Implementing decent agile working in the NHS
Key points
The research identifies mindset enablers and blockers to adopting decent, agile working practices in the NHS.
Enabling mindsets include considering how agile working can benefit both employees and services; ensuring that no harm results from inactivity or change; starting small, learning as you go, and designing customised solutions.
Mindset blockers include having a fixed idea about who can be an agile worker, concerns about fairness, and being overly concerned about external perceptions.
Resources to support enabling mindsets and developing knowledge around best practice and policies, and how digital tools and skills can be applied.
Evidence of mindsets that enable or block the implementation of decent, agile working in the NHS. A research report with recommendations
This report draws on four years' of evidence gathering and collaboration through the agiLab knowledge-exchange to identify key enablers and blockers to implementing decent, agile working. It challenges misconceptions about who benefits from flexible working to illustrate how more agile mindsets and approaches can mutually serve organisational and individual needs.
The recommendations in the report aim to help workforce leaders harness the benefits of decent, agile working across the NHS. The report's findings will enable and inform the development of actionable resources for stakeholders.
agiLab is the co-creation of academics, led by Dr Emma Russell at the University of Sussex, and the NHS. agiLab aims to promote and facilitate an evidence-based approach to best practice and research in agile working through academic and practitioner collaboration and knowledge exchange.
What is decent, agile working?
Decent agile working is a form of flexible working that involves adapting work patterns as individual and service needs change. It offers genuinely customised and responsive options to liberate workers and organisations from rigid, traditional constraints about when, where and how work can be done. It encompasses both formal and informal arrangements, often enabled by digital tools and innovative practices, to mutually benefit the organisation and the worker. It emphasises the need for work to be inclusive, dignified, safe and valued.
There are stark differences between occupational groups in accessing genuinely flexible, inclusive, and decent work arrangements, potentially because the scope of true flexibility has not always been realised or understood. The agile working approach goes beyond this, encouraging ‘true’ flexibility that involves ongoing adaptations and customisation of working time, place, and role to help deliver the NHS People Promise ‘we work flexibly’.
The central research question of the study was:
- How is decent, effective, agile working implemented across the NHS?
Key findings
The research identifies the mindsets that act as enablers and blockers to adopting decent, agile working practices in the NHS, and the resources that underpin these. Data was taken from agiLab conferences (with academic thought leaders, NHS best practice exemplars [BPEs], future-focused discussions, research reviews, and insights from agiLab delegates) and co-designed agiLab applied research studies.
Mindsets are the cognitive attitudes, beliefs and thought processes that are used to rationalise action and outlook. Resources are the assets that help an individual or organisation to achieve its goals. When resources are in place, enabling mindsets are more likely, but manager time and capacity is also essential.
Recommendations for the implementation of decent, agile working
The research identifies key priorities for leaders and line managers, and also for NHS trusts and stakeholders to facilitate the implementation of decent, agile working to support NHS reforms, policy and practice:
NHS leaders and line managers
- Adopt a ‘mutual needs, mutual gains, no harm’ mindset.
- Challenge ‘the ideal agile worker’ mindset.
- Be research led (experimental and evidence based).
- Develop digital resources around access, skills and capabilities.
NHS trusts, senior leaders and stakeholders
- Review and reframe NHS communications and materials, to incorporate clear definitions of decent, agile working across the service.
- Support managers to develop ongoing and compassionate ‘flex conversations’.
- Embed understanding of agile working into management/leadership training.
- Appoint agile working champions at trust level to help support leaders and managers.
The notion that decent, agile working can only be made available to some workers, and often with rigid and arbitrary conditions, must be reframed. This starts with ensuring that definitions of truly flexible, decent, agile working permeate the whole service. This should be accompanied by messaging that creates will among the workforce to adopt an agile approach as the default mode for all workers to deliver an NHS that is fit for the future.
Acknowledgements
Emma Russell is a co-Investigator at the ESRC Centre for Digital Futures at Work (Digit), and is supported by the UK Economic and Social Research Council [ES/S012532/1 and ES/Z504713/1], which is gratefully acknowledged.
