ArticlePublic health in practice (Oxford, England)2026
Empowering health care staff to address health inequalities: A policy-focused evidence brief.
Article in Public health in practice (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
The policy challenge: Leveraging the health care workforce to take action on health and care inequalities has significant potential, with the NHS in England employing 1.5 million people. Minority ethnic groups are over-represented in the NHS workforce, but underrepresented in senior roles, with high discrimination rates and limited career progression. Chronic workforce shortages exacerbate these issues, increasing workloads and reducing morale. Additionally, inequitable staff distribution, favouring affluent areas over deprived ones, hinders progress in disadvantaged communities. Systemic changes are needed to promote equity in the workforce and close health inequalities gaps. Here, we review the policy-focused evidence that explores how to empower healthcare staff to address inequalities. Key evidence to inform policy: We identified four key themes of how staff can be empowered to address health and care inequalities: 1) empowering through skills, 2) empowering through resources, 3) empowering through workforce structure, and 4) empowering through staff champions. There is evidence that training in cultural competency, anti-racism, anti-stigma, advocacy, health literacy, and game-based training can empower staff. However, these interventions require adequate time and should be complimented by innovative care models, such as trauma-informed care. Furthermore, the workforce should be diverse at all levels with enhanced professional development for employees from underrepresented backgrounds. Staff champion programmes can promote workforce equality, fostering collaboration and innovation. Further considerations and implications: Research on staff empowerment to tackle inequalities is limited and often focuses on staff rather than patient outcomes. There are also challenges in measuring cultural competence and comparing studies. Key training areas include cultural competency (ethnicity, LGBTQ+, and mental health), anti-stigma, anti-racism, advocacy, and low health literacy perspectives. Organisations should provide culturally competent resources, promote trauma-informed care, and ensure staff have sufficient time to support patients with complex needs and equity-focused improvements.
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