A diverse workforce is essential to tackle the challenges of NHS finance

A few months ago I wrote an article highlighting the plight of NHS finance and the extent to which we are seeing the decline of talented women when it gets to the more senior roles.

Women continue to dominate the NHS workforce, representing more than 77 per cent and making up 62 per cent of finance roles. Yet when it comes to the top jobs in organisations, only 26 per cent of finance directors are female.

Despite countless efforts to date, the picture hasn’t changed. And, the main problem with this is the further perceived barriers to progression the status quo brings.

According to our Future-Focused Finance Diversity Report, women are 28 per cent more likely than men to have experienced barriers to career progression that have stopped them applying for promotions or other positions, and 46 per cent more likely than men to think their gender is under-represented in senior roles.

Added to this, fewer than half of women working in NHS finance (43 per cent) think that promotion processes are fair and based on merit. Our recent report has again brought to light the lack of diversity and current state of play.

Clearly then, it is going to take a collective attempt across the sector, and a fully supported cultural shift, to change the situation. To this end, a taskforce of NHS leaders was recently assembled to build a programme of change that aims to bring greater gender equality representation to the NHS finance community.

A diverse leadership which bears a good resemblance to the community which it serves, and is better able to deliver patient-focused care.

Not only is gender a focus, and potentially the most well documented, but other diversity is lacking across the board. Let’s remember though, NHS finance is not alone in this, many other sectors fail to achieve ambitions of a diverse workforce either, with many much worse than the healthcare finance sector, and across all levels.

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.

All this despite 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.

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, and is better able to deliver patient-focused care.

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. Our taskforce meeting brings together of influencers in NHS finance in a positive first step in working together to achieve diversity via the practical areas identified below.

The programme will focus on four main objectives:

Education

Throughout my time working in NHS finance, I have been trying to raise awareness of the issues that minorities, be it gender, ethnicity or otherwise, face in the workplace.

Through my day job, and roles with Healthcare Financial Management Association and Future-Focused Finance (FFF), we have encouraged individuals, teams and organisations to think more about how a diverse workforce is more beneficial. Now we are working with organisations to share best practice and learnings between themselves, to help identify practical solutions for others.

At the taskforce meeting we heard from Audrey Fearing from Ernst Young. She highlighted progressive processes that the company has enacted in order to create a more diverse spread across all levels of the workforce.

By listening to employees in focus groups, Ernst Young has gained useful insights from staff about the current culture and moves that could evoke change. Furthermore, they have focused on setting the tone at the top and creating consistent messaging that is filtered down, so everyone is pulling in the same direction.

We are working with organisations to share best practice and learnings between themselves, to help identify practical solutions for others.

These approaches could be implemented into NHS finance roles and teams, and with some steer and motivation from the top, could help to inform change.

Influence and Policy

Those at the top of organisations and in positions of influence need to challenge the norm and the boardroom picture they are so used to seeing, as well as highlight the benefits of a diverse workforce to others. Introducing new and flexible ways of working could be a small change with a big impact.

These ways of working involve an increased focus on planning so that success rates will be higher and maximise resources. Perhaps changes to working patterns could be piloted and tested? This way, everyone can see what will work for them and feed into a structure before it is permanently deployed.

Sponsorship

This is something that all the taskforce felt strongly about, but now we are all committed to working to encourage senior leaders from all backgrounds to identify other talented staff and those with clear potential, and to support them in their careers by acting as their sponsor.

By offering our employees such sponsorship opportunities we will be able to increase confidence in the workforce and allow them to see clear routes to progression, and a significant support network to help them get there.

It is really important for staff to feel supported and positively challenged to move up into leadership roles. It’s essential we minimize people opting out for reasons that we have the power to change.

Narrative

The narrative about who makes it into senior positions has been the same for too long. We need a new stance. This is about ensuring consistency of diversity messaging across organisations to ensure everyone is working towards the same goal.

This will hopefully permeate through the organization and enable better decision making in all areas from recruitment to promotion.

It should lead to those starting out in their career seeing all the possibilities for their career progression, and those in more senior positions supporting them to do so.

We will also be able to create identifiable ways for organisations to measure whether they are achieving what they have set out to do. Are attitudes and behaviours shifting and can they see a marked improvement?

The narrative about who makes it into senior positions has been the same for too long. We need a new stance.

With its mission to ensure NHS finance is fully equipped to support the provision of high-quality patient care under increasingly challenging circumstances, FFF and the taskforce is spearheading this initiative to improve the finance function’s performance by bringing more diversity to its leadership.

We ask you to all join us and work towards this vision.

Sue Lorimer is the Future-Focused Finance Diversity lead and Business Director at NHS Improvement