Agile working to improve staff retention

This article looks at research into how customised working arrangements can meet the needs of employees and organisations and tips for implementation.

3 October 2023

To ensure that staff are kept within the healthcare service it’s important that employers can offer better support throughout their careers and boost working flexibilities so staff can work in ways that suit them and that works for patients.


Retention is a key priority area of the NHS Long Term Workforce Plan (LTWFP).


The LTWFP has an ambition to reduce the overall leaver-rate target to between 7.4 per cent and 8.2 per cent over the course of 15 years.

Flexible working and the power of choice

Research by Professor Claire Kelliher, Cranfield School of Management, Cranfield University, has looked at how customised working arrangements can meet the needs of employees and organisations. This allows some degree of choice over where they work, when they work and how many hours they work. By giving employees a level of discretion, it benefits the employer in several ways:

  • Organisations have seen improved employee performance, staff were able to fit in more tasks within the flexible time arrangements and where staff’s roles require them quiet thinking time, working from home offered that for them.
  • The ability to retain staff and lower turnover improved because employees were able to better balance their non-working lives with work commitments.
  • Organisations had seen enhanced commitment from employees and improved engagement. Agile working allowed employees to express reciprocal gratitude to their organisation for accommodating different working time arrangements.  
  • Organisations attracted a more diverse pool of employees and higher quality level of applicants when offering agile arrangements from the start of their recruitment drive.  

The benefit of choice given to employees include:

  • Greater choice over their working patterns, helping them to achieve more satisfactory work life balance. Staff do not have to sacrifice their family, friends and interests for work.
  • Higher levels of job satisfaction where employees feel empowered. According to the NHS staff survey, staff want to feel trusted to do their job and have a choice in deciding how to do their work.
  • Enable participation in employment by groups of people who would otherwise find it difficult to work standard hours, an example is flexible retirement, staff can retire gradually while accessing their pension. To support flexible retirement, please read this guidance from the NHS Staff Council on the process for considering flexible retirement requests.

Informal flexible working conversations

The concept of informal flexible working arrangement conversations is described as:

A voluntary, personalised agreement of a non-standard nature, negotiated between individual employees and their employers regarding terms that benefit both’. Studies show informal arrangements often deliver better performance outcomes than formal flexible working arrangements.

(De Menezes and Kelliher 2017).

These conversations can be incorporated into health and wellbeing conversations recommended by the NHS People Plan to be used by organisations to support staff. They are intended to be regular, supportive, coaching style one to ones that consider the whole wellbeing of an individual (physical, mental, emotional, social, financial, lifestyle and safety). 

The NHS Staff Council has incorporated a framework agreement for home and agile/hybrid working in the NHS Terms and Conditions of Service Handbook (Section 35). The new framework, which applies to England and Wales, includes clear definitions and guidance to support employers to commence creating and/or updating local policies, including outlining contractual considerations.

Top tips for implementation

When embedding agile working into your organisations plans, the following tips can help build a strong case for implementation.

  • Gain executive and senior leadership support, getting buy-in and support of senior leaders can help integrate agile working into wider strategic objectives. A top-down approach can encourage teams to act on change ideas. Read some top tips from the chief people officer at Sussex Community NHS Foundation Trust on how to gain board buy-in with the cost of living pressures. The methods described can be adapted to support the case of agile working
  • Build agile working into strategic plans, senior managers should have agile working as a key enabler in the trusts strategic plan and workforce strategy. Download and adapt this flexible working briefing for board members presentation to support your case for agile working. 
  • Work in partnership with a wide range of internal and external stakeholders to broaden the reach of the programme across the organisation, this incudes clinical and non-clinical staff, trade union colleagues.
  • Network with other organisations who have agile working embedded into their systems and learn from their experience. Using best practice case examples can help drive the agenda. Join one of our free programme networks such as the health and wellbeing network  and reward and recognition network who have produced a number of articles on flexible working.  

To find out more about further research undertaken by Professor Kelliher, and about Mid Cheshire Hospitals' journey to embedding flexible working in its organisation with its ‘the future is flexible’ campaign, access the recording and presentation slides by signing up to be a member of agiLab.