Women continue to face barriers to taking senior leadership positions in the NHS, new research finds

The results of a new survey, published today, suggest women are still facing barriers to becoming senior leaders in the NHS. Just under a half (49 per cent) of women who responded to a survey by the Health Service Journal (HSJ) and The King's Fund thought having children put their career at a disadvantage, and two thirds felt a greater pressure to prove themselves than their male counterparts. Other respondents said that they struggled with a culture of an old boys’ network and attitudes to women leaders.

The survey results are revealed at the same time as separate HSJ research and offers one of the most comprehensive analyses of the health service’s gender make-up since the Health and Social Care Act 2012 reforms. While women make up three quarters of the NHS workforce, just 37 per cent of senior roles on clinical commissioning group governing bodies and NHS provider boards are held by women. Despite women making up 81 per cent of the non-medical workforce in the NHS, men constitute the majority in the leadership teams of all but just 12 per cent of providers and 10 per cent of clinical commissioning groups.

The HSJ and The King’s Fund survey on female leaders in health care shows a significant minority of women in health report experiencing sexual discrimination. Over a third (37 per cent) of women who responded to the survey said they had encountered sexual discrimination. In addition, over half of women responding (52 per cent) said they had been bullied in the workplace.

When asked whether men and women lead differently, respondents most commonly highlighted that women had a more collaborative, inclusive, empathetic and/or understanding style than men. A minority of respondents though said that women could be more aggressive than men maybe because their felt greater pressure to prove themselves. Despite all this, three quarters of respondents would recommend a career in health care management for other women.

Nicola Hartley, director of leadership development at The King’s Fund, comments: 'Although women make up the large majority of the NHS workforce, they remain seriously underrepresented in leadership. These survey results, which chime with what we are told by the women we work with, show that they face serious obstacles in gaining senior roles. There some great women leaders in health care but the pace of change has been incredibly slow. These findings should act as a prompt to examine why we have too few women in the most senior roles and what we can do to change that.'

'Despite the huge advances in equality over recent decades, women are still underrepresented among healthcare leaders,' says HSJ editor Alastair McLellan.

'Last year’s HSJ 100 ranking of the most powerful people in health contained just 20 women – and that was an eight year high. Six women have appeared in the top ten since 2006 – but none of them have ever managed it twice.

'Women health care leaders often have it tough. As well as the challenges of juggling family and career and the overt sexism that still lurks in parts of the service, they face the hypocritical attitudes which limit their progress. Too often successful female leaders are deemed to be aping men, while those that fail are judged to have done so because they displayed a surfeit of supposedly female characteristics.'

Notes to editors: 

For further information or case studies of women who work in health care leadership roles or interviews, please contact Saskia Kendall at The King’s Fund press office on 020 7307 2603 or by email on s.kendall@kingsfund.org.uk

1,075 people responded to the survey, carried out by the HSJ in partnership with The King’s Fund. The breakdown of those who responded were:

  • 90 per cent of respondents were women
  • 45.7 per cent were from a clinical background, while 55.2 per cent were from a non-clinical background
  • 63.1 per cent had children, while 36.9 per cent did not
  • respondents were from a breadth of organisations (11 per cent from CCGs, 4 per cent from CSUs, 26.9 per cent from the acute sector)

The King’s Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.

Health Service Journal (HSJ) has served the leadership of Britain’s health services for 120 years. It is the only title to cover the planning, organisation, financing and performance of all aspects of the NHS at national and local level and widely regarded as the essential resource on health management and policy.