Networking and other important requirements for women leaders in their advancement to senior leadership positions in the National Health Service (NHS): A qualitative study

Abstract

Background Executive leadership boards in healthcare should be diverse, reflecting the populations they serve and the workforce serving in them. Worldwide, women constitute most of the healthcare workforce, yet the minority of leaders. Women experience barriers to progression to board-level positions at personal, workplace and wider systemic levels, including self-imposed barriers, prejudice and limited access to role models. Evidence to understand enablers to progression is limited. This study addressed the following research questions: What are the inspirations and/or enablers for women, especially those from under-represented backgrounds, in the pursuit of career progression? What are the coping mechanisms employed to respond to barriers for those women? Methods A qualitative interview study with ten women in board-level positions in National Health Service (NHS) organisations across South Yorkshire, with semistructured interviews carried out through 2022, and thematic analysis of data informed by an intersectionality lens. Results Three key themes emerged: (1) identities and self-improvement were informed by a sense of self, motivating experiences and the expectations of others; (2) barriers to progression included disability, disadvantage, limiting self-belief, lack of support and prejudice and (3) senior women proactively adopted coping strategies, leading to bespoke, blended solutions including formal programmes alongside personal approaches, notably the development of comprehensive peer networks. Conclusion The study highlights the need for NHS Systems and healthcare organisations to adopt facilitating enablers to respond to the challenges faced by under-represented staff, including coaching and mentoring, talent management programmes and peer networking, to enable diverse women leaders to successfully apply for board-level positions.