Happier staff, healthier patients: the benefits of flexible working

Introduction

Avril Smith has arrived for her health visiting shift at the Living Well Hub in Warrington on a grey Tuesday morning in October. The rain has done little to dampen her spirits - she loves working with the health visiting service and is proud to showcase it. 

Also, because she works flexibly, tomorrow is technically her Friday.

“Flexible working for me brings a whole new world really,” she says.

“Being able to know on Wednesday evening, this is my Friday … and knowing I've got time for myself … I've given myself and my personality to my job since 1984. And I think there is a point now where you are sitting back and thinking, I think there's a bit of time for me now.”

In an era of workforce shortages, service demand and shifting work-life expectations, that sentiment may well be the difference between a service that simply functions and one that thrives. 

It’s a story that is echoed across services throughout the Bridgewater Community Healthcare Foundation Trust, which has strongly encouraged staff to explore the opportunities offered with flexible working. 

Making Flexible Work

Now with retirement drawing closer, Avril says her flexible working arrangement has enabled her to continue doing the job she loves while affording her more time to spend with her husband and visit her elderly relatives.

Team leader Jo Gibbins, who manages 22 practitioners in the 0-19 Warrington health visiting service team, says virtually all her staff have embraced some form of flexible working. It all kicked off after the trust ran a campaign last year, Making Flexible Work, encouraging healthcare teams to see how flexible working could work for their service.

“I looked at it with the other two health visiting team leaders. We thought we would really benefit from flexible working, but then also recognised if we were going to do it, we needed to offer it to all our teams.”

The flexible arrangements come in all different shapes and sizes; some opt to work nine-day fortnights, some work condensed hours or some work flexibly part-time.

Crucially, Jo says, there has been no compromise on quality of patient care since the rollout, yet staff are much happier. 

"They really value that opportunity from the trust. They see it as a real advantage in their working conditions. And it really makes them want to stay in the service," she says.

"They wouldn't move to another service that didn't offer the same flex," she adds.

The start of Bridgewater's journey

For Tania Strong, assistant director of people and OD at Bridgewater and the people team at the trust, the starting point of Bridgewater’s flexible working journey was a set of underwhelming staff survey results which put them below the national average for community trusts. 

“We knew that [flexible working] was an area of work we wanted to focus on. For us it was about looking at the benefits and thinking about how we are going to improve this experience for staff … that was one of our key drivers.”

Since then, the trust has taken a considerable leap forward, an improvement Tania partially credits to flexible working, noting that it is a key element of their employment offer. 

“It's benefited the trust in terms of our recruitment and our retention. The feedback that we've received from staff who have been able to access flexible working has been really positive from a wellbeing perspective, in terms of their ability to balance home life and family life with work commitments,” she says.

Tania is keen to underline that ultimately, whatever the working arrangement, service delivery and maintaining high-quality patient care remains paramount. Even if it means that not every request for flexible working can be accommodated to the letter. 

“This is about having a conversation with your manager about the opportunities that are available,” Tania says. “What it isn't, is saying anybody can have a request granted.”

“We try and encourage a creative solutions focus. We try and encourage managers to put forward alternative proposals if perhaps the first suggestion isn't going to be suitable for the service,” she adds.

Encouragingly for the trust, in some instances the shift to flexible working has enhanced service delivery. 

In the audiology service based at Lowe House Resource Centre in St Helen’s, flexible working among the team has enabled the service to open before and after school appointment slots for families.

 “Parents often asked for them and now we can offer them,” highly specialist audiologist Emma Coxon says. 

Emma starts her day at 8am, handling early appointments and finishes early enough to be able to pick up her own kids from school, an arrangement that makes her feel ‘really, really lucky’. 

Her colleague Katie Bentley, clinical specialist adds:
“We’re all more rested and less burnt out. That means we’re giving even better care because we’re happy and energised.”

Jimmy Cheung, head of medicines management at the trust, says implementing flexible work has improved communication and visibility across his team. 

“There’s the respect for that flexible working opportunity [which] gives us a better understanding of how we work together as a team,” he says. “It's felt clearer as a team, where we knew where we were up to, what our working week looked like, and we were able to genuinely offer greater resilience.”

On the personal front, Jimmy says flexible working has enabled him to invest more time into professional development and he has recently been able to restart a two-year leadership course.

Bridgewater has also successfully addressed the myth that flexible working is just for people with caring, or family commitments. It can be a space for enjoying hobbies, doing the weekly shop, or simply, and importantly, recharging. 

Senior communications manager Adam Britton, who works a nine-day fortnight, chooses to head off to the countryside in his camper van on his days off. 

“I can very easily get out for the day, for a hike to the Lake District, or Snowdonia, on my day off,” he says. “Being out there in nature feels like such a contrast to work. I firmly believe I’m a better, more refreshed member of our team. I feel brighter because of it. It’s really good for my wellbeing.”

Since the Making Flexible Work campaign launched last year, around half of the trust’s workforce have enquired about flexible working; and they have seen an improvement in their NHS Staff Survey score for the We Work Flexibly people promise from 6.4 to 7.0.

Replicating Bridgewater’s success

Tania hopes that their success can be replicated in other sectors of the health service. 

“As a community trust, sometimes there's the perception that it's easier to implement flexible working,” she says.

“In some ways it isn't. Sometimes our teams are very small, very specialist, and they may only include two-to-three people in a team.”

In some cases, acute sectors with larger rosters could have more scope to implement flexible working arrangements without compromising service delivery.

“I would say that some of the principles that are common and core across all types of NHS organisations are things like self-rostering, empowering teams to be able to look at the service requirements, look at what their individual needs are as staff, and see where they can marry up and work together.”

Ultimately the message Bridgewater wants to convey to managers in their trust is to explore what they can do in terms of extending flexible working to their teams.

“We do have full rostering across the whole organisation, and we've used that as an opportunity to say to managers, look at the rota, look at the roster, have a look and see what this flexible working request would do to your service,” says Tania.

“This opportunity is here. If you can come up with a creative solution, we're happy as an employer, if it works for the service to, to consider it.”