Assessing the lack of senior opportunities for women in nursing

Transcription

1 Assessing the lack of senior opportunities for women in nursing #womeninwork June 2016

2 Introduction Victoria Short MD of Randstad Care Despite the nursing sector s predominantly female workforce, there is still a disproportionate amount of men occupying senior or management positions. It also saddens me to see that a pay gap still exists between the sexes despite having a wealth of nurses with the skills and experience to lead, manage and excel. It is disappointing that the gender spread isn t more evenly reflected at the top but the reasons why more women don t go onto senior positions are complex. The NHS needs to continue its work to ensure women are treated equally and fairly and that they no longer suffer career setbacks because of the motherhood penalty. NHS trusts must also reassess the flexible working and childcare options they offer employees in order to support women who return to work after maternity leave. Given that 45% of healthcare professionals believe not enough is being done to get women into the top jobs and cite employer attitudes as a major reason holding women back, the NHS also needs to look at how women are supported and trained at all levels. Empowering female nurses with more training and career development programmes will go some way to redressing the balance and greater attempts should be made to dispel inaccurate stereotypes around aggressive female bosses. As nurses sometimes lack the confidence to ask for pay rises, employers should also help improve confidence and self-belief and ensure female nurses acknowledge their best skills and achievements. Nurses really are the backbone of the NHS and without them it simply wouldn t function. Greater respect for nurses would in turn lead to greater self-belief and ultimately more women making it into senior positions and earning higher wages

3 Key takeaways 89.6% 14% 45% 89.6% of nurses and midwives are women but two thirds of senior positions are occupied by men A 14% pay gap exists between men and women in the nursing sector 45% of healthcare professionals believe not enough is being done to get women into the top jobs 36% 29% 84% 36% of care workers believe a glass ceiling still exists for women 29% increase in graduate nurses but 83% of NHS trusts still reported nursing shortages 84% of women have never asked for a pay rise compared to 71% of men Nurses really are the backbone of the NHS and without them it simply wouldn t function. Greater respect for nurses would in turn lead to greater self-belief and ultimately more women making it into senior positions and earning higher wages. Victoria Short, MD of Randstad Care 3

4 Demand for nurses and midwives continues to grow The UK s nursing workforce has grown to record levels as the NHS struggles to keep up with an unrelenting demand for healthcare workers. The UK s population, which is expected to hit 74.3 million by 2039, the number of nurses reaching retirement age and increasing life expectancies are all contributing to staff shortages and the pressing need for more nurses and midwives. In 2014, the UK registered the highest number of nursing and midwifery professionals in Europe, and according to our recent UK nursing report, the number of qualified UK nurses grew by 18,342 from To add to this, figures show that the NHS workforce has grown by more than 2.1% in the last 12 months and there were 660,120 registered nurses in December 2015, with London, the North West and the West Midlands predicted to see further growth in the next few years. In 2014, the UK registered the highest number of nursing and midwifery professionals in Europe Graph: Number of nurses and midwives employees (evolution and forecast) London South East North West 92,450 84,819 81,333 95,430 88,266 83,054 West Midlands South West East of England East Midlands 64,659 60,880 53,535 45,894 68,028 62,904 56,169 47,633 Wales North East 35,133 34,584 36,759 35, * 2016* 2017* 2018* * Forecasted number of employees Source: Nursing Study United Kingdom, Randstad 4

5 Although approximately 4 billion is spent on staff nursing in hospital wards, 83% of NHS Trusts say they are experiencing workplace shortages, forcing them to look to migrant workers to fill the vacancies. Philippines, 76% more than in previous years. More than a quarter of non-british registered nurses are from the Philippines and another 19% are from India. Together they account for more than 45% of the workforce trained abroad. Such is the demand that during 2014, the NHS recruited 5,778 nurses from overseas, particularly from Italy, Portugal, Spain and the The ever-increasing demand for qualified nurses and midwives has also led to a rise in nursing graduates and entry level employment. According to our UK nursing report, graduate figures increased from 20,666 in 2010 to 27,006 in 2013 with 96.5% moving straight into nursing roles and one in ten becoming midwives. 90% of these nursing graduates are hired within the first six months of graduating and figures show that there has been a 28.26% increase in graduate nurses between 2010 and graduate figures increased from 20,666 in 2010 to 27,006 in 2013 with 96.5% moving straight into nursing roles and one in ten becoming midwives. Graph: Number of nursing graduates in the UK +4.55% +8.36% % 20,666 21,606 23,412 27, Source: Statista.com 5

6 Gender imbalance at the top Despite the continued growth of the nursing workforce and the efforts being made to employ more staff from abroad and at graduate level, there appears to be a worrying gender imbalance at the top. Women currently make up a staggering 89.6% of the UK s nursing workforce, yet almost two thirds of the sector s top jobs are occupied by men and a pay gap of 14% still exists. According to the King s Fund study, only 37% of the NHS s foundation trust directors are women and only a small minority fill chair or chief executive roles. This seems to suggest that there is a disproportionately high number of men in senior roles and that more needs to be done to improve the amount of female leaders in the NHS. Our recent women in work survey, which involved a cross section of men and women currently working in nursing and social care, appears to support these claims as it revealed that 36% of healthcare workers believe a glass ceiling still exists and 45% believe not enough is being done to encourage women into the top jobs. The survey also revealed that 43% of men believe they are paid equally compared to just 24% of women and 13% actually argued that men and women will never be paid the same. The arguments surrounding equal pay are also supported by the fact that pay increases at grassroots level and in senior positions have varied greatly in recent years. According to a report published by Women currently make up a staggering 89.6% of the UK s nursing workforce, yet almost two thirds of the sector s top jobs are occupied by men and a pay gap of 14% still exists. the Royal College of Nursing, pay for nurses has only risen by 1.6% in the last two years, whereas the sector s senior executives saw a much larger pay increase of 6.1% during the same period. 6

7 Decline in senior positions and wage caps are making matters worse for women The lack of senior opportunities for female nurses is further exacerbated by a series of recent cuts to the NHS s Band 7 and 8 positions. These positions, which include job titles such as chief nurses, modern matrons and nurse consultants have been in decline since 2010 and tend to pay employees between 31,000 and 81,000. According to our recent UK nursing report, demands for lower NHS running costs has seen a 4.5% decline in Band 7 positions, an 8.4% drop in Band 8a positions, an 18.5% decline in Band 8b positions, a 15.8% decline in Band 8c positions and a 3.4% drop in Band 8d positions. competition for the sector s top jobs will become much fiercer and women, who are already held back by a gender imbalance, are now likely to find it even harder to climb the career ladder and earn more money. 7

8 Graph: Percentage change of nurses by Band ( April September 2013) 4% 2% 0% -2% -4% BAND 5 BAND 6 BAND 7-6% -8% BAND 8-10% -12% April 2010 October 2010 April 2011 October 2011 April 2012 October 2012 April 2013 October 2013 ALL STAFF Source: Nursing Study United Kingdom, Randstad UK To add to this, it was reported in 2012 that there had been 8.9% decline in the number of managers in the NHS altogether. These cuts mean that competition for the sector s top jobs will become much fiercer and women, who are already held back by a gender imbalance, are now likely to find it even harder to climb the career ladder and earn more money. To make matters worse, caps on the amount NHS trusts can pay agency staff (which were introduced by Monitor and the NHS Trust Development Authority in November 2015) are also likely to have an impact on the gender pay gap. In a bid to tackle the high fees paid to agency staff, the latest reforms mean trusts are unable to pay agency workers more than 55% more for a shift than a permanent member of staff. The move is intended to curb spending on agency staff in light of recent figures which revealed the NHS in England overspent by 1.6 billion in It is hoped the money saved can be invested in frontline staff and services. These wage caps will therefore have a detrimental effect on agency nursing pay rates, as it s unlikely that the pay gap will improve for female agency nurse temps in the foreseeable future. To make matters worse, caps on the amount NHS trusts can pay agency staff are also likely to have an impact on the gender pay gap. 8

9 What can women do about the gender imbalance at the top? Transparent pay structures and a clear Banding system allow male and female nurses to start on the same salaries, but as they rise through the ranks a pay gap starts to emerge and there appears to be a decreasing proportion of women as the level of seniority rises. There are many reasons and contributing factors for this and many will argue that a culture change needs to take place in order to improve the situation. A recent study by the Kings Fund revealed that almost half of female respondents said having children put their career in healthcare at a disadvantage. Having children usually means taking a career break and some respondents felt they had to work twice as hard to keep up with colleagues who hadn t taken time off. Many respondents also felt that women had to work much harder to establish themselves and earn the respect that has been routinely granted to men. Some said they felt pressure to adopt more masculine traits in the workplace and that developing an authoritative style that wasn t perceived as a negative stereotype was difficult. In addition, 37% of women said they had encountered gender discrimination and 52% said they had been bullied in the workplace, surprisingly sometimes by other female leaders. Victoria Short, MD of Randstad Care, addressed these issues when she recently argued that: Both sexes feel like they are treated reasonably equally but the work to publish clear pay structures needs to be ongoing and organisations must be careful not to penalise women for taking career breaks to raise children or look after family. The NHS and private sector employers also need to look at ways to promote women into senior positions to redress the imbalance at the top of the profession. Results from our recent women in healthcare survey also reveal that confidence also plays a huge role in holding women back from the top nursing jobs, especially when it comes to pay rises. According to our research, 84% of women have never asked for a pay rise compared to 71% of men. half of female respondents said having children put their career in healthcare at a disadvantage The top factors for not asking were lack of confidence or belief in their own ability (35%), fear of being turned down (23%) and fear of how colleagues or senior management might perceive them (23%). Another 23% of women believe employers attitudes also hold them back in the workplace, as female respondents felt fear of their boss s reaction (19%) and worrying about having to justify themselves (18%) had a big effect on whether they asked for a raise or not. Graph: Reasons women give for being held back in the workplace (486 respondents) lack of confidence in own abilities 35% fear of being turned down 23% fear of how colleagues might perceive them 23% believe employer s attitudes hold them back 23% fear their boss s reaction 19% worry about having to justify themselves 18% Source: The level paying field: UK working women and pay rises, Randstad UK 9

10 Female nurses beginning to receive more support In order to address the issue of gender imbalance in the nursing sector, a number of schemes and initiatives have been set up to ensure women receive the training and confidence they need to succeed at a higher level. The Athena Programme was established to support and help women fulfil their potential as leaders across the public sector. The programme, which welcomes applicants from the NHS, focusses on personal development and aims to help women overcome the barriers they face in leadership positions; both real and perceived. The Health Service Journal has also launched an initiative which aims to celebrate the healthcare sector s most inspirational female leaders. The HSJ s Inspirational Women list has been created in order to give women in healthcare more role models and has helped shine a light on the achievements of the sector s most remarkable female leaders. Empowering female nurses with more training and career development programmes will go some way to redressing the balance and greater attempts should be made to dispel inaccurate stereotypes around aggressive female bosses. Victoria Short, MD of Randstad Care Finally, an organisation called Disruptive Women in Healthcare also helps to provide a platform for female healthcare professionals to share provocative ideas and solutions to workplace problems. The scheme has over 100 influential contributors and regularly showcases work from prominent female figures from across the globe. The organisation also hosts networking events which aim to bring female healthcare professionals closer together to share ideas and discuss issues surrounding female underrepresentation. 10

11 Sources The level paying field: UK working women and pay rises, Randstad UK Nursing Study United Kingdom, Randstad UK