Diversity in NHS Finance Leadership: beliefs, behaviours and barriers

Author: Camilla GodfreyDate: 3 years 7 months Ago

Fewer than half of women working in NHS finance (43%) think promotion processes are fair and based on merit, according to our new report, which aims to inform a plan to bolster performance by bringing more diversity to the workforce.

We questioned a cohort of more than 1,000 finance employees about their experiences of elements of diversity including gender, ethnicity and disability in the NHS organisations they work for, to inform our new Diversity in NHS Finance Leadership: beliefs, behaviours and barriers report (attached).

Other findings include that women are 40% more likely than their male counterparts to think they have experienced bias in their careers, 28% more likely to have experienced barriers to career progression that have stopped them applying for promotions or other positions, and 46% more likely than men to think their gender is under-represented in senior roles. Under a third (30%) of NHS finance employees believe their organisation’s board fully represents the community it is supposed to serve when it comes to aspects of diversity, including ethnicity, age, disability and gender.

We have put together a working taskforce of leaders from all corners of the NHS who met on April 20th to discuss the issues. The individuals who attended have pledged to build and implement a programme of change which aims to bring greater diversity to the health service’s 16,000-strong finance workforce and address the imbalance at senior level. Taskforce members include senior representatives of numerous NHS Trusts, including the Royal Free London NHS Foundation Trust and Tameside Hospital NHS Foundation Trust, NHS England and private sector firms Deloitte LLP and Ernst & Young.

The programme will focus on four main objectives:

  • Education - raising awareness of the issue, whilst working with organisations to share best practice and learnings between themselves, to help identify practical solutions for others.
  • Influence & Policy - those at the top of organisations and in positions of influence need to challenge the status quo and highlight the benefits of a diverse workforce. Introducing new and flexible ways of working could be a small change with a big impact.
  • Sponsorship - senior leaders from all backgrounds identifying other talented staff and those with a clear potential, and supporting them in their careers.
  • Narrative - ensuring consistency of diversity messaging across organisations to ensure everyone is working towards the same goal.

The initiative is supported by Bob Alexander, Deputy Chief Executive and Executive Director of Resources at NHS Improvement and NHS England’s Chief Financial Officer, Paul Baumann.

Bob Alexander said: “This new research shows significant differences in gender representation at senior levels in NHS finance, as well as a workforce whose ethnic diversity is failing to reflect the communities it exists to serve. The whole NHS finance community is pulling together so it can play its part in helping make the efficiency savings and service transformations needed to build a fit-for-the-future NHS. With significant international evidence showing that a lack of diversity hinders performance, the NHS can’t afford not to make progress when there is currently so much pressure on the service to improve efficiency whilst keeping standards high.  Our task force meeting and bringing together of influencers in NHS finance is a positive first step in working together to achieve diversity via the tangible areas identified.”

Paul Baumann said: “Diversity within the workforce, and in particular finance, can be used to drive business success, enabling organisations to become more successful, sustainable and better equipped to meet future challenges. A diverse leadership, which bears a good resemblance to the community which it serves, is better able to deliver patient-focused care. With its mission to ensure NHS finance is fully equipped to support the provision of high-quality patient care under increasingly challenging circumstances, FFF is spearheading this initiative to improve the finance function’s performance by bringing more diversity to its leadership.”

Providing context for the report, new figures from the HFMA (Healthcare Financial Management Association) and NHS Finance Skills Development (FSD) biennial census of NHS finance staff show the workforce is predominantly white British (72%) and at senior levels this proportion grows further – 88% of finance directors identify themselves as such.

The data from the six years since the census was first conducted also suggests there is scope to make more progress in improving gender diversity in NHS finance. While almost two thirds of the NHS finance workforce is female (currently 62% are women), the proportion of women that make it into senior roles is smaller. Currently only 26% of finance directors are female, a figure which has increased only slightly since the first census in 2009 when it was 21%.

The report identifies a range of potential barriers to diversity in the workforce, including:

  • Female-only flexible working. While 62% of NHS finance workers work flexibly, the vast majority of these are women, who make up 100% of job sharers, 92% of part time workers, 75% of those working compressed hours and 72% of home workers.
  • Concerns about workload curbing ambition. 71% of women working in NHS finance say it would be harder for them to maintain a work-life balance if they moved up to a more senior role.
  • Lack of progression parity. Men are 20% more likely than women to believe that both genders are given equal opportunities to progress and 19% more likely to see men and women as having the same chances of getting into senior roles.
  • Management bias. Men and women get different levels of access to their superiors – men are 15% more likely than women to have regular one-to-one sessions with managers and 14% more likely to believe senior managers are open and accessible.
  • Ineffectual policies. While the vast majority of respondents (90%) said their organisation had an equality and diversity policy, just 30% believe their Board properly represents the community it serves.