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3 June 2015
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Female GP representation in local leadership roles

Join the #wedocs Twitter chat on diversity in leadership today 17 June at 8pm. Dr Nikita Kanani, FMLM Quality Improvement Lead, and Ahmed Rashid, National Medical Director’s Clinical Fellow at NICE, are co-hosting the conversation.

Some of the questions we will be looking at:

  • Why do we need diversity in clinical leadership?
  • What are the barriers?
  • Is there a role for positive discrimination or quota systems?
  • What can we learn from positive role models?


In a recent paper published in the Journal of Health Services Research and Policy, Julie Segar from the University of Manchester takes on the important and often overlooked issue of how female general practitioners (GPs) are under-represented on clinical commissioning groups (CCGs)[1].  

The most recent reorganisation of the National Health Service (NHS) in the UK has meant these CCGs have considerable proportion of the local health budget and are able to plan, choose and procure services for local communities.

It is well reported that female GPs make up a significant proportion of the primary care workforce in the NHS and looking ahead, females are in the majority when it comes to medical school entrants and junior doctors in GP training posts. It comes as some surprise, then, that most of the approximately 200 CCGs in the country have few female GPs on their boards. As Segar points out in her paper, the exact numbers vary across the country, although they are consistently in the minority and in some cases, completely absent altogether.

Segar goes on to outline some potential reasons why they may be so under-represented. The fact that many female GPs are in salaried and sessional roles and many CCGs specify that only partners can be included is one possibility. The prevailing culture in the NHS of favouring heroic leadership styles is also mentioned as a potential reason that male GPs are more likely to be selected for these roles.

The paper also looks at the vast number of reasons why this lack of representation is problematic. First and foremost, justice is important and from a moral point of view, the reasons for this under-representation need to be addressed. In addition, the hope of including practising GPs is to include a frontline perspective and female GPs are likely to have unique insights. Finally, they are important role models for future generations and should be contributing for this reason.

The obvious solution to this problem, outlined in the paper, is a quota system. However, there must surely be more intelligent and thoughtful levers to try and engage and recruit female GPs to these important roles.

Share your thoughts and suggestions on this topic with other FMLM members by joining the conversation on our GP Leadership group page.

[1] 1 Segar J. Under-representation of women on governing bodies: women general practitioners on Clinical Commissioning Groups in England. J Health Serv Res Policy. 2015 Jan 13. pii: 1355819614567912. [Epub ahead of print] (Available at:

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About the author

Ahmed Rashid's picture

Ahmed Rashid

Ahmed is a National Medical Director’s Clinical Fellow (2014/15) working at NICE and an academic GP trainee (ST4) in Cambridge.

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