Decent and agile flexible working: practical options for managers
About this guidance
This guidance has been designed by agiLab which is a collaboration with the NHS and the University of Sussex and represents NHS voices.
Evidence from the collaboration shows that decent and agile flexible working involves using innovative practices and digital tools to customise and adapt how, when and where people work, to fit with individual needs and organisational goals. These arrangements should be negotiated with individuals and teams to ensure they are inclusive, safe, fair and valued.
Practical solutions to real workforce and service challenges
This guidance shows how decent and agile flexible working can be applied to address common pressures such as recruitment shortages, retention risks, burnout, skills gaps and changing patient needs.
Flexible work design that is fair, safe and negotiated
The guidance emphasises negotiated, transparent and inclusive approaches to meet worker and service-delivery needs.
Learn from what already works in the NHS
Tested NHS examples are provided that demonstrate improved service access, staff wellbeing and retention outcomes, alongside the risks of doing nothing.
How to navigate this guidance
Click on the + signs for ideas about how adapting how, when and where people work can help meet worker and service needs.
Workforce provision challenges
Workforce care challenges
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.
This guidance has emerged from the NHS-academia collaboration agiLab, a forum where NHS practitioners share evidence of best practice, discuss challenges and generate knowledge and reflections on how decent and agile flexible working can really work across the NHS. Their voices on ‘what works’ are supported with rigorous academic research and thought leadership.
While decent and agile flexible 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 accordions above.
Think Flex First NHS
Think Flex First NHS is a cultural change that encourages employers to build flexibility and choice into roles from day one. It promotes a proactive approach to job design and service planning, ensuring flexibility is an employer-led offer rather than something staff must request.
