The number of nurses working in the UK is increasing as the NHS tries to keep pace with a growing population and a major increase in demand. According to our recent nursing report, the UK had the highest recorded number of nursing and midwifery professionals in Europe in 2014 and records show that the NHS employed 377,191 qualified nursing staff in the same year – which is 18,432 more nurses compared to 2004.

Recent statistics show the NHS workforce has grown by more than 2% over the past 12 months with London, the North West and the West Midlands predicted to have the highest increase in nursing jobs for the next two years.

However, despite the continued growth of the nursing sector (a sector which has an 89.6% female workforce), women still struggle to fill senior positions as almost two-thirds of the sector’s top jobs are currently occupied by men. This means there is now a 14% pay gap between the sexes as men tend to be favoured more for higher-paid positions. 

gender imbalance at the top.

Although the nursing workforce is growing and there is a lot being done to encourage people to join the sector (the number of graduate nurses increased by 28.6% from 2010-2013), it is at the top where there appears to be an imbalance between the sexes. 

According to the Royal College of Nursing, pay for nurses rose by 1.6% over two years whereas senior executives saw much larger increases of up to 6.1%. To add to this, studies also show that women currently only account for 37% of senior positions and even less for a chair or chief executive roles. 

Our recent survey, which involved a cross-section of men and women currently working in nursing and social care, appears to support these claims as it revealed that 36% of women believe there is a glass ceiling at work. The survey also showed that almost half of healthcare professionals who responded (45%) said not enough was being done to get women into top jobs too. 

Victoria Short, Randstad Care MD has addressed the issue when she argued that: “fewer men in the profession should mean there are more roles for women at senior levels but there are still a disproportionately high number of men occupying such positions.

Given the high proportion of women working in nursing, HR departments need to be looking at what they are offering women and how they can encourage them into those senior roles to create a more equal gender spread.”

Click here to read our latest report on the gender pay gap to find out more about changing attitudes towards pay rises and gender imbalance in the workplace. 

decline in senior positions making matters worse.

The lack of women in senior roles is further exacerbated by the decreasing numbers of senior positions available in the nursing sector. In the last five years, there has been a significant drop in positions with salaries between £31,000 and £81,000 meaning women are now likely to find it even harder to land the top jobs. These declining higher-paid roles fall within the Band 7 and 8 nursing job categories and tend to include positions such as nurse consultants, modern matrons and chief nurses.

Demand for lower running costs in the NHS between has seen a 4.5% decline in Band 7 positions between 2010 and 2013. During the same period, there has also been an 8.4% decline in Band 8a positions, an 18.5% decline in Band 8b positions, a 15.8% decline in Band 8c positions and a 3.4% drop in Band 8d positions. 

These drops mean competition is now much fiercer for senior management vacancies and there are now significantly fewer opportunities for women to progress to higher-paid roles. This is likely to have an adverse effect on the gender pay gap and, until this issue is addressed, it seems that men will continue to occupy most of the sector’s top jobs. 

the reasons for gender imbalance.

The reasons for the gender imbalance are myriad but chief among them is lack of confidence among female staff. Traditionally, men are more likely to ask for pay rises than their female counterparts and results show that they are more likely to be given them. Our recent survey results show that on average men get three raises in five years compared to women who only get two. The top reasons given for women not asking are lack of belief in their own skills (35%) and fear of how their colleagues will perceive them (23%).

maternity leave and lack of flexible hours still holding women back. 

Women taking time off for childcare and lack of flexibility are also seen as big contributing factors to the gender gap. Maternity leave means women return to work on lower pay scales than their male counterparts, particularly in NHS organisations where incremental pay scales based on length of service are common.

There is also less flexibility surrounding childcare and working, particularly in senior roles, which discourages women from applying. According to a King’s Fund study, a significant number of women in senior roles have experienced sexism (37%) or feel there is a distinct culture favouring men. Many women also said there was a perception they had to work twice as hard as men, merely to prove themselves fit to do the job and establish their authority. 

Of those who responded to the study, 61% had children but almost everyone asked said having children put them at an immediate disadvantage, especially for senior roles. It was much harder to make early morning meetings or conferences or informal evening networking events, all things which were crucial to maintaining a leadership position within the NHS.

If you want to find out more about the gender pay gap in the nursing sector, Randstad Care will be publishing a report on these findings this summer.