An HSJ analysis has revealed the great majority of emerging clinical commissioning groups are led by men.

Women comprise only 15 per cent of chairs or clinical leads at the 285 CCGs on strategic health authorities’ most recent lists.

This is despite the fact that around half of GPs are women and three quarters of NHS workers are female, according to NHS Information Centre statistics extracted for HSJ. Just over half of the primary care trust cluster chief executives named in April were women.

In the West Midlands, only two out of 32 named pathfinder lead GPs are women, the lowest proportion in the country at 6 per cent. In neighbouring East Midlands, just two out of 25 pathfinders, or 8 per cent, are led by women.

London has the highest proportion of female CCG leads, at 26 per cent.

Royal College of GPs chair Clare Gerada said she was “disappointed” and “surprised” at the figures and hoped women were not being “excluded from these new and exciting posts”.

The high proportion of male leaders could shape the areas of care that CCGs would choose to focus on, she said.

“As chair [of the RCGP], part of my priority is addressing health inequalities and things like domestic violence and family issues. Is that because I’m a woman? I suspect it is,” Dr Gerada said.

“Does [having a female leader] slightly shift the agenda into areas we can’t quantify? With more women leaders you do move into areas of importance to women and families.”

She suggested that one reason for the low proportion of women leaders was the dominance of men in medical politics and on local professional executive committees. In addition, women with children found it difficult to attend evening meetings, she said.

However, she suggested some women may be “sensibly waiting to see what happens [with clinical commissioning]”.

The 285 CCGs were identified by SHAs. Six SHAs only had details for those with pathfinder status. The 266 pathfinders are those CCGs deemed ready to take on commissioning duties.

Gender breakdown figures

Bassetlaw Commissioning Organisation chair Steve Kell said the low number of female CCG leads was “as much about choice as anything else”.

He said: “Without a doubt there are some really engaged commissioning chairs who are female. It’s relatively new role and there’s a lot of GP engagement beneath the chair level and that’s just as important.

“We’ve seen female GPs who didn’t want to be chair but are really involved in things locally.” The time commitment required was likely to affect some GPs’ decisions, he said.

Gender of GPs (headcount)*

52.9 per cent47.1 per cent


Gender composition of NHS as a whole (headcount)*

23.3 per cent76.7 per cent

Unlike Dr Gerada, Dr Kell did not think that male and female GPs were interested in different areas of care or that the gender imbalance would affect CCGs’ agendas.

HSJ was able to determine 91 per cent of leaders’ names and genders using information from SHAs, primary care trusts, GP practices, CCGs and other public sources. This was for either chairs or lead GPs, depending on the information available, although many postholders were interchangeable.

In eight regions, HSJ could verify more than 95 per cent of names and genders, although this was lower in South East Coast (72 per cent) and the North West (83 per cent).

Where the top post was shared by GPs with differing genders, their contribution was split evenly for the purposes of the analysis.