Career pathways taken by female healthcare leaders: a qualitative study

Background/Aims Despite comprising over three-quarters of the NHS workforce, women are underrepresented in senior leadership positions. As part of a larger study on gender inequality in the English NHS, this study aimed to explore approaches to career progression among female healthcare leaders. Methods A total of 15 female leaders and five male leaders were recruited from different NHS organisations for semi-structured interviews about their career pathway. Interviews were conducted via video call. Interview transcripts were analysed using narrative analysis with the Labovian method. Results Two distinct approaches to career progression emerged from the data. Approach one was non-linear, characterised by sideways moves and prioritisation of other responsibilities, such as childcare. Approach two was more linear in nature, reflecting deliberate efforts to progress in one's career as quickly as possible by seeking out promotions and professional development opportunities, networking and acquiring a mentor. Eight female participants were classified as taking approach one, while seven took approach two. Participants noted both intrinsic and extrinsic factors affecting their approach. Conclusions Healthcare leaders may take one of two distinct approaches to career progression, influenced by intrinsic and extrinsic factors. The author does not suggest that either approach is better than the other. However, those who take approach two are arguably likely to progress in their career more rapidly than those who take approach one. Implications for practice Activities and resources associated with approach two may be beneficial for women seeking leadership positions in the NHS. These include building networks, having a mentor, being geographically mobile and having a support network to help with childcare. That said, this approach may not be accessible or preferable for all female leaders.