Friday, 22 March 2013

Why are clinical commissioning groups dominated by men?

Why are clinical commissioning groups dominated by men?: Too few women are on CCG boards – meaning they don't properly represent the workforce or the local population
Soul singer James Brown sang It's a Man's Man's Man's World and 40 years later it's hard to argue that things have changed among the senior ranks of the NHS.

The current revolution in primary care is no exception. GPs are enjoying increasing influence with the introduction of clinical commissioning groups (CCGs) but senior roles in these organisations remain dominated by men.
The government's pledge to put GPs in the driving seat has left many female clinicians feeling like backseat passengers.
Female representation on CCG governing bodies' is relatively small (21%) when you consider they outnumber their male counterparts in general practice (63%).
This lack of female leadership is reflected across the wider health landscape in academia, senior clinical and medical directorships in hospitals and organisations like the British Medical Association.
There are exceptions, such as Dr Clare Gerada, chair of the Royal College of GPs, but it is telling that she is the first female to hold the position for 50 years.
The NHS needs creative leadership more than ever as it wrestles with the conundrum of delivering more for less.
My own CCG chair has already said that the NHS is lacking in depth when it comes to innovative leaders, and one way of addressing that is to bring more women to the table.
We bring distinct skills that can complement and balance a male dominated environment including the ability to empathise, build relationships and multi-task without losing focus on what matters.
This will help deepen the NHS's existing pool of talent and help increase our capacity and capability. Evidence shows that gender diverse boards increase financial and organisational performance.
This isn't about "positive discrimination" as much as making use of all the resources we have at hand – a problem the NHS wrestles with in various guises.
So why aren't more women taking a leading role? The key is work-life balance, or rather the lack of it, which puts female GPs with families at a huge disadvantage.
Work-life balance is a much touted phrase but how many firms in the public or private sector genuinely accommodate it? Yes, it dutifully appears in most job application packs but the reality is it is rarely accommodated.
It is an optimistic and, some would say, foolhardy soul who would breeze into the boss's office in the current economic climate and demand to work at home three days a week.
It is outdated working practices rather than some shadowy cabal of the old boys' network that is holding women back in healthcare today.
Small, seemingly innocuous measures such as holding meetings and training in the evenings instead of during the day, the difficulty of GPs returning to practice after periods of maternity leave, the lack of co-opted posts and robust role models combined with scant networking opportunities all add up.
The real tragedy is that many female GPs are lost to the profession after they have children or return on a sessional basis which accommodates the demands of childcare but keeps them on the periphery of gaining enough experience to sit on a CCG board.
CCGs are running to stand still at the moment but they have to genuinely look at female representation at board level ensuring it reflects not just the workforce but the local community.
Interestingly, a number of countries, including Norway, have introduced a quota system where 40% of public sector boards have to comprise of females members.
In the UK, this work is being progressed by the 30% Club, a group of prominent chairmen and organisations committed to increasing female membership on corporate boards.
It's important to note that this is all about about strengthening the NHS's leadership pool, not telling men they aren't doing a good job.
Mentors can also play an important role in helping female GPs bridge the divide and have proved invaluable in my own career.
I have been and continue to be mentored by some great men and women who provide a good sounding board to bounce ideas off, discuss challenges and opportunities, suggest useful contacts and potential openings, and provide a critical but constructive voice.
My greatest mentor is my mother, a pharmacist, who instilled the belief that my sister (an astrophysicist) and I could do and be anything we wanted to as long as we were was prepared to work for it.
Finding a mentor can be as simple as approaching someone you respect after a lecture, offering to take them out to coffee for a chat or contacting them via Twitter or LinkedIn.
The majority of people, however successful, are flattered and only too happy to share what they know, especially if you share a common interest.
All you have to do is ask. You may be surprised by the results
Dr Nikita Kinani is a clinical executive with Bexley clinical commissioning group, medical adviser for NHS Direct, and co-chair of the Network, an online forum where health professionals can share best practice. You can follow Nikita on Twitter at @NikkiKF Guardian Professional. 

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