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Women underrepresented in senior roles in NHS

Women make up over three-quarters of all NHS staff, but only a minority in very senior roles

Louise Prime

Thursday, 08 March 2018

Even though more than three quarters of all NHS staff are female, as are nearly half of the medical profession, women still account for only the minority of people holding the most senior posts, according to the latest official figures for England on the representation of women across the hospital and community health services (HCHS) workforce. The BMA is calling for greater scrutiny of the ongoing barriers that women face during their careers.

NHS Digital’s figures, released for International Women’s Day, include NHS trusts, clinical commissioning groups, support organisations and central bodies. They give the total numbers and percentages of men and women by staff group – broken down by band, chief executives, very senior managers, doctors by speciality, senior roles by ethnicity and non-executive directors – covering the past eight years, from November 2009 to November 2017.

The analysis revealed that although women make up more than three quarters of all NHS staff overall, they are still in the minority in the most senior roles:

  • total HCHS workforce: 77% female
  • HCHS doctors: 45% female overall, with a low of 27% in surgery and a high of 67% in obstetrics & gynaecology and 66% in public health medicine and community health services; only 36% of consultants are women
  • general practice: 46.3% of GPs are women, and 62.1% of those in GP six-month training
  • nurses and health visitors 88% female; midwives 100% female
  • HCHS ‘very senior managers’: 47% female overall, but varies by age – from just 27% of 25-34 year olds and 29% of those 65 and older, up to 53% of 50-54 year olds
  • chief executives: 44% female
Chair of the BMA’s representative body Dr Anthea Mowat commented: “There has been a lot of progress for female doctors over the last decade – women now make up almost 50% of the medical profession and the majority of students and trainees are female.

“However, as these figures today highlight, this progress is slow and there is something of a bottleneck emerging, as women are still in the minority in more senior roles and almost two-thirds of consultants are men. Women can face all kinds of barriers during their careers – they are more likely to take time off to have children and then work part-time because of childcare or caring for relatives, which affects career progression, as well as experiencing discrimination and undermining behaviour at work. These issues also have an impact on the gender pay gap in medicine, which is heavily linked to part-time working, and an unequal share of childcare responsibilities.

“The BMA hopes that the new review of the gender pay gap will scrutinise these ongoing barriers and lead to policy changes that will benefit women doctors at all stages of their careers.”

Dr Mowat said the BMA is working to understand these trends better so that it can increase its support for women’s medical careers and address any ongoing discrimination and bias. She added: “In the meantime we would like to see more tailored support for women in medicine, such as mentoring, role models and leadership training.”

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