NHS Employers Strategic Forum Meeting

The use of a UN accountability framework to address gender

equalityDr Penny Newman

Medical Director, Norfolk Community Health and CareAssociate, Health Education England

First wave CCGs

General Practice

Hospital

Women 57% of medical students

70% of salaried GPs 43% of SAS* doctors

41% of GP Partners

33% of Consultants

26%CCG leaders

24% of MDs

? ?

Source: HSJ Womens issue 2013, Heath and Social Care Information Centre 2013, NHS England 2013 Clinical Commissioning Group Workforce Equality and Diversity Profile

67% of GP registrars 53% of Registrars

Women doctors career progression

Women predominate at middle and lower levels in the NHS

• Bands 8a-9 (senior clinical and managerial) - 31% men and 69% women

• Bands 5-7 - 17% men and 83% women • Bands 1-4 - 19% men and 81% women

Women in ‘top jobs’

Source: BBC (http://www.bbc.co.uk/news/uk-18187449)

NHS- 24% MDs- 26% GP CCG leads (15% all male) - 26% DoFs - 36% CEOs

Contract

Role models

Part-time roles

Childcare

Individual

OrganisationalMindset

Structuraland role conflict

Hie

rarc

hy

Barriers – “cumulative disadvantage”

Organisational mind-set

The problem is not access to medical school but how we ensure that the female medical workforce is able to fulfil its potential once in employment. Baroness Deech October 2009

The business case for increasing the number of women on corporate boards is clear. When women are so under-represented on corporate boards, companies are missing out..... Lord Davies February 2011

I have seen myself what women, often in the toughest circumstances, can achieve for their families and societies if they are given the opportunity. The strength, industry and wisdom of women remain humanity’s greatest untapped resource. We simply cannot afford to wait another 100 years to unlock this potential. UN Women Director Michelle Bachelet March 2011

The gap matters not only because of the familiar glass ceiling is unfair, but also because the world has an increasingly urgent need for more leaders. All men and women with brains, the desire and perseverance to lead should be encouraged to fulfil their potential.

Five Year Forward View: creating a modern workforce • Commitment to “radically alter the way we plan and train our

workforce” • “supporting the health and wellbeing of frontline staff; providing safe,

inclusive and non-discriminatory opportunities; and supporting employees to raise concerns”

• “primary care is entering the next stage of its evolution. As GP practices are increasingly employing salaried and sessional doctors, and as women now comprise half of GPs, the traditional model has been evolving".

Advancing women in medicine: Kings Fund, 16th December

Would the UN accountability framework be useful?• Accountability: UN organisations have a policy and plan for themselves

and their programmes and report • Oversight: Programmes are analysed for gender • Resources: Sufficient allocated resources, policies, architecture and

tracking in place • Capacity: Mandatory training on gender • Coherence: Participation in networks and communications

15 indicators established in 2012 across 62 organisations, and 90% reporting.

Yes - workforce majority• Improved board and financial performance• Fish from the whole talent pool / improve the pipeline• Balanced leadership reflecting society • New leadership styles and behaviours e.g. collaborative and distributed style required by system leaders • Thought diversity leading to more innovation, better decision making • Address problems with recruitment and retention, pay gap • Return on investment and increased productivity • Meeting global legislative requirements

No• Individual expertise vs gender• No longer held back – much improved

Interviews with 12 senior leaders - Does it matter?

Could gender equality help address the big

issues – quality, productivity and system

leadership? Yes

Is gender a priority?

• Advantages and disadvantages of a sole focus on women• Discomfort over positive discrimination: double jeopardy• A priority, but mixed sense of urgency, no guiding coalition• Better framed as a business case and/or equality issue?• Actions focused at system, organisational (board) and individual level• UN accountability framework useful contribution; NHS needs to

develop its own

NHS senior level commitment

Enablers

Measurement

Leadership

- HR policies inc talent management, flexible working, appointment panels/shortlists, returner schemes, bias awareness training, infrastructure e.g. crèches,

- Showcasing- Investment

50:50 goal, senior champion (s), task force and strategy

Accountability framework

Developing consensus on action

- Review of leadership: what's valued- Board development- Women only programmes- Coaching & sponsorship

Identify gaps, good practice and monitor improvements

Next steps?

Penny.newman1@nhs.netMobile 07900560224