New study reveals stark gender pay inequality in UK nursing workforce

Nursing is predominantly a female occupation (89%) in the UK, but men still hold one in five of the best paid jobs, which raises questions about the lack of gender opportunity in the profession, says a new study published this week by London South Bank University researchers.

In one of the highest pay bands, men occupy almost one in five jobs despite making up a much smaller percentage of the workforce. For example, in England although men make up only 11.3% of the workforce they hold 17.1% of the pay band 8d jobs (£70,206+salary). In Northern Ireland men make up just 6.6% of the workforce but hold 27.5% of the highest paid “very senior manager” grade jobs. These findings are reflected across all four UK countries and pay.

The study, entitled ‘Nursing pay by gender distribution in the UK - does the Glass Escalator still exist?’ is authored by a team of academics at LSBU headed by Professor Alison Leary, Chair of Workforce Modelling – with additional input from NHS arm’s length bodies.

Professor Leary and colleagues looked at a UK-wide population of registered nurses (pay bands 5 to 9) in the NHS over a one-year period (2016-17). This population consisted of 63,387 registered nurses in Scotland and Wales and 337,682 whole time equivalent registered nurses in Northern Ireland and England. It also looked at the promotion prospects of specialist advanced practice nurses over a ten year period.

A regional breakdown of the data shows that men in the nursing profession in Northern Ireland are higher paid than their regional counterparts.

The key findings show:

• Men are over-represented in top end nursing jobs across the whole of the UK compared to the rest of the UK female nursing population and this situation has barely changed in the last 30 years
• An analysis of 9,845 specialist advanced nurse roles in the NHS, using data gathered between 2009 and 2017, shows that men take less time to reach higher pay bands and they progress to them at a faster rate than women. Male nurses achieve higher paid nursing jobs more quickly than women do (on average 6/7 years faster). The findings show that men reach Pay Band 7 after 6 years compared to ten years for women and Pay band 8B, on average, 7 years before women, who took, on average, 22 years to achieve this level of pay compared to 15 years for men.
• Female nurses are more likely to accept a demotion or a compromise in pay in a role, whereas men do not. No males accepted a lower pay band to obtain their desired post but females did in bands 6,7 and 8a;
• The reasons why women tend to take a demotion more than men are unclear. Further study is needed to determine the root causes of this inequality and how to overcome it. Higher quality routine data collection on the demographic and population characteristics of this group is required

Professor Alison Leary said: “Nursing as a profession has a sticky floor, rather than a glass ceiling with a lack of gender opportunity rather than the gender pay gap, being the problem.

“This study shows that lack of gender opportunity in the nursing profession hasn’t changed much in 30 years – in fact the situation might even be worse now than when Christine Williams published her 'Glass Escalator' work in 1992.

“It is absolutely vital now that employers strive to create a more supportive working environment for women. The Health Service needs to focus on helping this disadvantaged group to maximise its opportunity in light of the 41,000 nursing vacancies currently available in England.”

Read a snapshot of the full report.