To celebrate the recent International Women’s Day, Meet Health Events is shining the spotlight on women from across the healthcare and health tech sector. This week, we sat down with Paula Lloyd-Knight, Deputy COO at Black Country Healthcare NHS FT. 

In an era where representation and diversity in leadership remain pressing concerns, Paula Lloyd-Knight’s journey offers both inspiration and a call to action. As Deputy Chief Operating Officer at Black Country Healthcare NHS Foundation Trust, her career spans social services, local government, and the NHS. Through her experiences, her story provides insight into the challenges and triumphs of being a Black woman in leadership, the importance of representation, and the enduring need for systemic change. 

A Journey Rooted in Justice and Advocacy 

Lloyd-Knight’s path into healthcare leadership was not linear. Originally planning to pursue a career in law, she studied Politics and Law at the University of Leicester, where her passion for equality and justice took root. “My passion had already been ignited around equality and inequality,” she reflects, particularly through studying apartheid in South Africa. Her work with the Leicester local authority during university introduced her to social services, and ultimately, she chose to forego law school to work with underprivileged children in the local government sector. 

Her early career was marked by rapid progression. In 1993, she was hired as the youngest unqualified social worker at Leicestershire County Council. She quickly became involved in the Black Workers Group, which provided her with firsthand exposure to disparities in employment, recruitment, and disciplinary actions. “Being the chair of the Black Workers Group gave me access to the Director of Social Services,” she recalls. “It opened a lot of doors for me.” 

By 1996, at just 26, she secured her first management role in social housing. “I was still very young, managing people in their 50s who were questioning my abilities—because I was young and because I was Black,” she admits. Despite initial skepticism, she won over colleagues by proving her skillset and enacting meaningful changes. “Those experiences really helped build resilience,” she adds. 

Her career progressed through various roles in the West Midlands before she transitioned into the NHS in 2002. She took on increasing responsibilities at a regional level, then moved to London in 2007 as National Associate Director for Cancer Patient Experience within the National Cancer Action Team. The role gave her a national platform until 2013, when her team was dissolved as part of the restructuring of the national teams to create the NHS Commissioning Board.

After a period in acute hospital leadership, she transitioned into mental health in 2020 at the height of the COVID-19 pandemic. “My first day was spent writing a plan on how to manage COVID across our mental health wards,” she recalls. In 2022, she took on her current role as Deputy COO, stepping in as Acting Chief Operating Officer for six months. 

The Women Who Inspired Her 

Lloyd Knight’s leadership philosophy has been shaped by the Black feminist thought she immersed herself in during university. “I started reading African American feminist literature—Alice Walker, bell hooks, Zora Neale Hurston, Angela Davis, Patricia Hill Collins,” she explains. These works provided a crucial lens to understand her own experiences as a Black woman navigating predominantly white spaces. 

“In the 90s, there wasn’t as much literature in England from a Black female perspective,” she reflects. “I had to look to America for that inspiration.” The narratives she found there validated her experiences and strengthened her resolve. 

Progress and Persistent Barriers for Black Women in Leadership 

Reflecting on shifts in representation, Lloyd-Knight acknowledges progress but highlights glaring disparities. “In the 2020 NHS Women on Boards report, the proportion of women on boards across trusts was 42.6%,” she notes. However, when factoring in ethnicity, the numbers tell a different story. “Only 11.2% of very senior managers (VSM) in the NHS were from BME backgrounds. And that includes men.” (*2023 Workforce Race Equality Standard (WRES), data published in March 2024.)

The challenge is even starker at the highest levels, as shown in the Nursing Times 2020, Analysis: Nursing and the quest for equality in the NHS leadership: “In 2023, 45% of NHS Chief Executives were women, but that doesn’t reflect Black women.” While there have been improvements, the pace of change for Black women has been sluggish. “The ‘snowy white peaks’ report exposed how white-dominated NHS leadership was. Yes, we’ve seen some movement, but not at the pace we would expect if this were just a gender issue.” 

Beyond statistics, the daily reality of navigating leadership as a Black woman remains fraught with bias. “There’s still prejudice, whether conscious or unconscious. If I speak in my natural style, I can be labeled aggressive or bossy. That’s something my white colleagues don’t face in the same way.” 

She shares a common frustration: “I’ll say something in a meeting, and two minutes later, someone else—usually a white colleague—says the same thing, and suddenly it’s a great idea. That’s incredibly demoralising, and I hear it time and time again from the Black women I mentor.” 

Advice for Future Leaders 

Lloyd-Knight’s key message to Black women entering leadership? “Know yourself.”

Understanding one’s values and strengths is crucial, particularly in environments where unwritten rules and biases exist. “You have to be aware of the system you’re operating in. Without that, you might internalise external behaviours and become disheartened.” 

Building a strong support network is another essential strategy. “You need a circle of people you trust—people who will hold a mirror up to you and validate your experiences.” 

She also encourages Black women to find their voice. “It’s important to articulate your feelings. If you don’t call out behaviours, they continue. Often, people don’t realise they’ve acted in a biased way until it’s pointed out.” 

Finally, she highlights the importance of mentorship. “I mentor a lot of Black women in the NHS and private sector. Many struggle with confidence because their experiences have eroded it. My job is to help them rebuild that confidence and leverage their skills.” 

A Call to Action 

Lloyd-Knight’s reflections make it clear: while progress has been made, there is still much work to do. “Women in leadership has improved. Black women in leadership? Not at the same pace. The disparity is huge, and we need to keep pushing.” 

Her story is a powerful reminder of the resilience, determination, and advocacy required to break barriers. And as she continues to pave the way, she remains committed to lifting others with her: “Leadership is about ensuring those who come after you have an easier path than you did.”