any ground, and it applies to what you witness too.

How can I talk about equality and diversity in my medicine interview?

Start from something you have seen, because equality answers are far more convincing with an example than with a slogan. Almost everyone has one:

• Work experience: an interpreter being used, or not used, or a patient whose needs were met with a small adjustment
• Volunteering or a part-time job: a customer or resident who was treated differently, and what you noticed about how the staff responded

Then shape the answer:

1. Define the term you have been asked about in one sentence
2. Add one fact, such as the nine characteristics or a WRES figure with its year
3. Give your example and what you learned from it
4. Say what it means for you as a future doctor

Here's what interviewers are looking for:

• Accuracy: that you know what the law says and do not confuse equality with sameness
• Judgement: that you can discuss a contested area, such as trans patients, calmly
• Reflection: that you can see your own assumptions and say how you would check them

These answers are worth saying aloud to someone who will push back, which is what our medicine interview coaching is for.

Key Takeaway: Define, add one fact, give your example, and end with what you'd carry into your own practice.

What interview questions could come up on equality and diversity?

You are unlikely to be asked any of these word for word, and you do not need a prepared answer to each one. Use them to check your understanding: if you could speak for a minute on most of them, you know this topic well enough for whatever the interviewer actually asks.

Questions to get you thinking

1. What do equality, diversity and inclusion mean to you?
2. Can you name the protected characteristics in the Equality Act 2010?
3. If you could add one characteristic to the Act, what would it be and why?
4. Why does it matter that the NHS workforce reflects the population it serves?
5. What is the difference between direct and indirect discrimination?

Harder questions to stretch you

1. On placement you hear a nurse make a racist comment about a colleague. What do you do?
2. A patient refuses to be examined by a doctor because of their ethnicity. How should the team respond?
3. How would you care for a transgender patient on a hospital ward?
4. Is it fair that some applicants get lower offers through widening participation schemes?

Model answer: "Why does diversity matter in a medical workforce?"

Diversity matters because patients get better care from a workforce that understands them, and because the NHS depends on staff from every background. In March 2025, around 30 per cent of NHS trust staff and about half of doctors and dentists were from Black, Asian and minority ethnic backgrounds, so a service that treated them unfairly could not run.

For patients, the clearest benefit is trust. People disclose more to clinicians they feel understand them, and a full history is safer than a partial one. Language is part of that, and so is cultural understanding.

There's also evidence of what happens without it. The national maternity investigation found that between 2022 and 2024 Black women were 2.7 times as likely as White women to die in pregnancy or soon after birth, and it linked part of that to stereotypes about pain and resilience.

On my work experience I watched a receptionist switch into Urdu for an elderly patient who had been nodding along without understanding her appointment letter. Within a minute she had an answer to a question she had carried for weeks.

For me, that's the point: diversity is a safety issue, and I would want to work in a team where every patient can be understood.

Why this answer works:

• It is accurate: it uses two checkable figures with their years and does not inflate them
• It argues from patients: fairness to staff is in there, but the weight sits on disclosure, safety and outcomes
• It is personal: a small observed moment carries more than a general claim, and the last sentence turns it into a commitment

There are many more in our medical school practice interview questions.

Key Takeaway: Define it, give one figure with its year, give one example of your own, and finish with what it means for your practice.

The one thing to take into the room

The Equality Act 2010 protects nine characteristics, and a diverse NHS is safer for patients because people disclose more to those who understand them. If you can list the nine, separate equality from sameness, quote one figure with its year and talk about a trans patient with calm, you are ready for most equality questions.

Related reading: health inequalities and the Marmot Review, Good Medical Practice 2024 and the wider NHS hot topics guide for the other current topics.

Key Takeaway: Fair treatment is not always the same treatment, and that single idea unlocks most of this topic.