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Why there’s still work to be done to close the gender pay gap in the NHS and social care

It is impossible to avoid discussions about pay for health and social care staff at the moment. There is widespread industrial action over pay, the country is facing a cost-of-living crisis and more than half of NHS staff are doing unpaid overtime. One thing that is not talked about enough though is the gender pay gap in the health and social care sector in the UK.

The gender pay gap is a measure of the percentage difference in pay between all male and female workers. Pay gaps often indicate that female workers are missing out on opportunities that could lead to higher pay, such as opportunities to progress in their careers, or to work full-time hours through flexible working patterns. Closing the gender pay gap is about more than just the numbers, it’s about increasing support for female staff.

It’s been five years since it became mandatory for large organisations, including NHS organisations, to report their gender pay gaps. And there’s good and bad news about how the gender pay gap has changed over that period.

The good news is that progress has been made. Gender gap reporting shows that over the last five years the UK gender pay gap has fallen by a fifth to 14.3% in 2023.1 This includes falls across all health and social care roles, with the biggest fall being for doctors, where the gap has fallen from 20.9% to 5.5%. In fact, for female-dominated roles in the sector, females are now paid marginally more than male workers – median pay is 3p more for care workers and 16p more for nurses. This suggests there has been real progress towards equal access to opportunities in these professions.

Bar graph showing Over the last 5 years, the gender pay gap has fallen across all health and social care roles

The bad news is that the gender pay gap is persisting. For example, when health care staff are grouped together under the umbrella category of ‘health professional’,2 male workers are still paid 10.2% more than female workers in 2023.

Part of the issue is that male workers are disproportionately in higher-paid roles. For example, in NHS England in 2022, 42.2% of the highest earners were male, but the overall workforce was only 31.3% male. Similarly, in the social care sector in 2022/23, 31% of senior management were male but the overall workforce was only 19% male. The other issue is that even when female workers do progress to higher-paid roles, there is still a gender pay gap. For example, there is still a 9.9% gap for care service managers and care provider owners.

Going into an election year, one of the priorities for national leaders should be to make the health and social care sector a more attractive place to work. And with such a large female workforce, 77% across the whole NHS and 81% in social care, it makes sense that part of the focus should be on actions that support the female workforce and consequently reduce the gender pay gap, particularly as pay also impacts workforce retention in the health and social care sectors.

There are lots of actions government can take to close the gender pay gap in the NHS and social care. For example, implementing more flexible working options would benefit female workers who are disproportionally impacted by caregiving responsibilities. Changing the narrative around the importance of NHS managers would encourage more female staff to apply to senior roles. And improving the workplace culture by helping people feel valued and a sense of belonging would reduce turnover rates in female workers. Social care is also an example of a female-dominated profession that is undervalued, so improving pay in social care would help close the overall UK gender pay gap.

The most important action for everyone is to keep measuring and discussing the gender pay gap in the health and social care sector. While it is great that there has been progress over the last five years, any gender gap should raise questions for national and organisational leaders about what more they could be doing to support such a large proportion of their workforce.