Can flexible working solve the staffing crisis in the NHS?

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26 May 2022

Can flexible working solve the staffing crisis in the NHS?

There has been a lot of talk about digital transformation in the NHS in response to the Covid-19 pandemic and what huge strides have been made in a short space of time.

We have also seen a huge shift taking place in working patterns across a whole range of sectors. The NHS however, still seems to have an underdeveloped and inconsistent adoption of flexible working. There is a huge disparity across the organisation in terms of what options staff can access. In this blog we consider whether the pandemic will also be a driver to change this?

Staffing crisis

We often hear of the staffing crisis in the NHS with reports of 100,000 vacancies, an 8% shortfall in staff and statements like;

More nurses are leaving the NHS than joining it (Independent); and GPs are leaving at a rate of 400 per month (FT).

Studies have shown that the lack of flexibility is one of the top 5 causes of job dissatisfaction for UK hospital doctors and nurses. In fact a recent study* examined the top five causes of job dissatisfaction for UK hospital doctors and nurses. Poor work-life balance was top for doctors aged 18- 45 (more important than pay). Work-life balance also came top for nurses aged under 35 (more important than pay), and second for those aged 36 and over (after pay).

Drain on NHS resources

What is also stark is the heavy reliance on agency staff and the huge cost that comes with that. Despite attempts by the NHS to reduce this reliance, the bill in recent times has been around £2.4bn a year** and it is flexibility, which many agency staff cite for working in this way. Staff like to have control over the number of hours they work. Breaking this cycle has to be one of the main drivers for improving the flexible working offering.

Life changing

Flexible working can make a huge difference to someone’s life – their decisions about staying in a job for the long term, their health and wellbeing and also financially, especially if childcare is needed. It is clear therefore that improving the approach to flexible working could have long-term benefits for staff and the NHS alike and go some way to improving job satisfaction and retention rates.

What action is the NHS taking?

The NHS did appoint a head of flexible working in December 2019 and the NHS Interim People Plan aims to “give people greater choice over their working patterns, help them achieve a better work-life balance and help the NHS remain an attractive career choice”.

We’ve been interested to read recently about a pilot programme in 3 hospitals called ‘FLEX-Ability in Nursing’, run by the flexible working consultancy Timewise, where a team based approach to rostering was trialed to give nurses greater control of their working patterns. The aim was to increase nurses’ input into their own shifts and to work collaboratively to produce a fair rota based on everyone’s needs and wishes and not just taking into account the needs of those with childcare responsibilities.

The initial results have shown increases in nurses feeling that their preferences are being considered more and that there is the opportunity to influence their schedule and consequently a general feeling that the system is fairer.  We know all too well that producing a fair rota is never easy and this project has shown how complicated it is to get things right. With this recognition, people may be willing to be a bit more flexible themselves.

Things heading in the right direction

Flexible working in the NHS is never going to be easy given the huge range of roles and grades and the fact that most are shift based. There are of course hurdles such as having the right technology in place also. It will also require a culture change for it to succeed and a more collaborative approach to managing teams.

There are it seems lots of projects taking place across the NHS and the experiences of these will hopefully be shared for others to benefit from. Hopefully these will have a positive impact on the so-called staffing crisis.


Flexible Working in the NHS: The case for action – Timewise

The NHS Workforce in Numbers – The Nuffield Trust

*Time to Care: Securing a future for the hospital workforce in the UK – Deloitte 2018


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