Trusts should make committee nominations more “democratic” and hold meetings during child-friendly hours to allow more women to take part, a government commissioned review has urged.

Organisations should also extend childcare for staff working unsocial hours, according to Women in Medicine: making a difference, published last week.

In a foreword to the report, Baroness Deech, chair of the national working group on women in medicine, said there was “worrying evidence of a series of obstacles” in the system for women, forcing them to make career decisions that were “compromises rather than choices”.

The report says positions on boards and internal committees should be advertised more widely, with a “transparent and democratic process rather than simply an appointment by nomination”.

The Equality and Human Rights Commission should audit the appointments process for all such posts, it says, to assess whether sufficient opportunity has been created to increase access for women.

The report also calls on NHS Employers to draw up guidance on the additional provision NHS trusts should make for childcare allowances for unavoidable unsocial hours of work.

NHS Employers deputy director Alastair Henderson said: “Detailed arrangements for childcare are a matter for local organisations. Of course, it is not just doctors who may have issues around childcare out of hours.”

A “good deal of work” had been carried out on the issue, according to Mr Henderson.

Internal committees within NHS organisations require specific membership, he said, adding that selection processes “need to be transparent”.

Chief medical officer Sir Liam Donaldson said he welcomed the report and would ensure the Department of Health considered each recommendation before deciding how to proceed.