“The NHS is a huge employer of women, I want it to be one of the best as well”

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I think it’s safe to say that most of us welcomed Matt Hancock’s comments last week around supporting and enabling women to reach (I prefer ‘ be appointed’) to senior positions and to close the gender pay gap. The Secretary of State for Health and Social Care says he won’t rest until it has.  In his article in the Guardian on 25 April he said that despite doing around 80% of the life-saving and caring roles across our NHS, the uncomfortable truth is that women are paid less, promoted less and systematically underrepresented among the top jobs. Whilst he is right in the latter of this sentence, it’s not just the caring and lifesaving roles which are impacted and I don’t believe it’s as simple as focusing just at the top of organisations. The truth is that gender inequality is not just a senior leadership issue, nor is the gender pay gap which doesn’t appear to be closing any time soon.

In his solutions to this he discusses getting more women into senior leadership roles, seeing tailor made training programmes, more role modelling to inspire women and better support networks to help women navigate their careers successfully, of course because women in the NHS need more training just for them. We also need inspiration to reach senior positions because we don’t already aspire to this and, of course, we need more networks for women as we independently can’t navigate our own path. Ok so I’m being somewhat facetious here because, let’s face it, we’ve been doing this for years and it’s not working!

Flexible working isn’t just a women’s issue

What I really welcomed was the thinking around flexible working and ‘the need to create a working culture that truly embraces flexible working and encourages women to stay in the workforce and helps them move up the career ladder, even after career breaks to have children’. Hurrah and Amen to that, but ‘simply expanding the use of smart rotas for shift workers’ won’t achieve this alone.

For starters, it’s not just clinical staff that need flexible working, there’s a broader societal issue here, if we continue to see flexibility as a women’s issue because they have kids. We need to also be supporting Dads, many of whom want to play a more active part in parenting and spending time with children. We all need a supportive employee to enable us to live a fulfilling life both in and out of work. It affects everyone, at all levels and roles in healthcare, all ages and all genders.  Badging this as a woman’s issue is dangerous and unhelpful, whilst we know it is part of the solution to gender equality it’s not just about women, flexible working is about people and being a good and responsible employer.

Childcare isn’t just an additional role for women

There are some really great examples of where some companies are leading the way in encouraging and normalising shared parental leave. Aviva is one of the brands leading the way who introduced equal parental leave, offering all male and female employees up to 12 months leave, with six months at full pay. To date, 67% of new dads working at Aviva have taken six months off and a further 95% have taken more than the statutory two weeks paid paternity leave. Many other companies are following suit such as Linkedin, O2 and Spotify to name just some. I’m sure this will really start to create a culture where flexibility is the cultural norm and where things such as childcare as seen as both men and women’s responsibilities.

Flexibility isn’t just about the hours you work, it’s about the jobs you do

I’ve written previously about closing the gender pay gap (see http://www.nationalhealthexecutive.com/Comment/is-the-glass-ceiling-much-lower-than-we-realised) and about what traps women into low paid jobs, The Modern Families Index (2016) suggests that seniority in roles allows flexibility. Nearly 80% of those surveyed earning £50,000 to £70,000 reported that they had access to flexible working, whilst in contrast only 50% of those earning less than £30,000 did. Do we, therefore, need to extend our efforts to middle and lower grade staff, not just senior leadership?

I’ve also said many times that I believe we have a generational workforce challenge ahead of us that will impact significantly on recruitment and retention as well as gender equality. Evidence demonstrates that generation Y want flexible working above promotion or pay, they want flexibility in role not just hours. When Matt Hancock talks of supporting ‘those in the early stages of management who are the future leaders of the NHS’ I can’t help but think of the NHS Graduate Management Training Scheme (which I myself went through and loved and am thankful for), however I am curious and wonder if the application and requirements disadvantage women, especially those with families. For starters, it’s full time (no part time version), you’re not guaranteed to be placed in your region, it’s incredibly full on with study and work placement, working a full time job whilst studying for a professional qualification, especially the finance stream. We advertise the scheme as recruiting and developing the best and it takes on only 1% of applicants. These are the future senior leaders, the ones who will be fast tracked to influential positions in the system. So, what happens if I can’t work full time hours, or if I’m dependent on family support to raise my kids and can’t relocate. What if the pressure of doing work and a professional qualification and manage a toddler or teen is too much, does this mean I’m not resilient or maybe it’s just unrealistic?

A culture change is needed, not more training opportunities

 So, SoS, I welcome your enthusiasm and ambition, but let’s not make this a woman’s issue, let’s not just talk about networks, and training programmes for women. Women know how to lead, we know how to influence, we know how to do the role.

We need the culture to change to make practicalities a reality and to develop a vision and culture of flexibility that’s owned by everyone, that’s coproduced within the system, by the people, for the people supported by policy at the highest level.

What do we need to do?

Here are some thoughts on some of the things I believe will help steer the changes required to make this a reality not just rhetoric:

  • Consider all staff as equally important and contributors to this work
  • Encourage ICS and system responsibility for flexible working as part of the new leadership and transformational workforce needs.
  • See flexible working as a solution, not a problem
  • More men are needed to not advocate or be an ally but to lead the conversations in true partnership with women
  • Coproduce what good looks like with the people and workforce, let’s not make it a policy made in an office, get out there and ask what and how
  • Have yes as default to flexible working
  • Create a pipeline approach and don’t just focus on the top
  • Take a risk, be courageous, challenge the status quo and empower people to show you how it can work

Kirstie Stott, The Inspiring Leaders Network