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The UK began delivering its COVID-19 vaccination programme on 8 December 2020, with health and social care workers (H&SCWs) given high priority for vaccination. Despite well-documented occupational exposure risks, however, there is evidence of lower uptake among some H&SCW groups. We used a mixed-methods approach-involving an online cross-sectional survey and semi-structured interviews-to gain insight into COVID-19 vaccination beliefs, attitudes, and behaviours amongst H&SCWs in the UK by socio-demographic and employment variables. 1917 people were surveyed- 1656 healthcare workers (HCWs) and 261 social care workers (SCWs). Twenty participants were interviewed. Workplace factors contributed to vaccination access and uptake. SCWs were more likely to not be offered COVID-19 vaccination than HCWs (OR:1.453, 95%CI: 1.244-1.696). SCWs specifically reported uncertainties around how to access COVID-19 vaccination. Participants who indicated stronger agreement with the statement 'I would recommend my organisation as a place to work' were more likely to have been offered COVID-19 vaccination (OR:1.285, 95%CI: 1.056-1.563). Those who agreed more strongly with the statement 'I feel/felt under pressure from my employer to get a COVID-19 vaccine' were more likely to have declined vaccination (OR:1.751, 95%CI: 1.271-2.413). Interviewees that experienced employer pressure to get vaccinated felt this exacerbated their vaccine concerns and increased distrust. In comparison to White British and White Irish participants, Black African and Mixed Black African participants were more likely to not be offered (OR:2.011, 95%CI: 1.026-3.943) and more likely to have declined COVID-19 vaccination (OR:5.550, 95%CI: 2.294-13.428). Reasons for declining vaccination among Black African participants included distrust in COVID-19 vaccination, healthcare providers, and policymakers. H&SCW employers are in a pivotal position to facilitate COVID-19 vaccination access, by ensuring staff are aware of how to get vaccinated and promoting a workplace environment in which vaccination decisions are informed and voluntary.

Since the inception of the NHS in 1948, race equality had never been mandated and built into contracts--until 2015, when the Workforce Race Equality Standard (WRES) was introduced into the NHS standard contract. The standard made clear that all protected characteristics were important, but that for many years no focused attention had been paid to improving race equality in the NHS. As an organization with 18% of the workforce from black and minority ethnic (BME) backgrounds, it was important that we looked more closely at this complex and highly sensitive issue. WRES is designed to enable BME employees to receive equal access to career opportunities and fair treatment in the workplace. That might be through job appointments, career progression, or avoiding bullying and harassment. The root of the initiative lies in the NHS constitution, which states as one of its first principles that the NHS is for all people, regardless of background.

Approaches are needed that tackle the root causes, including the structural drivers of health, argue Raquel Catalao and colleagues

The evidence and policy options for eliminating inequity are clear; what is needed now is political and institutional commitment and action, say J S Bamrah and colleagues

November was the NHS awards season, hot on the heels of October's Black History Month, which celebrated the achievements and contribution to society of people of African origin.

Earlier this month I went 'back to the floor' to work alongside nursing colleagues at Wrightington, Wigan and Leigh NHS Foundation Trust in north west England.

August 28 saw the 50th anniversary of Martin Luther King’s ‘I have a dream’ speech, made during the March on Washington in 1963 when segregation laws were in full force in the United States.

If the NHS were a boxer, it would be battered, bruised and shaken, face down on the boxing ring floor with the referee's final countdown resounding in its ears.

At last month's RCN congress I was invited to give a presentation at a Nursing Standard fringe event on how equality and diversity will be managed in the new NHS.At last month's RCN congress I was invited to give a presentation at a Nursing Standard fringe event on how equality and diversity will be managed in the new NHS.