As we mark the anniversary of the Race Equity Maturity Index (REMI), its importance to the future of the NHS is undeniable. Developed by the Race Equality Foundation through the London Anti-Racism Collaboration for Health (LARCH), REMI is the first evidence-based self-assessment tool enabling health and care organisations across Greater London to track, measure, and strengthen their commitment to race equity.
Why REMI Matters in Health and Social Care Reform
The NHS – and, at a slower pace, social care – is undergoing significant transformation amid growing political pressure to boost productivity and ensure financial sustainability. During times of major change, equality initiatives are often treated as optional when savings need to be made, especially with rising public criticism of equality, diversity and inclusion (EDI) efforts. Yet cutting back on EDI when building an NHS for the future is a false economy.
London’s health and care system reflects the UK’s diversity; over one-third of NHS staff come from Black, Asian, and minoritised ethnic communities. However, these staff continue to experience harassment, discrimination and barriers to career progression despite years of commitments to change. And patients from minoritised ethnic communities continue to face poorer health outcomes.
A successful NHS is one where staff not only stay, but feel like they belong and thrive; and where fair and effective care is accessible to all.
To meet the needs of an increasingly diverse population and workforce, equity must be front and centre of planning, otherwise we risk persistent racial health inequalities and workforce disparities deepening.
REMI ensures race equity is not an optional add-on but is integral to organisational culture and governance, helping to deliver fairer and more trusted care for all.
A System-Wide Approach
Dismantling structural racism in health and care requires collective action and shared responsibility. REMI supports whole-system alignment across NHS organisations, Integrated Care Systems, local authorities, public health teams, and voluntary and community sector partners, reflecting the collaborative approach taken in its design.
It provides a structured six-stage pathway for organisations to embed anti-racist practice at every level:
- Awareness: recognising racism as a systemic issue.
- Commitment: developing a clear race equity strategy.
- Implementation: turning strategy into measurable action.
- Embedding: Aligning policies and decision-making with anti-racist principles.
- Creating: Innovating to address racial disparities.
- Championing: Organisations leading the way for others.
One early adopter noted: “REMI allows one to gauge where they are in tackling racism. It provides objectives that organisations can work towards, and it underscores that tackling racism is an ongoing process.”
It has been created to complement existing EDI efforts across Greater London, so health and care organisations are able to move from compliance toward cultural transformation.
Designed for Today’s Challenges
REMI was designed to address the realities health and social care leaders face:
- Initiative Fatigue: REMI consolidates existing frameworks – Workforce Race Equality Standards (WRES), Workforce Disability Equality Standards (WDES), CQC standards, and Public Sector Equality Duty (PSED) requirements – by providing an overarching structure to connect existing equality work. As one NHS practitioner observed: “This [REMI] looks at the anti-racism side of things from a different angle. And that’s why I think it can complement what you’re doing in the WRES. REMI could be part of your arsenal with the WRES.” REMI allows you to structure what you’re already doing into a coherent narrative that demonstrates genuine progress.
- Capacity Constraints and Competing Priorities: REMI is flexible and non-prescriptive. There are no external deadlines or mandatory reporting requirements imposed by NHS England. Organisations move through the maturity stages at their own pace, integrating race equity into existing board priorities rather than creating parallel streams of work. This reduces pressure on already-stretched leaders while ensuring equity remains embedded in core business.
- Fear of Naming Racism: REMI’s systems-focused approach addresses institutional structures rather than individuals, creating the space for honest conversations about racism without triggering defensive responses. This makes change feel achievable rather than accusatory.
- Poor Data Infrastructure: REMI strengthens ethnicity data systems by requiring organisations to examine the processes that affect data quality – such as recruitment, decision-making pathways, and reporting structures. This helps to build the evidence base needed to demonstrate progress, identify where change is needed, and drive meaningful change.
- Low Staff Trust: Years of statements without structural change have left many staff of minoritised ethnic backgrounds skeptical about new initiatives. REMI moves organisations from statements to structural actions. It focuses on visible, tangible changes: fair recruitment pathways, meaningful staff engagement, and community co-production. Staff can see where their organisation is in its journey and what specific actions are being taken at each stage. This transparency rebuilds trust through evidence, not promises.
The Strategic Case for REMI
REMI is more than a moral imperative – it’s a strategic investment. NHS workforce data shows that staff who experience discrimination are significantly more likely to leave the organisation and report lower engagement. The evidence is clear: equitable and inclusive organisations deliver better patient outcomes, foster greater innovation, and build stronger organisational resilience. REMI provides the measurable progress indicators, and accountability to embed race equity practices that build these inclusive conditions.
As the NHS reforms to become more integrated and responsive to community needs, tools like REMI are essential to ensure that equity is at the heart of transformation – not an afterthought. REMI helps organisations demonstrate their commitment to race equity through real improvements to staff experience, organisational culture, and patient outcomes.
Join the Movement
On this anniversary, we call on health and care organisations to put your commitment to race equity into practice with the REMI tool, designed for the reality you face.
REMI offers a structured, evidence-based pathway that identifies where you are and supports steady, sustainable progress.
Whether you’re at the beginning of your journey or already implementing anti-racist strategies, REMI provides the framework to assess your current position, identify next steps, and demonstrate your progress to staff, patients, and communities.
The challenges facing London’s health and care system are significant, but so is the potential for transformation, with the right tools and support.
Learn more and access the REMI framework: Race Equity Maturity Index
Have questions about how REMI could work in your organisation? Get in touch.
REMI was developed by the Race Equality Foundation as part of the London Anti-Racism Collaboration for Health (LARCH), with support from the Greater London Authority and Health Innovation Network South London.
Dr. Amanda Simon is a Senior Researcher at the Race Equality Foundation, focused on anti-racism policy and implementation, working closely with community partners and individuals from Black, Asian, and minoritised ethnic communities.