Decent agile working: practical options for managers
Key points
Practical solutions to real workforce and service challenges
This guidance shows how decent, agile working can be applied to address common pressures such as recruitment shortages, retention risks, burnout, skills gaps and changing patient needs -with clear options for changing how, when and where work is done.
Flexible work design that is fair, safe and negotiated
Agile working is not a one‑size‑fits‑all offer. The guidance emphasises negotiated, transparent and inclusive approaches that balance individual circumstances with service delivery, supported by regular review, risk mitigation and engagement with unions and HR.
Learn from what already works in the NHS
Managers can explore tested NHS examples that demonstrate how small‑scale trials, digital tools, e‑rostering and new shift patterns have improved service access, staff wellbeing and retention, alongside the risks of doing nothing.
Decent, agile working uses innovative practices and digital tools to adapt how, when and where work is done, aligning individual needs with organisational and service goals. These arrangements should be negotiated with individuals and teams to ensure they are inclusive, safe, fair and valued.
New work designs can be informal and small‑scale, allowing teams to trial, evaluate and review approaches regularly, or they can be formalised through contractual flexible working arrangements. Managers are encouraged to consider how decent, agile working can help them respond to the key challenges they face by exploring the options set out below.
For each challenge, practical agile working solutions are presented, showing how work patterns could change, the potential benefits for staff and services, and real‑world NHS examples where these approaches have been successfully adopted.
Managers should also consider the risks of any approach and tailor solutions to their local context through regular one‑to‑one and team discussions, with support from union representatives and HR colleagues where appropriate.
For further information or to discuss implementation ideas, please contact agiLab.
While decent, agile working provides a useful way of designing work to address key challenges in the NHS, managers are also encouraged to consider implementing this approach alongside other approaches. This should help to maximise the likelihood of achieving effective outcomes that benefit both staff and service delivery. Additional NHS resources to deal with a range of issues from staff retention to burnout can be found in the box below.
