Why aren’t there more women leaders in the NHS?

How likely do we think it is that David Nicholson’s replacement as chief executive of NHS England will be a woman? Although women make up three-quarters of the NHS workforce, they still remain under-represented in senior leadership roles. For example, only 37 per cent of foundation trust directors are women, and a minority of them are in chair or chief executive roles. Similar disparities are found in medical leadership across primary and secondary care.

Why is this and why does it matter? To answer these questions we need to know more about women’s leadership styles and the barriers that prevent women achieving their full potential. A survey run by the Health Service Journal and The King’s Fund has elicited some interesting insights which resonate with much of what we hear when working with public sector leaders. They particularly echo the experiences and views of the participants on our executive women’s leadership development programme, Athena.

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. Such qualities are well aligned with the open and honest culture advocated in the Francis Report. But are they the sole territory of women? Don’t men exhibit these characteristics too?

And do all women behave in this way? A minority

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#40666 john smith
interim commissioning manager
self employed

I think that such articles are unhelpful and fail to strike the right balance about discrimination in the NHS.

The last 5 CCG commissioning teams I have worked with have been led by female directors and each circa 20 strong team has been female only - not a single man in sight in over 100 staff.

If you think this is bad (and I suspect that many wont), the number of disabled staff in these teams was also zero; yet disabled staff make up circa 12% of the workforce in the private sector.

Why does the Kings Fund bring some balance into this debate?

#40860 Sanjay VYDIANATH
Clinical a Director, Radiology
The Royal Wolverhampton Ahospitals a NHS Trust

I find this emphasis on recruiting women to leadership roles worrying. Men are taking on an increasing role in family responsibilities and I find I have the same limitations in taking up leadership roles. I also find that in many committees the women heavily dominate in terms of numbers. There is no clear impact from this on the decision making process. These committees tend to be marginalised because they are seen as ineffective, although some gender bias may come into this.
One should aim at getting good leaders rather than worrying about whether they are men or women. Fairness is important not numbers.

#40997 susan oliver
Chair of European League Against Rheumatism Health Professionals
Eular (European League Against Rheumatism)

My comment on this topic relates to the sad fact that nurses form the largest NHS workforce and as such the largest proportion of these are women. Yet the structures, frameworks and opportunities to develop lead nurses (and not only women) is frankly sadly lacking. NHS managers would do well to actively encourage a strong voice for their nurses and as such will show respect and encourage leadership for those with a small voice within the NHS power systems which currently maintain a steady focus on the views of the consultant body perhaps more than they should do !

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