NHS staff wellbeing and work–life balance is a priority for the NHS. However, we do not currently have a systematic approach to one key area that could increase retention: flexible working. A landmark case, reported by Parry (2021) involving a nurse dismissed for not agreeing to work weekends, is to be reviewed after she successfully appealed—and is likely to highlight where the NHS needs to be.
There are already plans (Ford, 2021) to scrap a range of restrictions around NHS flexible working requests from September this year following agreement between the NHS and unions aiming to boost work–life balance and staff retention. This agreement, it was stated, had been made at a time when many health employers and staff were considering new ways of working.
Under new arrangements NHS staff will be able to make an unlimited applications for flexible working each year instead of the current one. Applications will not require any justification and can be made on commencement of NHS employment rather than the previously required 6 months' service. The new contractual terms will also allow NHS staff to access a process whereby managers must refer on requests that cannot initially be accommodated, to ensure that all possible solutions are explored.
Flexible working is one of the biggest factors influencing employee happiness (Rotageek, 2021). Between 2011 and 2018 more than 56 000 staff left the NHS solely due to poor work–life balance and, as highlighted by management software provider Rotageek, a flexible approach to working brings improved job satisfaction and reduced work-related stress, which in turn has a direct impact on productivity, as well as helping improve retention and absence rates, both key aims of the NHS people strategy (NHS England/NHS Improvement and Health Education England, 2020).
The Interim People Plan (NHS England/NHS Improvement and Health Education England, 2019) recognised that the NHS was operating in a highly competitive employment market with changing expectations about careers, and it acknowledged that more people were choosing to work less than full time. Furthermore, people joining the NHS today are aware they will be working for longer than the generation before them. Increasing numbers may therefore wish to take breaks from NHS employment throughout their training and career, reinforcing the need for the NHS to be an excellent, flexible employer.
According to Rotageek (2021):
- In 2019, 8.7 million people said that they had the option to work remotely
- By April 2020, almost half of the UK workforce was working from home, with 86% doing so as a direct result of the COVID-19 pandemic, with others adapting to flexible shift working.
- Within weeks 1 to 8 of the UK lockdown, the NHS saw a more than a six-fold increase in virtual meetings
- Over the same period, almost 500 000 messages were sent a day between the 1.3 million NHS employees using digital technologies.
With several national bodies sharing good practice to transform the NHS and its approach to flexibility, the People Plan (NHS England/NHS Improvement and Health Education England,) offers the most pragmatic approach, with the points below especially pertinent to those of us in nursing:
Flexibility by default
Since January 2021, all jobs within NHS England and NHS Improvement are advertised as flexible, with all former staff encouraged to return with the promise of a better working pattern.
Normalise conversations about flexible working
Current employees can expect personalised health and wellbeing plans, with room to discuss flexible working requirements.
Flexibility from day one
Recognising that individual circumstances can change without warning and that flexible working can ease complications.
Role modelling from the top
A key performance indicator will be implemented within the oversight and performance frameworks regarding the number of roles advertised as flexible.
E-rostering
Organisations will be given full support when implementing e-rostering systems that promote continuity of care, advance annual leave requests and preferred working patterns.
Management support
Staff and managers have been provided with online training and guidance on flexible working, This reinforces benefits and provides tools for assessing applications.
Supporting people with caring responsibilities
The new working carer's passport will be introduced to establish and protect flexible working with compassion.
For me, the plans to improve flexibility are long overdue. However, the timing is critical to success and, with the whole of the NHS considering the longer term working patterns that they and their teams will deliver post pandemic, I am extremely hopeful that the NHS will progress at pace to being an excellent, flexible employer.