Comment / Smashing the glass

If you’ve ever wondered whether there is a glass ceiling for women in NHS finance, it appears there might be.

And if you’re interested in where that ceiling sits, it’s between Agenda for Change bands 8b and band 8c, according to early results from the latest NHS finance staff census.

The survey, conducted by Finance Skills Development in conjunction with the HFMA, covers all finance staff in every region in England (similar exercises are for the first time also being undertaken in Scotland and Wales this year).

The results show that at band 8b and below women outnumber men, significantly so within the lower bands.

But once you get to band 8c, the ratio of women to men starts to diminish, reaching a low of not much more than 1:3 by the time you reach the top jobs of finance director and chief financial officer.

These figures from a nearly complete survey represent the position in 2015 and disappointingly this finance director ratio has not improved much since the last survey two years ago. In 2013 women made up 62% of the finance workforce in the NHS but only 27% of director roles.

The 2015 results show this to be virtually unchanged with women accounting for just 28% of director positions.

We should all be concerned about the gender imbalance in senior NHS jobs. There is a significant body of evidence to show that diverse boards are the most successful and with the challenges we face in the NHS currently we need all of the help we can get.

Our organisations need to attract and retain the best people of both sexes and the best women will feel there is better scope for career development if they see more women in the top jobs.

When we look at the survey results across the years, it’s clear the situation will not resolve itself.

The need for focused work in this area has been recognised by the Finance Leadership Council and developing good practice in gender and ethnicity issues will be a key feature of the ‘Great place to work’ work stream of future-focused finance.

This work stream recently conducted its own survey on diverse leadership and the results show we have some way to go to convince staff that practice in this area is fit for purpose. Of more than 1,100 responses, 28% said they had experienced bias at some time in their career and 33% felt there were barriers to progression.

A number felt equality policies were a tick-box exercise and not taken seriously. On a positive note, respondents welcomed the initiative taken and the opportunity to make their views known.

The HFMA has been ahead of the game in this area. I’m pleased to say our board of trustees has equal numbers of men and women and we have moved on from the times when female presidents were thin on the ground. Shahana Khan from the George Eliot NHS Trust takes over the presidency next year and she will be the fourth woman in six years.

We need a better understanding of why we are where we are – taking account of experience in other disciplines and sectors. If there are obstacles, we need to examine the best ways to remove them.

A roundtable event early in November is bringing together a group of senior women (and men) to consider how we enable, encourage, support and develop women to step forward into senior roles.