1. NHS Employers Strategic Forum Meeting The use of a UN accountability framework to address gender equality Dr Penny Newman Medical Director, Norfolk Community Health and Care Associate, Health Education England

2. First wave CCGs

3. General Practice Hospital Women 57% of medical students 70% of salaried GPs 43% of SAS* doctors 41% of GP Partners 33% of Consultants 26%CCG leaders 24% of MDs ? ? Source: HSJ Womens issue 2013, Heath and Social Care Information Centre 2013, NHS England 2013 Clinical Commissioning Group Workforce Equality and Diversity Profile 67% of GP registrars 53% of Registrars Women doctors career progression

4. Women predominate at middle and lower levels in the NHS Bands 8a-9 (senior clinical and managerial) - 31% men and 69% women Bands 5-7 - 17% men and 83% women Bands 1-4 - 19% men and 81% women

5. Women in ‘top jobs’ Source: BBC (http://www.bbc.co.uk/news/uk-18187449) NHS - 24% MDs - 26% GP CCG leads (15% all male) - 26% DoFs - 36% CEOs

6. Contract Role models Part-time roles Childcare IndividualOrganisational Mindset Structural and role conflict Hierarchy Barriers – “cumulative disadvantage”

7. Organisational mind-set

8. The problem is not access to medical school but how we ensure that the female medical workforce is able to fulfil its potential once in employment. Baroness Deech October 2009 The business case for increasing the number of women on corporate boards is clear. When women are so under-represented on corporate boards, companies are missing out..... Lord Davies February 2011 I have seen myself what women, often in the toughest circumstances, can achieve for their families and societies if they are given the opportunity. The strength, industry and wisdom of women remain humanity’s greatest untapped resource. We simply cannot afford to wait another 100 years to unlock this potential. UN Women Director Michelle Bachelet March 2011 The gap matters not only because of the familiar glass ceiling is unfair, but also because the world has an increasingly urgent need for more leaders. All men and women with brains, the desire and perseverance to lead should be encouraged to fulfil their potential.

9. Five Year Forward View: creating a modern workforce Commitment to “radically alter the way we plan and train our workforce” “supporting the health and wellbeing of frontline staff; providing safe, inclusive and non-discriminatory opportunities; and supporting employees to raise concerns” “primary care is entering the next stage of its evolution. As GP practices are increasingly employing salaried and sessional doctors, and as women now comprise half of GPs, the traditional model has been evolving".

10. Advancing women in medicine: Kings Fund, 16 th December

11. Would the UN accountability framework be useful? Accountability: UN organisations have a policy and plan for themselves and their programmes and report Oversight: Programmes are analysed for gender Resources: Sufficient allocated resources, policies, architecture and tracking in place Capacity: Mandatory training on gender Coherence: Participation in networks and communications 15 indicators established in 2012 across 62 organisations, and 90% reporting.

12. Yes - workforce majority Improved board and financial performance Fish from the whole talent pool / improve the pipeline Balanced leadership reflecting society New leadership styles and behaviours e.g. collaborative and distributed style required by system leaders Thought diversity leading to more innovation, better decision making Address problems with recruitment and retention, pay gap Return on investment and increased productivity Meeting global legislative requirements No Individual expertise vs gender No longer held back – much improved Interviews with 12 senior leaders - Does it matter? Could gender equality help address the big issues – quality, productivity and system leadership? Yes

13. Is gender a priority? Advantages and disadvantages of a sole focus on women Discomfort over positive discrimination: double jeopardy A priority, but mixed sense of urgency, no guiding coalition Better framed as a business case and/or equality issue? Actions focused at system, organisational (board) and individual level UN accountability framework useful contribution; NHS needs to develop its own

14. NHS senior level commitment Enablers Measurement Leadership -HR policies inc talent management, flexible working, appointment panels/shortlists, returner schemes, bias awareness training, infrastructure e.g. crèches, -Showcasing -Investment 50:50 goal, senior champion (s), task force and strategy Accountability framework Developing consensus on action - Review of leadership: what's valued - Board development - Women only programmes - Coaching & sponsorship Identify gaps, good practice and monitor improvements

15. Next steps? Penny.newman1@nhs.net Mobile 07900560224