Women are at the heart of both the health service and social care. They make up the majority of both workforces, constituting 77% of NHS staff and 82% of social care staff. They are the ones who are most likely to care for us when we need it most.
That means the burdens of working through the pandemic, caring for some of the sickest and most vulnerable people, have fallen mainly on the shoulders of women. Compounding the pressure even further is the high job vacancy rate. According to the latest figures published by Skills for Care, there are 112,000 vacancies across the care sector.
At the Health & Care Women Leaders Network, which is delivered by the NHS Confederation, we have been monitoring the impact on women working in the health and care sector since the COVID-19 crisis began.
Through two surveys in this area, which the Network carried out last summer and this spring, the impact on both physical and emotional health of working through the pandemic became abundantly clear. Most respondents reported effects on their physical and mental wellbeing and also reported negative effects as a result of the burden of caring responsibilities they face.
It’s fair to say, then, that female care staff have felt the impact of the COVID-19 crisis particularly acutely – and their experiences, views and concerns must therefore be taken into consideration, especially in light of the impact of the pandemic, as the Government formulates its proposed Women’s Health Strategy. Any resulting strategy must absolutely have these women in mind; we would expect it to include at least some reference to how they will be supported to recover from the trauma of working through the pandemic and how to apply the lessons learnt – for example, more flexible working.
Skills for Care data also showed about 27% of adult social care staff are over 55 and one of the key challenges raised by the workforce, as evidence-gathering on the Government’s proposed strategy got underway, was the physical demands of caring, particularly as staff – eight in ten of whom are women – get older. This must also be taken into consideration, so that the health implications of both the physical and emotional toll of caring can be addressed properly.
As part of the Network’s response to the Government’s call for evidence on the strategy, the Network has come up with a series of recommendations designed to improve the lives of women working in the health and care sector. Chief among these is that national leaders, at NHS England and NHS Improvement and within the Government, should develop a Women’s Health Strategy specifically for the health and care workforce, so that the issues they face are addressed at every level and any intervention is appropriately tailored to them.
Beyond this, to make sure all women’s needs are properly addressed, it is imperative that the strategy from the Government is developed from an intersectional perspective. For example, the NHS Confederation-led BME Leadership Network found staff from BME backgrounds were more likely to take high-risk roles, including working in front-line COVID-19 wards, for fear their contract may not be renewed or shifts reduced, especially if they were agency staff or had a vulnerable immigration status.
The clear consequence of this is that their physical and mental health is at even greater risk because of the resultant additional pressure and anxiety they are facing. Any Women’s Health Strategy must also tackle this issue.
Similarly, this strategy must take into account the needs of people who were not assigned female at birth but identify as female, or who were assigned female but now identify in another way. In our own surveys, people who self-described or preferred not to report their gender showed much worse levels of wellbeing, suggesting further work is needed to ensure their specific needs are met, to understand the health inequalities they face and the variance of experience among LGBTQ+ identities.
The COVID-19 pandemic has shone a light on inequalities within our society that have existed for far too long.
From the Government and national bodies, we must see investment and policy targeted at addressing these issues. That means there must be investment in ongoing, tailored mental and physical health support and, importantly, investment in recruitment and retention to help alleviate workforce shortages and in turn, minimise the pressure on women, who are stretched ever more thinly as workloads increase but staff numbers remain the same or fall.
Health and Social Care Secretary Matt Hancock was right to flag the ‘male by default’ system, under which so many people have suffered, as something that must be addressed. The key priority now is to make sure these words translate into real, lasting change, for women working in health and care and for all women.
This, in turn, will help us continue to provide the best possible care and treatment to the communities we serve.
Samantha Allen is the Chair of the Health & Care Women Leaders Network, which is delivered by the NHS Confederation, and is Chief Executive of Sussex Partnership NHS Foundation Trust. Email: ChiefExecutive@sussexpartnership.nhs.uk Twitter: @samanthallen and @hcwomenleaders