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Female leadership in the NHS – a conversation with Jacqueline Bilcliff

by Helen Dodds | 29 July 2019

As the UK’s single biggest employer, the NHS currently employs 1.5 million people and deals with over 1 million patients every 36 hours, making it an incredibly challenging organisation to run. For that reason the NHS needs strong leadership throughout the organisation, which up until now has been predominantly male.However this is rapidly changing. The NHS is currently on a mission to improve their gender ratio, hoping to achieve 50/50 balanced boards by 2020. By making boards fully representative we could help ensure stability and improve patient care further within the NHS.
But how is the NHS getting on with their target? 

Jacqueline has been an accountant since 1996 and worked in various roles in a number of public sector organisations, gradually working her way up to her current role as Group Director of Finance at The Queen Elizabeth Hospital Gateshead. We were keen to find out Jackie’s thoughts about the NHS’ ambitious target, how she has achieved her success and what she thinks needs to happen to improve gender parity across the UK.

The need to ensure NHS boards are representative

The increase in the number of females taking on senior positions is all part of the NHS’ commitment to increasing the number of women in leadership positions and embracing their target of achieving gender balanced boards by 2020. For a number of years the NHS has had a national policy that boards should be representative of the communities they serve. The belief is that 50/50 boards would greatly benefit the planning and provision of services, and it is encouraging to see some real progress being made in this area. Currently 45 percent of CEOs in NHS trusts, CCGs, support organisations and central bodies were women with 55 percent being men, a 3 percent increase since the targets were introduced.  

Jacqueline explained that although she feels there is an element of her being in the right place at the right time, her progression has taken a lot of hard work and determination. She believes that in order to be successful woman need to be confident, tenacious and true to themselves. Jacqueline also told me that she thinks the perception of what being a senior leader is changing as more women progress. Businesses – including the NHS – are now seeing the benefits that both male and female leaders can have, which gives them a variety of viewpoints and a truly inclusive decision making process.

The diverse makeup of our NHS 

While looking at female leadership in the NHS I think it is also important to consider the diverse makeup of the NHS overall, and how difficult it must be for the UK’s biggest employer to represent our society as a whole. I have always thought of the NHS as a truly diverse place to work, however even an organisation with diversity at its core can struggle to be truly representative. Jacqueline summed it up nicely by saying;

“I think when taken as a whole the NHS does have a diverse profile but I also think this isn’t by any means consistent across organisations. It can be difficult to ensure that an organisation reflects the population where it is based and those who it treats. It’s something that needs to be worked at and actively pursued. We are lucky enough in the NHS to have an ethos and desire to be diverse and representative and we work hard at it.”

It was also interesting to hear her viewpoints on particular job roles and sectors within the NHS. She believes that women have been traditionally attracted to roles that are people based and that can provide flexible working arrangements to enable them to have a family. Despite Shared Parental Leave, the majority of childcare is still carried out by women. This is slowly changing, but it means that roles within the NHS that offer flexibility have become more attractive to women, which for a long time often put many leadership positions further out of reach. Job roles within the NHS have also previously followed a pattern, according to Jacqueline.

“Roles such as nursing have been traditionally more female orientated and therefore senior leaders in those disciplines tend to be women as well. Other disciplines such as finance, estates and IT could do more to attract and nurture female leadership, but that has to be right at the beginning of someone’s career.”

I would hope that as we continue to see the female/male ratio improve within the NHS that we will also see balanced representation across different job roles as well.

Female leadership makes good business sense

There is increasing evidence that a diverse workforce where all staff contributions are valued and taken into account results in better patient care, but as Jacqueline said, we need to do more to encourage these women throughout their career. To do this the NHS needs a collaborative style of leadership that includes women at all levels in order to address the growing pressures it is currently facing.

It is positive to see that many organisations – including the NHS – have woken up to the benefits of having females in leadership roles. Jacqueline believes that this is because women bring something different to the party, and offer businesses a balanced viewpoint that can promote growth.

“Traditionally directors are expected to behave in a certain way and to have a level of confidence that is based on a male stereotypes. If we are to change things we need to understand that women get results in a different way.”

It is partly this difference in style that gives women such a great opportunity to succeed. The world of work is changing by the day, and organisations need new ideas, new styles of leadership and a new approach to dealing with staff. Some organisations would benefit greatly from having a real mix of opinions, from both men and women, rather than sticking with what has become comfortable for such a long time.

Hitting the target

In order to achieve their ambitious target, I believe the NHS needs to adapt recruitment strategies to ensure they attract and are able to retain the best female candidates. To accomplish this, current NHS leaders must support women looking to secure senior roles by listening to their individual needs and tailoring remuneration packages to suit. This may include adopting flexible working patterns, offering more robust maternity/paternity provisions and ensuring salaries are parallel to that of their male counterparts. The NHS also need to look at their current workforce and promote/train from within.

I would however also the NHS and organisations trying to reach a set quote to look at their reasons for promoting/employing women into senior roles. Jacqueline and other female leaders like her have achieved their success through hard work and sticking to what they believe in. If we start hiring women into similar roles to fill quotas we would be undermining all the great work these women have achieved. Instead we need to ensure that women – and men – are giving roles on merit alone.

In my experience, women often have the skillsets required and the opportunity to move into senior roles but some feel uncomfortable putting themselves forward, and we need to do more to encourage women to speak up and be heard. It is the confidence that we see in women like Jacqueline that is needed to succeed. Of course, there is going to be a lot of hard work in-between, but women should be confident in their abilities and reach for the sky in whatever sector or organisation they choose to work within. 

The NHS has a huge advantage over many organisations when it comes to gender diversity – it already has a diverse workforce and therefore has a huge pool of female talent it can nurture, which makes the 50/50 female representation target a very viable and a realistic one to hit. The NHS currently has a real chance of leading the way in the battle against gender inequality and they have the opportunity to surpass most organisations if they are prepared to adapt, and tailor roles in order to attract the right candidates.

Jacqueline is lucky to work for an organisation which already has a balanced board as well as female chair, chief executive and director of finance, which gives her hope that the NHS’ overall target although ambitious, is very achievable. Her advice to women looking to emulate her success is simple.

“First of all I would say make sure it’s what you really want to do, pursuing any type of career is tough but especially so if you’re not convinced it’s for you, you have to be true to yourself. Be brave, don’t accept that you aren’t as good as anyone else, male or female, and always keep a sense of humour and perspective.”

Can we help you? 

We have helped numerous female – and male – candidates achieve senior positions with NHS and public sector organisations across the UK. If you are considering a move to the NHS or are interested in what senior NHS vacancies we currently have available, head over to our jobs page or get in touch with me today.

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