Working in the NHS and running the London Leadership Academy, I have been only too aware over the years of 
the imbalance between the number of women we have working in the NHS, and the number that make it into senior roles. Whilst 77% of the NHS workforce are women only 36% are chief executives, 26 % finance directors and 24% medical directors; and out of 211 clinical commissioning groups (CCGs), the workforce is mostly female (70%), while women make up only 37% of governing body members and 26% of lead GPs . We know that women are still having to make child care choices over career, and that the impact of this is that women’s careers can slow down from their late 20s through to their early 40s as they take time out to look after children, or they seek part time employment as child care costs can be a barrier to work. Despite new shared parental leave laws, it is rarely being taken up by fathers – and therefore the burden of childcare still disproportionately falls on women. This means a significant loss of female talent to the NHS, at a time when we need the best leadership possible for our healthcare system alongside the benefits a more gender balanced and diverse leadership can bring.
I was very lucky that in my first job within the NHS I worked for directors who did a job share. They set great role models by showing what was possible, incorporating their different styles into a whole role that had consistency and provided great leadership to the team that I worked within. The organisation was far sighted enough to employ them each for 3 days a week so they had a day of handover and cross over, which really enabled them to work as a strong team. They were both caring and empathetic, balancing the needs of their families with their dedication to the job, and creating a flexible working environment for members of their team. Recognising that allowing us to take time out for carol concerts and parent evenings or hospital appointments for elderly relatives enabled us to be more fully present and engaged at work. So when setting up a women’s network in London one of the key areas for us to focus on was role modelling; bringing examples of how women (and men) have taken advantage of the great flexible working policies that the NHS has, to show both women and their employing organisations what’s possible.
In my own experience as a working mother with two children, I have always worked full time apart from 6 months maternity leave with each of my children. This was a conscious choice, as even with subsidised childcare costs, working part time would never have been affordable. I was and am lucky to share child care arrangements with my husband, who for many years worked shifts to enable him to collect the children from after school care, whilst I dropped them off at the beginning of the day. But when my children were small (both under 3) I experienced discrimination at work, when I needed to take time off to look after them when they were unwell. I was advised that this was unacceptable and that if I couldn’t commit to the job (not in the NHS) then life would be made difficult for me, or they would help me move on. With the stresses of being a mother of two young children I chose to move on rather than fight. From the interviews that we are carrying out with women leaders this sort of experience is not uncommon, although many of our interviewees were not comfortable saying so explicitly on camera.
Our network will provide space for women not just to share their experiences, but also to become advocates for behaving differently in the workplace. We recognise that if we are to create the cultural and behavioural shift required in the NHS for more women to reach their potential, that this is not just an issue for women, but for men as well. So our network is ‘led by women, for women, and with men’. In fact, the idea started from a suggestion from a mid career woman who was being mentored by the outgoing male chair of the academy, who is also a long serving London NHS chief executive. He suggested that she approach us to see if we could do something more to support female talent within the NHS in London, sure that she was not alone in some of the challenges that she faced.
But more than just creating safe spaces to share experiences our network will enable its members to work together on the areas that they are interested in doing something about. To do this we are setting up communities of practice, described by Etienne Wegner as “groups of people informally bound together by shared expertise and passion for joint enterprise”. These will provide both support and development for a group of active practitioners who want to advocate and influence on a range of issues around the domain of women’s equality in the NHS. Unsurprisingly the sorts of topics that are emerging are: overcoming stereotypes associated with the female gender, demonstrating the benefits of women leaders in the workplace, improving women’s confidence and supporting greater flexibility for all staff. As well as communities of practice, we will support members of the network with their personal development and masterclasses, and access to senior NHS mentors to expand their networks and provide coaching and individual support. We are also developing an on-line forum to share ideas and thinking, with a dedicated space for job share seekers. The network is still in its infancy, but we are already have a core group committed to taking it forward, who are passionate about change. Women’s networks create spaces of solidarity and support, for people to come together to share and reflect on the leadership challenges that face them. Now, looking back in my career I can see the impact that being mentored and inspired by other women can have on our confidence and ambition, creating a better working environment for all staff within the NHS and holding on to our talented women and enabling them to flourish.
Anne-Marie has held a variety of roles at a strategic level in the NHS including being the national lead on the NHS leadership qualities framework at the Leadership Centre, overseeing the development of Workforce for London, the NHS London workforce strategy, and being Programme Lead for the leadership team at NHS London. Currently she is the Head of the London Leadership Academy, the local delivery partner of the NHS Leadership Academy.
