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Bamrah and colleagues’ commission paper should be a watershed moment in the way the NHS deals with racism and sexism.1 For too long we have known that these problems existed but not how bad they were or how to tackle them. As this paper clearly shows, racism and sexism have adverse effects on patient safety, staff wellbeing, and the reputation of the service, and the authors have clearly described the solutions. There should now be no excuses for failure to solve these long running problems.