Home Health Sam Allen: The women working in health and care look after us; it’s time we looked after them – The BMJ

Sam Allen: The women working in health and care look after us; it’s time we looked after them – The BMJ

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Sam Allen: The women working in health and care look after us; it’s time we looked after them – The BMJ

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There is an often trotted out statistic that women make up more than three-quarters of the NHS workforce. It’s one of those facts that is used so often that it’s frequently glossed over or not taken into account. 

But if we take a closer look at that figure, it is actually staggering: of 1.4 million staff in total, more than 1 million are women. If the NHS is the country’s largest employer, that means it’s also the largest employer of women. 

It’s women who are doing most of the caring for the sickest and most vulnerable. It’s women who are keeping the NHS running. It’s women who form the backbone of the health and care sector. And it’s these women who have seen an extremely significant impact from the covid-19 pandemic. That means, therefore, that their needs and concerns should be high on the Government’s list of priorities. 

Importantly, that must include making sure more women are able to move up the ladder across the NHS, so that leaders and key decision makers across the service reflect the true composition of the workforce.

The hardships women working in health and care have faced as a result of the covid-19 crisis have the potential to have an extremely damaging long-term effect on these women themselves in the coming months, and the health and care sector as a whole. The health service cannot afford to lose the people that make up the greatest proportion of its workforce to stress and burnout, especially as the NHS is being called on to restore normal service by the autumn, at a time when staff, who have done so much for us, are already exhausted and overstretched. 

Of course, the covid-19 pandemic has put unprecedented—and unsustainable—pressure on health and care staff, right across the board, irrespective of gender. But the Health and Care Women Leaders Network, of which I am chair and which is delivered by the NHS Confederation, recently carried out a survey of more than 1,300 women working health and care, and the results of the survey lay bare the burdens, pain and fears women (and we use that term through an intersectional lens) working in health and care have faced. 

Above all, they demonstrate the physical and emotional toll on women, of caring responsibilities, both in and outside of work, as a result of the pandemic. Indeed, nearly three-quarters reported that their job had a greater negative impact than usual on their emotional wellbeing, and more than half had suffered a negative impact on their physical health.

Given how many women work for the health service alone, it’s fair to say, I think, the experiences of women working in health and care are reflective of the experiences of women across the UK. They will not be alone in their feelings of guilt at not being able to devote enough time to both work and home responsibilities, or of anxiety and uncertainty, or of isolation from friends, family and colleagues, or of feeling as though they must work longer, at personal cost and for little in return.

Beyond that, it’s clear that, by dint of their sheer numbers across the health service, we should be paying attention to what female health and care staff are saying about the impact on them—and doing something about it. That means paying particular attention to the physical and emotional needs of female staff during the pandemic and beyond; discouraging staff from working unpaid overtime; the continuation of wellbeing and psychological support; and creating a culture where workers feel able to speak up and seek help. 

This crisis is not going away any time soon. Its effects will continue, and the fact that the survey’s results cover the period after the peak of the virus in terms of severe illness and hospital admissions demonstrates that. We’re also starting to learn more about “Long covid”, with reports suggesting many of those hospitalised suffer symptoms for three months or more, and they will of course need to be supported in their recovery.

The extreme pace and intensity of change brought about by the crisis has come at a great cost to mental wellbeing, among health and care staff and across the UK, but it’s not all doom and gloom. It has demonstrated that new ways of working can be extremely successful, and that it is possible to build on these—for example, encouraging more flexible working, providing wellbeing support for staff, and strengthening home working policies.

The findings of the survey draw out some of the positive experiences of health and care staff, such as opportunities for learning and the strength of support many have seen from their managers, as well as bringing teams together and building resilience. The findings also give voice and shape to the needs of the female workforce, and my hope is that will drive far-reaching and much-needed change. 

But most importantly, they show support will be needed as the crisis continues and beyond, in order to minimise the risk of burnout among female health and care staff, to protect women’s wellbeing, and to make sure they are mentally and physically well enough to continue to care for and support our communities. 

Sam Allen, chief executive of Sussex Partnership NHS Foundation Trust and chair of the Health and Care Women Leaders Network

Competing interests: None declared

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