NHS mental health trusts failing to improve gender pay gap five years after data first published

Press release
20 April 2023

The Royal College of Psychiatrists has warned it could take NHS mental health trusts in England decades to close the gender pay gap if they don’t take urgent action and sign up to its Gender Pay Gap action plan.

The College has collected and analysed median hourly pay data for healthcare workers employed at 49 out of the 50 NHS mental health trusts in England. This analysis found the gap between men and women’s hourly median pay has narrowed by just 0.1 percentage points over the last five years (2017/18 - 2022/23) with male workers still paid 6.0% more than their female colleagues on average.

The data reveals significant variations across England. In 2022-23, nine trusts reported a double-digit gap between the median hourly pay of male and female workers. Lincolnshire Partnership NHS Foundation Trust had the largest gender pay gap with men paid 17.7% more than women on average. The median pay of female workers was higher than male colleagues at four trusts while just three trusts reported no difference between male and female median hourly pay. 

The Royal College of Psychiatrists has warned thousands of female mental health key workers are still not being paid what they are worth and are effectively working for free compared to male colleagues. 

Female staff at mental health trusts are being forced to work part-time while others are missing out on promotions and new job opportunities because not enough support is in place. 

The College is calling on mental health trusts in England to address this issue by signing up to its Gender Pay Gap action plan. 

This includes:

  • A commitment to take positive steps that actively ensure diversity when recruiting for senior and leadership roles. 
  • A commitment to offer all staff the opportunity to apply for flexible working arrangements. 
  • A commitment to take positive actions during the local Clinical Impact Awards scoring process that actively increase equity. 

Dr Sarah Smith, a consultant psychiatrist at a mental health trust in England, has asked to remain anonymous and is using a fake name for the purpose of this press release.

Dr Smith said:

“When I first joined my trust, my clinical director asked me to help with covering an additional cohort of patients whilst a colleague was on long-term sick leave.

“I agreed and every 1-2 weeks I would review these patients without being paid for my work. These patients were very complex with significant risk issues, and it took up a lot of my clinical time.

“I eventually asked my line manager if someone else could take on these patients instead, if I could have some additional medical support, or if I could start being paid but he told me there was no money available. He compared me to another female psychiatrist with a busier job plan than mine which made me feel guilty for asking for more money.

“Before I went on maternity leave, I discovered that a male colleague who was helping with similar work was being paid extra sessional time. I found out that another male psychiatrist who was brought in to cover my maternity leave was paid an extra session for covering these patients.

“When I contacted my manager about this, he didn’t acknowledge there had been an issue or apologise. He did however agree to start paying me. I don’t know why the male consultants in the Trust were paid more than me for doing similar work, but it felt unfair and unfortunately this experience has left me feeling disengaged from the Trust.

“I feel we need more women in senior leadership roles to ensure female consultants are treated on an equal footing with their male colleagues.”

“I know there are women who don’t feel comfortable asking their colleagues about pay and who are trapped in a similar situation to mine. We all would benefit from more transparent data so that men and women can compare how much they are being paid for their work.” 


Dr Faith Ndebele, a consultant psychiatrist at Solent NHS Trust which has a gender pay gap of 0.5%, said:

“I first applied to join Solent because they were advertising a new and innovative role that would allow someone to work full-time from home. As a parent with complex care responsibilities, I knew it was an opportunity worth exploring. I am now one of the first consultant psychiatrists to work completely remotely within the NHS and it has transformed our family life. 

“I am still able to provide clinical care, participate in teaching and training of junior doctors as well as take part in research but with the added bonus of a more balanced life. It would have been easy for my trust to assume that I wouldn’t be able to fully engage in the work of the trust, attend meetings or form working relationships with colleagues, but we’ve proven it can be done. My team can knock at my virtual door whenever they need to, and we’ve had fantastic feedback from people on the ground.

“Solent has fostered an environment that has enabled me to take on additional projects that have not only benefitted my career but also matched my personal interests. In my additional role as the clinical lead for neurodiversity pathways in Hampshire and Isle of Wight (HIOW), I am working alongside the HIOW Integrated Care System on pathways to improve access to assessment services for ADHD and autism in our region. 

“Many parents and carers are forced to work part-time so that they can balance their responsibilities. We need to explore innovative ways of working that give clinicians a chance to develop and to continue to progress professionally. 

“I think every trust needs to create a similarly supportive environment where staff have an opportunity to work in ways that enable them to thrive. Better access to flexible working supported by digital technology would help them to retain workers and the pandemic has already proven it is possible, so why not embrace it?” 


Dr Beena Rajkumar, co-chair of the Women and Mental Health Special Interest Group at the Royal College of Psychiatrists, said:

“We are in the middle of a cost-of-living crisis and women can no longer afford to pay the price of the gender pay gap. Thousands of female workers are missing out on better pay and exciting career opportunities purely because of their gender.

“Many NHS mental health trusts have struggled to make progress on this issue since they were first required to publish their gender pay gap data in 2017. They are still decades away from closing the gap and every year they fail to act is another year that women are forced to settle for less than they are worth.

“We are calling on Trusts to sign up to our Gender Action Plan. This should include commitments to improve maternity policy so that women are not forced to choose between starting a family and fighting for a promotion. There should also be a flexible working policy to support those who are experiencing menopause. 

“Mental health trusts are trying to tackle a chronic workforce shortage. These policies will help them to retain staff and attract new talent.” 


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