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Calls for action as NHS misses target to achieve gender balance in leadership


By Awil Mohamoud
Reporter
10 September 2020

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‘Much more’ still needs to be done to ensure women are equally represented in leadership positions within the NHS, a report by the University of Exeter on behalf of the NHS Confederation has found.  

On average, fewer than half (44.7%) of executive and non-executive roles across NHS trusts are held by women (up from 39% in 2017), found the study

A previous investigation in 2017 recommended a series of changes needed to reach equal gender representation (50:50) on boards by 2020. 

The latest report – originally scheduled for March but delayed due to Covid – welcomed progress, but said more needs to be done, and that gender equality in leadership positions is ‘essential, overdue and needed now’. 

Variation between organisations 

Significant variation in female representation was found between individual organisations, ranging from as low as 15.4%, up to 77.8%. 

Women would need to be in an additional 150 executive and non-executive directorships, including 40 medical director and 50 chief finance officer roles, to achieve the European Commission’s definition of gender balance of 40% to 60%, the figures show. In 2017, this figure stood at 500.

The recent data showed representation varied in different roles, as only 25.3% of chief financial officers and just 29% of medical directors across the NHS are women.

Researchers decided not to include clinical commissioning groups (CCGs) in the latest study due to ‘the amount of change currently occurring’ within these organisations, instead choosing to focus on progress within trusts and arm’s-length bodies. 

Ambulance trusts were found to have the lowest proportion of women holding board-level positions with just 38.8%, compared with community trusts and mental health trusts, which have 50.5% and 51.5%, respectively.

‘Change is needed now’

Sam Allen, chair of the NHS Confederation’s Health & Care Women Leaders Network, said: ‘It is well-established that boards that properly reflect the communities and staff they serve lead to stronger decision-making and better outcomes for patients.

‘The NHS has made progress, but there remains much more for leaders to do in order to achieve consistent and meaningful gender balance.

‘We must move away from the concept that gender balance is tokenistic or a ‘nice to have’, to something that is essential, overdue and needed now. This requires an inclusive and compassionate approach to leadership, with everyone in these vital positions held to account for their contributions.’

Danny Mortimer, NHS Confederation deputy chief executive and NHS Employers chief executive, said: ‘If we compare the diversity of the NHS’ leadership in 2017 with the position now, we can see there has been some progress made in gender representation, but we are not where we need to be. The challenge for race and ethnicity is even greater.

‘The NHS is the largest employer in this country, with a workforce of 1.4 million people, of which more than one million are female. It is leading by example, but at a time when the NHS is experiencing the greatest challenge in its history, it is vital we make full use of all the existing and emerging talent at our disposal.’

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