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GRI 405/103-1, GRI 406/103-1

Fresenius respects and promotes a culture of diversity. We are convinced that the combination of different perspectives, opinions, cultural backgrounds, and experiences enables us to tap the potential that makes us successful as a global company. The knowledge and social skills of our employees and their different ethnic, social, and religious backgrounds help us to develop a particular sensitivity for the local needs of our customers and patients. For further information on our diversity concept for the Management Board and the Supervisory Board, please see our Corporate Governance Declaration.

Our approach

GRI 406/103-2

At Fresenius we support equal opportunities for all and consciously oppose discrimination of all kinds. No one may be discriminated against on the basis of skin color, ancestry, faith, political views, age, gender, ethnicity, nationality, cultural background, sexual orientation, physical condition, appearance, or other personal characteristics. We work in an atmosphere of mutual respect. Our dealings with each other are open, fair, and appreciative. We do not tolerate insults, humiliation, or harassment. Our managers have a special responsibility in this respect and act as role models. These values and our aspirations with regard to diversity are laid down in the Fresenius Code of Conduct, which is binding for all employees. This code makes our stance clear, i.e., to support equal opportunities for all. This lays the foundation of our cooperation and corporate culture. Further information on our approach to equal opportunities is provided in the Human rights section.

Dealing with incidents of discrimination

GRI 405/103-2, GRI 406/103-2

Information about violations of the principles of the Fresenius Code of Conduct and other possible misconduct can be reported via various notification systems – anonymously, if necessary, as described in the Compliance chapter. All information is carefully examined and appropriate action taken in accordance with the results of the investigation. Depending on the type and severity of misconduct, sanctions such as actions under employment, civil, or criminal law can be imposed. After finishing the investigation, measures that prevent future misconduct, or at least make it more difficult, are implemented. If business segments have implemented additional, specific reporting channels, these are described in this chapter.

Diversity lived in the business segments

GRI 405-1, GRI 406/103-2

Fresenius promotes international and interdisciplinary cooperation as well as diversity in our business segments and regions. The diversity of our markets and locations is also reflected in the workforce of the four business segments. In our home market in Germany, we have employees of around 140 nationalities. All business segments attach great importance to equal opportunities for all employees in the workplace as well as in the application, selection, and development procedures. In order to integrate equal opportunities in all processes and workflows, the business segments develop diversity concepts that are adapted to the requirements of their respective business models and regions.

Employees with disabilities

GRI 405-1

The Fresenius Group also employs people with disabilities, severe disabilities, and other limitations. The spectrum not only includes people in wheelchairs or with mental disabilities. Survival of cancer, or diabetes, rheumatism, depression, back problems, or cardiovascular disease can also be the cause of a disability or impairment.

Fresenius is committed to the inclusion of severely disabled people. We want to enable our employees to apply their knowledge and skills as fully as possible. In doing so, the respective local legal requirements must be implemented. As these differ significantly in some cases, management is decentralized and local. For example, severely disabled employees in Germany are entitled to a workplace suitable for the disabled, part-time work if the disability requires shorter working hours, special protection against dismissal, and additional leave.

In Germany, elections for representatives of the severely disabled are held every four years at Fresenius facilities where at least five severely disabled persons are employed on a more than temporary basis. All members of the company can stand for election to the office of representative for severely disabled persons.

In 2020, Helios Germany concluded an overall inclusion agreement with the business segment’s representative body for persons with severe disabilities. It strengthens the participation of (severely) disabled people and employees at risk of disability and promotes equal opportunities. Furthermore, it aims to prevent employees with (severe) disabilities from being discriminated against or socially excluded. In addition, two online training courses on the topics of severe disability law and the Corporate Inclusivity Agreement were developed in 2021 and integrated into the training catalog of the management academy.

In Spain, we are obliged to employ at least 2% of people with disabilities in relation to the total workforce in our hospitals. In accordance with the Spanish “General Law on the Rights of People with Disabilities and their Social Inclusion”, and in order to ensure their integration, Helios Spain has dedicated recruiting, training, and inclusion protocols for disabled people. Further, we engage with special employment centers to hire disabled employees or collaborate with social entities to develop training and awareness campaigns. In addition, Helios Spain has signed an agreement from the representative foundation Fundación DKV Integralia to promote diversity in the corporate sector.

In total, 5,051 persons with disabilities were employed by the Fresenius Group in Germany in 2021. This corresponds to a rate of 5.1% in Germany (2020: 5,027; 5.2%).

Fresenius Medical Care

Fresenius Medical Care’s commitment to inclusion and diversity is incorporated in its Code of Ethics and Business Conduct. The business segment introduced a guideline stipulating that the interview round for senior-level positions should, where possible, include at least one qualified candidate from an underrepresented group. The objective is to increase diversity levels in the company, taking global ambitions and local environments into account.

Various channels are available to employees, patients, and third parties to report potential violation of human or workplace rights, laws, or company policies. Based on an analysis of its grievance mechanisms in 2020, Fresenius Medical Care is working on improving the complaint handling practices and to establish globally consistent processes.

In 2021, Fresenius Medical Care built on its past efforts to foster a diverse and inclusive workplace, and to raise awareness of the benefits the company believes such an environment brings. The business segment further developed global inclusion and diversity initiatives. For instance, it held an inclusion workshop for the Management Board. In addition, an Asia-Pacific Women’s Leadership Initiative was launched in 2021 as a catalyst to continue driving inclusion and diversity among the 13,000-strong workforce in the region.

Fresenius Medical Care also established a main contact for Diversity, Equity, and Inclusion (DE & I) in North America, who is focused on supporting the advancement of the key objectives in this area in alignment with the global inclusion and diversity work. She is supported by both the business segment's DE & I Executive Committee and its DE & I Council. Together these form a diverse group of employees who provide input on the business segment’s continued efforts to build a more trusting and inclusive culture.

Fresenius Medical Care intends to further strengthen inclusion and diversity beyond gender diversity over the next few years. For example, the business segment plans to increase the focus on ethnic diversity in the future. To support these efforts, the company plans to help establish new employee resource groups (ERGs) across the regions. These groups refer to employees who meet based on shared common interests. In the United States alone, Fresenius Medical Care has 14 ERGs dedicated to different employee interests and aspects of diversity.

Fresenius Kabi

Fresenius Kabi emphasizes equal opportunities for all employees in their daily work as well as in recruiting, application, and development processes. Numerous projects are placed in an intercultural environment. Transnational teams are working on solutions to the manifold challenges in the health care sector. The company values of Fresenius Kabi – customer focus, quality, integrity, collaboration, creativity, passion and commitment – form the basis for the day-to-day actions of all Fresenius Kabi employees. The company values of Fresenius Kabi underline the importance of respectful collaboration between all employees and are part of its Code of Conduct.

Fresenius Kabi has a Center of Expertise Talent, Leadership, and Organizational Development (CoE TLO), which reports directly to the head of the Global Human Resources department. The CoE TLO is tasked with anchoring diversity and inclusion in the organization and supporting the regional and divisional human resources functions in their activities with a global framework.

Fresenius Kabi has guidelines and reporting systems for reports of potential violations of the principles defined in the Fresenius Kabi Code of Conduct. Employees can report possible violations of the principles to their supervisors, their human resources department, or the compliance department, for example via e-mail. An online platform also offers the possibility of anonymously reporting violations of corporate principles to the company in various languages.

In the reporting year, the management approach and the governance structure of Fresenius Kabi remained as reported in 2020. Progress focused on further embedding diversity management in the business segment. The COVID-19 pandemic had no impact on Fresenius Kabi's diversity management in 2021.

In 2021, Fresenius Kabi established a diversity, equity, and inclusion (DEI) department as well as a Steering Committee for the region North America. Activities there focused on building competencies for diversity- and equity-friendly and inclusive behavior and developing regional DEI concepts for Fresenius Kabi employees.

To determine the focus areas as well as measures for DEI activities, the regional organization began analyzing the status quo. Furthermore, a communication campaign was developed to regularly inform employees about DEI-related topics and raise awareness of DEI among the workforce in North America.

Fresenius Helios

GRI 406-1

At Fresenius Helios, the aspiration to be non-discriminatory and provide equal opportunities extends equally to employees, business partners, and patients. In Germany, it is also anchored in Helios’ vision and mission, which were finalized in 2021, and in its six guiding principles: the guiding principle “Working together” emphasizes how valuable human diversity is – for example in nursing or medical teams at the clinics.

At Helios Germany, the Director of Human Resources has overall responsibility for diversity. A separate diversity working group was set up in 2021 to design and implement overarching measures. In the hospitals, the clinic management is responsible for implementing the diversity concepts.

In the fourth quarter of 2021, Helios Germany signed the Charter of Diversity (Charta der Vielfalt) – an employer initiative for diversity in the workplace. Underpinning this commitment, the business unit is developing tools to strengthen diversity in all dimensions. The Helios intranet makes information, internal and external networks, and examples of best practice transparently available to employees.

Incidents involving discrimination are processed via the clinic management in cooperation with the human resources managers and, depending on the severity of the incident, escalated to regional or central level. As a rule, in the event of incidents of discrimination, a crisis management team is deployed to advise on the specific procedure to be used on a case-by-case basis.

Helios Spain commits to a diverse corporate culture in its Code of Conduct. The management is committed to using gender equality tools – for example, through integrative language and training, or in procedures such as personnel selection processes and internal promotions, as well as in cases of sexual harassment or gender discrimination. Helios Spain is currently in the process of negotiating equality plans for all locations in the hospital group. This kind of equality plan respects the European directives and the national rules in Spain on equal opportunities and wage transparency between men and women, and also guarantees non-discrimination in the workplace. Negotiations with trade unions on these equality plans took place during 2020 and 2021.

Each clinic of Helios Spain employs an equal opportunities officer, who is specially trained and exercises an advisory function for the respective management. In addition, the equality plan is monitored by a central committee comprising members from the management and employee representatives, who report on the implementation and development status at the locations. Specific action plans are also drawn up to ensure inclusion and equal opportunities for all employees in our clinics and health care facilities.

At Helios Spain, incidents involving discrimination can be reported via the Human Resources department, the intranet and the employee portal. In addition, sexual and gender-based harassment can be recorded via a dedicated complaint protocol. Three reports were received in 2021. Those related to own employees were investigated internally by the labor relations department. Two reports were solved and not further substantiated. One report is still under investigation.

A wide range of measures are being implemented in our hospitals to promote diversity and equal opportunities. The status of implementation varies between the clinics. Examples are:

  • Intercultural after-work meetings
  • Prayer rooms for different religions
  • Changing rooms for transgender employees
  • In-house interpreter pools for foreign patients
  • A queer community with drop-in centers and regular meetings
  • Gender equality training for all employees
  • Workplace harassment protocols in case of potential incidents in each hospital
  • Development of a language guide on equality to raise awareness of the power of language in everyday and professional life (Spain)
Integration of international nursing staff

In order to counter the shortage of skilled nursing staff and to strengthen this occupational group, Helios Germany has implemented a diverse package of measures. Among other things, the business segment is specifically recruiting international nursing staff. Since 2019, a total of 1,660 nurses have already been employed from abroad.

To support its foreign employees, in particular foreign nurses, Helios Germany began to train staff as integration managers in 2020. In the course of the year, 40 integration managers who were either still undergoing or had already completed training supported nurses who had come to us from abroad when they arrived in Germany, helping them to deal with authorities and providing support in other situations. The aim here is to help with social and cultural integration, as well as aiding professional and linguistic integration. This is supported and complemented by local initiatives at each hospital location.

Helios wants to ensure good integration into existing nursing teams, strengthen the team spirit among all employees, and retain them for as long as possible. A guide was created for this purpose in 2020 on the basis of employees’ experiences and personal impressions, which were collected in a survey.

Integration measures such as training for international employees took place digitally in 2021 due to the pandemic.

Helios Spain has developed a procedure to address the questions of new employees from abroad and thus facilitate their arrival in Spain. In addition, the division has a function for labor law and related employee services through which international nursing and medical staff can obtain their residence and work permits.

In a joint integration network, the representatives of Fresenius Helios and Fresenius Vamed continue to develop the Helios integration tools for international professionals on a monthly basis. The spectrum of topics ranges from educational and language offers, to intercultural training, culturally sensitive integration concepts, and learning mentors. The professional measures of the Helios education centers can also be booked by employees of the Vamed clinics.

Fresenius Vamed

Fresenius Vamed focuses, among other things, on addressing diversity in the effective promotion of young talent and the management of succession planning. In the area of training and development in particular, the diversity of employees is taken into account and, for example, online training is offered in various languages.

At Fresenius Vamed, a diversity and gender representative oversees equality issues.

Suspected cases of discrimination or violations of diversity provisions are reported to and investigated by the Compliance Organization. Various reporting channels through which possible compliance cases can be reported are available to Fresenius Vamed employees for reporting suspected cases of discrimination, as explained in the section Reporting channels.

Fresenius Vamed has developed concepts for the integration of foreign nursing staff. Additional information can be found in the section on Fresenius Helios in the Diversity chapter.

Our ambitions

GRI 405/103-3, GRI 405-1

Promoting diversity and inclusion at all levels of the company is a priority at Fresenius. The Fresenius Group Management Board welcomes the activities within the business segments to further building on this diversity in future and benefiting from it more widely.

In the past, the Management Board of Fresenius had already set targets for the proportion of women in the two management levels directly below the Management Board. For more information, please refer to our Corporate Governance Declaration, pages 232 f.

Diversity and equal opportunities are important to Fresenius Kabi. Possible approaches to strengthening diversity management were already developed in 2021 and are currently under evaluation.

For many years – and independently of legislative activities and regulations – Helios Germany has pursued the clear goal of increasing the proportion of women in management positions. In the area of our regional management, the figure is already approximately 46% (2020: 40 %).


GRI 405/103-3, GRI 405-1

The proportion of female employees in the Fresenius Group increased slightly to 69% as at December 31, 2021 (Dec. 31, 2020: 68%). The proportion of females in services or care is traditionally higher than in the area of production. This is reflected in the proportion of female employees in our business segments: Our business segment Fresenius Helios has with 74% the highest proportion of female employees among the Group. The number of female participants in the Group-wide Long Term Incentive Plan (LTIP 2018) is a good indication of the share of women in management positions. According to this, the ratio of women among the more than 1,800 top executives increased to 32.6% as at December 31, 2021 (Dec. 31, 2020: 31.6% of 1,700 top executives).

At Fresenius Medical Care, as of December 31, 2021, women accounted for 69% of the total workforce and 26% of positions in the first two management levels. Gender diversity in the business segment's main governance bodies and at management level has remained stable over the past two years. In 2020, the Management Board of Fresenius Medical Care defined a new target of 22% for the share of women in the first management level below the Management Board and 32% in the second management level. The business segment aims to achieve these targets by 2025. In 2021, the definition of the two management levels below the Management Board for which targets were set was also adjusted in this context.

The progress and measures conducted in 2021 are still under evaluation at Fresenius Kabi. Results are expected in the course of 2022, along with measures based on the outcome.

Fresenius Helios publishes the annual quotas for Germany and the target resolutions on the proportion of women in the respective management positions on its corporate website (German language only). The target resolutions of the individual hospitals are valid until June 30, 2022. In 2021, a working group began to systematically record diversity measures in the German Helios clinics. The aim is to strategically embed diversity in all its facets more broadly in the business segment in future.

Female employees

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Dec. 31 2021 2020 2019 2018 2017
­Fresenius Medical Care 69% 69% 69% 69% 69%
­Fresenius Kabi 51% 50% 50% 50% 51%
­Fresenius Helios 74% 75% 75% 75% 76%
­Fresenius Vamed 62% 62% 63% 64% 56%
Corporate / Other 40% 38% 39% 39% 39%
Total 69% 68% 68% 68% 68%