Equality delivery system 22 (EDS22)

The Equality Delivery System (EDS) is a system that helps NHS organisations improve the services they provide for their local communities and provide better working environments, free of discrimination, for those who work in the NHS, while meeting the requirements of the Equality Act 2010. The NHS developed the EDS, taking inspiration from existing work and good practice

Background to the EDS

The NHS EDS was launched as a continuous development tool in November 2011. In November 2012. Shared Intelligence published their report ‘Evaluation of the equality delivery system for the NHS’ which looked at how the EDS had been adopted across NHS organisations. Based on this evaluation and subsequent engagement with the NHS and key stakeholders, a refreshed EDS – known as EDS2 – was made available in November 2013.

A review of the EDS2 was undertaken to incorporate system changes and take account of the new system architecture for Integrated Care Systems. Through collaboration and co-production and taking into account the impact of COVID-19, the EDS has now been updated and EDS 2022 is now available for live testing during 2022/23.

The main purpose of the EDS was, and remains, to help local NHS systems and organisations, in discussion with local partners and local populations, review and improve their performance for people with characteristics protected by the Equality Act 2010. By using the EDS 2022, NHS organisations can also contribute to delivering on the Public Sector Equality Duty.

EDS 2022 is aligned to NHS England’s Long term Plan and its commitment to an inclusive NHS that is fair and accessible to all.

EDS 2022/23 is a generic system designed for both NHS commissioners and NHS providers. As different systems apply EDS 2022/23 outcomes to their performance, NHS organisations should do so with regard to their specific roles and responsibilities.

EDS 2022/23 implementation by NHS provider organisations is mandatory in the NHS Standard Contract and the completion of an EDS will be part of provider CQC inspections

EDS22 Domains

There are three different domains to be reported on within the EDS.

At the heart of the EDS are eleven outcomes, against which NHS organisations measure their successes and challenges with protected characteristic and vulnerable community groups using evidence and insight. The outcomes, grouped into three Domains, are as follows:


Domain 1: Commissioned or provided services

1A: Patients (service users) have required levels of access to the service  (simpler version of EDS2 2.1)

1B: Individual patients (service user’s) health needs are met 

(simpler version of EDS2 1.2)

1C: When patients (service users) use the service, they are free from harm  (like EDS2 1.4)

1D: Patients (service users) report positive experiences of the service  (same as EDS2 2.3)


Domain 2: Workforce health and well-being

2A: When at work, staff are provided with support to manage obesity, diabetes, asthma, COPD, and mental health conditions (response to COVID-19)

2B: When at work, staff are free from abuse, harassment, bullying and physical violence from any source (like EDS2 3.4)

2C: Staff have access to independent support and advice when suffering from stress, abuse, bullying, harassment, and physical violence from any source (response to Covid-19) 

2D: Staff recommend the organisation as a place to work and receive treatment (like EDS2 3.6)


Domain 3: Inclusive leadership

3A: Board members, system leaders (Band 9 and VSM) and those with line management responsibilities routinely demonstrate their understanding of, and commitment to, equality and health inequalities (like EDS 4.1)

3B: Board/Committee papers (including minutes) identify equality and health inequalities related impacts and risks and how they will be mitigated and managed (like EDS2 4.2)

3C: Board members, system, and senior leaders (Band 9 and VSM) ensure levers are in place to manage performance and monitor progress with staff and patients (response to Covid-19)

EEAST’s EDS22 Report for the Year 1st April 2021 to 31st March 2022.


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