Observatory urges race equity to be central to the future of AI in NHS care
Artificial intelligence (AI) used across NHS healthcare must embed racial equity to ensure full participation and build further trust with diverse communities and patients.
The call comes from a new paper out today from the NHS Race and Health Observatory which highlights how patients and communities from diverse communities need early involvement and engagement to help ensure equitable and trusted AI-enabled NHS heath care.
Towards Trustworthy, Equitable AI in the NHS, follows a national roundtable convened by the independent organisation in July 2026; the publication coincides with the publication of the Regulation of AI in Healthcare.
Co-chaired by Professor Habib Naqvi, Observatory chief executive and Board member, Professor (Dr) Chaand Nagpaul CBE, GP partner and Board member, the roundtable examined a broad range of perspectives, opportunities and challenges associated with the growing use of AI in health and care with a focus on implications for Black, Asian and ethnically diverse communities.
Whilst the NHS is utilising opportunities afforded by AI to improve care for patients, as with previous waves of technical innovation and medical devices, there remains the risk that AI can reproduce or amplifying existing racial inequalities. This can occur when systems are designed, implemented and governed without sufficient attention to ethnicity recording, fairness, inclusion and trust for diverse communities.
This long-term risk can be anticipated before racial bias becomes embedded in AI systems, through unrepresentative ethnicity datasets, variables that act as substitutes for race and ethnicity, and data shaped by longstanding inequalities in access, treatment and healthcare expenditure. Once trained, tested and deployed, AI systems can entrench, amplify and scale bias across every patient-facing decision they support.
Professor Habib Naqvi, chief executive, NHS Race and Health Observatory, said:
“AI has real potential to improve healthcare, but that potential will only be fully realised if these technologies are designed, regulated and deployed in ways that actively reduce inequalities rather than risk entrenching them. Our paper sets out why fairness, transparency, patient safety and public trust must be central to the development of AI, so that every community can benefit from innovation and no one is left behind.
“We must ensure that AI in healthcare is developed and implemented in ways that advance racial equity, strengthen accountability and command the confidence of the communities it is intended to serve.”
The roundtable brought together organisations spanning healthcare, academia, policy, regulation, technology and community organisations, including stakeholders representing the Patients Association, NHS England, Medicines and Healthcare products Regulatory Agency, National Voices and the Department of Health and Social Care. Current discussions around AI primarily focus on technical governance, data quality and algorithms, with minimum research and attention given to the perspectives, experiences and trust concerns of ethnically minoritised patients and communities.
Professor Chaand Nagpaul, GP partner and NHS Race and Health Observatory Board member, said:
“Artificial intelligence is becoming increasingly integrated into healthcare systems, including across the NHS. It being used to support diagnosis, clinical decision-making, provide patient facing information, operational efficiency and administrative processes on a daily basis.
“AI presents significant opportunities to improve patient outcomes and transform healthcare delivery, including the potential to demonstrate lesser bias than human decision-makers and can represent a significant leap towards health equity. However, to leverage this, we must prioritise equitable algorithmic design, rigorous data assessment, active community engagement, and robust regulatory oversight.”
Rachel Power, Chief Executive, Patients Association, said:
“AI has the potential to improve healthcare, but patients need to be confident that it is being developed and used safely, fairly and transparently, and without reinforcing the inequalities that already exist in healthcare.
“Patients have told us that they want to be involved in decisions about how AI is used in their care, and that involvement needs to happen from the start. This is particularly important for communities who may be more likely to experience bias, exclusion or barriers to accessing care.
“Patients should not be brought in once an AI system has already been designed. Their experiences and perspectives need to help shape how these systems are developed, tested, implemented and monitored. Patients also need to know when AI is being used in their care, who is responsible if something goes wrong, and how they can raise concerns.
“Building trust in AI means putting patients and communities at the heart of its development. Equity, transparency and accountability need to be built in from the beginning, rather than addressed after problems emerge.”
Mark Wong, Professor of Social and Digital Policy, University of Glasgow and former Co-Chair, Design Advisory Group of the Anti-Racism Observatory for Scotland said:
“Although AI has the potential to unlock significant benefits, more than a decade of research has shown that AI exacerbates racial discrimination in healthcare, from cancer detection, triaging, to ambient voice technology. Stronger safeguarding and AI governance must be developed urgently, so that communities and patients who have been harmed are at the heart of decision-making about AI use in the NHS.
“This paper is a ‘wake-up call’ that communities demand to be actively involved in every step of the governance of AI to ensure public trust. AI bias and inequities must be evaluated through a race equity lens with diverse communities, and AI use should remain a choice without compromising access to inclusive, equitable care. Discriminatory processes reinforced by AI should be prioritised as an issue of patient safety.”
The roundtable discussion highlighted a series of equity-focused recommendations for policy makers and regulators to ensure AI systems are designed, deployed and monitored in ways that support anti-racist practice, strengthen public trust and contribute to more equitable healthcare outcomes across the NHS.
Participants urged for creation of engagement and insights from those with lived experience of discrimination in healthcare provision, and for community voices to be placed at the centre of existing gaps conversation and future decision-making. Enhanced governance, accountability, evaluation and monitoring assessments linked to patient trust, safety and transparency, can transform AI and other technological advancements into powerful tools for the benefit of all patients and communities – supporting an NHS that truly is fit for the future.
Organisations present at the roundtable:
- Ada Love Lace Institute
- Data, Tech and Black Communities
- Department of Health and Social Care (DHSC)
- Health Innovation Yorkshire & Humber
- Imperial College London
- National Institute for Health and Care Excellence (NICE)
- National Institute for Health and Care Research (NIHR)
- National Voices
- Newtons Tree
- NHS England
- Medicines and Healthcare Products Regulatory Agency (MHRA)
- The Patients Association
- University of Glasgow