Policy briefing: the Mann Review

What has been published?

The Mann Review was commissioned by the UK Government in October 2025 following a number of serious incidents and allegations of antisemitism within the NHS and wider concerns about how racism was being identified, reported and addressed across the health service. Led by Lord John Mann, the review was tasked with examining how the NHS, employers and healthcare regulators respond to antisemitism and other forms of racism, and with recommending measures to better protect both patients and staff from discrimination, improve accountability, and strengthen reporting and investigation processes.

The published report made the following findings:

• While the origins of the review was accusations and examples of antisemitic behaviour by doctors and other health professionals, the Review says that this should not be seen in isolation from other types of racism and discrimination
• Lord Mann quotes figures for discrimination experienced by Jewish and Muslim NHS staff, and of staff from ethnic minorities – discrimination both from patients and from other staff and managers
• Patients also report being treated differently – or expecting to be treated differently – because of their religion or race
• The consequence is that people will not seek help when they need it. Health outcomes will be worse
• The review is most critical of the Medical Schools, and some of the Medical Royal Colleges, but he makes recommendations for NHS employers and regulators too
• Lord Mann recommends that the NHS adopt the Seven NHS Race and Health Observatory workforce principles which include naming racism and calling it out and examining our own attitudes and behaviours, identifying bias and reflecting on how well we are doing to serve our whole community
• He also makes practical recommendations about improving data collection. Although being Jewish is both a religious and an ethnic category in law, the NHS only collects information on religious identity. Mann argues that Jewish ethnicity/identity should be a recorded category in data collection. He says the same should apply to Sikhs
• The review argues that, while freedom of expression is important and should be protected, “employers must set policies that strike the right balance between protecting the rights of other people and the freedom of expression of their employees”. It adds: “To be more specific, saying ‘Free Palestine’ or ‘I love Israel’ are reasonable beliefs and expressions but the identification of such views or beliefs on public-facing NHS-owned profiles might, in of themselves, be a barrier to patients presenting. NHS guidance in relation to this must be precise on what is acceptable, not vague or open to interpretation”.

In light of the findings, the report concludes: “In order to spread knowledge and regain trust and confidence, a reset is needed, which requires homing back in on the NHS’s foundational principles and those of the health service in general, including the fundamental responsibilities of healthcare professionals, dating back to the Hippocratic Oath. It requires the re-prioritisation of the patient and inculcating a sense of pride for – and protection of – the NHS, focusing on creating an environment where anyone can feel safe to work and seek treatment and care.”

What do we say? 

While most AOP members do not work for NHS employers, the vast majority do provide NHS services. Our members have responsibilities, as described in GOC standards, to provide high quality services to all who present, to make those services sensitive to each patient and of course to provide care of the highest standard to every patient. Our members also occasionally experience prejudice from patients, and we are pledged to support all our members who face racism and other forms of prejudice, as well as support our employer members to provide workplaces in which all employees feel safe and valued.

Traditionally optometry was attractive to Jewish people and now many people joining are people of Asian heritage, including many people who are Muslim. AOP members have disclosed experiences of racism or discrimination from patients and who have not always found their employers as supportive as they should be. We are clear that racism and discrimination is unfair, causes distress, and is often unlawful. We support all of our members, both employees and employers, to tackle racism and other forms of discrimination. We have also updated our guidance to reflect the changes in the employer’s duties in relation to harassment.

One in four of our members has either experienced or witnessed racism or discrimination in the profession. We have asked all our members – and all optical employers – to sign our 100% Respect pledge as part of our campaign against racism and discrimination in optics. This includes our commitment to:

• Support our employer members to create safe working environments in which employees are protected from discrimination
• Support all our members if they are subject to abuse, harassment or discrimination.

Who else is involved?

The General Optical Council is one of the regulators that need to respond to the review. The GOC has already undertaken research to identify any bias in its procedures when handling complaints against registrants. The research indicated no issues with the GOC’s systems, although low numbers and the tendency for people not to answer the questions about protected characteristics makes it hard to identify statistically significant conclusions.

Other healthcare regulators are likely to attract more immediate attention than the GOC, but we welcome the fact that the GOC will be taking the opportunity to examine its work and we encourage the GOC to seek direct involvement in the work required by the recommendations.

What will we do?

Building on all our previous work, we have reviewed all of our advice and education tools to ensure they fully reflect the findings of the Mann Review. We are also looking at adjusting our data collection to reflect the recommendations of the review.

We will also offer to support the GOC in its planned response to Mann’s challenge to regulators. We stand ready to share feedback on our experience of representing our members at GOC proceedings.