NHS trusts are "discriminating" against white job applicants by manipulating interview shortlists to favour black and ethnic minority candidates.
Documents show NHS England encourages the use of the Rooney Rule, an American football policy making it mandatory for ethnic minorities to be shortlisted for interviews if they apply.
Other "inclusive recruitment practices" range from making managers justify hiring white British nationals to using race as a "tie-breaker" when candidates are equally qualified.
An NHS hospital in Liverpool admitted it had previously used "positive discrimination" to shortlist applicants from minority backgrounds, The Telegraph has revealed.
Documents show NHS England encourages the use of the Rooney Rule
PA
These revelations come amid growing controversy over hiring policies in public sector services.
The Rooney Rule is just one of several measures being implemented across NHS trusts.
NHS England's East of England region guidance titled "improving the selection process" explicitly tells employers to "consider using a version of the Rooney Rule".
Some trusts only interview if there is "at least one BME candidate and one woman candidate shortlisted".
NHS Employers encourages hospitals to use race as a "tie-breaker" if two candidates are equally qualified.
This "equal merit" provision of the Equality Act allows under-represented groups to be given priority when equally qualified as white candidates.
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Some NHS trusts have gone further, requiring managers to explain why they hire white candidates
PA
East Lancashire Hospitals Trust and several NHS boards have adopted this measure.
Liverpool Women's NHS Foundation Trust introduced "positive discrimination at the shortlisting stage" until 2023 to guarantee interviews for people from "the global majority".
Some NHS trusts have gone further, requiring managers to explain why they hire white candidates.
The London Ambulance Service and Royal Free Hospital require interview panels to justify not appointing shortlisted ethnic minority candidates.
NHS England guidance called "A Model Employer" encourages recruiters to always include at least one minority person on interview panels.
It states hiring managers are "accountable for institutionalising diverse shortlisting and interview panels" with "seldom acceptable exceptions for not having a BME member".
Grant Shapps, the former Tory Cabinet minister, described these policies as a "tick-box exercise" that is "entrenching racial quotas".
Former Defence Secretary Grant Shapps said the policy was 'patronising'
PAHe said: "This kind of tick-box policy is patronising, divisive, and fundamentally wrong. Jobs should be awarded on merit, not skin colour."
Neil O'Brien, a former health minister, criticised "race-based hiring policies" where "people are chosen based on the colour of their skin".
A Conservative Party source called the practices "social engineering" and "racial discrimination".
They added: "No employer, least of all one funded by taxpayers, should discriminate against applicants based on their race."
The NHS has a target of ensuring its leadership is representative of the overall BME workforce by 2028.
A national scheme called the Workforce Race Equality Standard measures NHS organisations' progress on increasing diversity.
One key metric is the "relative likelihood of white applicants being appointed from shortlisting compared to BME applicants".
The practice has spread beyond the public sector to major companies.
Welsh Water, ITN, and Reed in Partnership all offer guaranteed interviews to minority candidates.
Riverside Group Ltd guarantees interviews to qualified ethnic minorities for roles with salaries above £35,000.
An NHS spokesman said: "All NHS organisations should have recruitment policies that are fair for everyone."
