Flexible working toolkit: individuals working in the NHS

NHS Employers has developed this toolkit in partnership with NHS England, Timewise and the NHS Staff Council.

The NHS and primary care define flexible working as an arrangement which supports an individual to have greater choice in when, where and how they work. This may include changes to their working pattern, hours and role, and/or the location in which their work takes place. 

You may hear the terms flexible working, agile, hybrid, dynamic, smart and remote and home working used interchangeably, and they can mean different things to different people. For clarity and consistency, the term flexible working and the definition described above are used throughout this toolkit. This aims to support the shared and common understanding of flexible working that we need; to achieve fair, equitable and consistent practice.

The NHS is starting a cultural movement ‘Think Flex First’ which builds flexibility and choice by default, from day one and for all NHS staff. It shifts our approach from reactive towards proactive through job design and service planning with flexibility in mind upfront at the onset rather than as an afterthought. This will ensure flexibility is an offer driven by employers first to staff rather than requested by individuals. 

Having a flexible working arrangement can help individuals to have better notification of, and predictability in, their work schedules and so may facilitate greater variation in their work. Achieving a work-life balance with practical benefits that support overall wellbeing and productivity will help staff to thrive, and in turn, deliver the best patient care.

Good flexible working arrangements should balance the needs of the individual with three key organisational factors:

Bridgewater Community Healthcare Foundation Trust's Making Flexible Work campaign reaps benefits for both staff and patients. Read the full case study.

Your regular health and wellbeing conversations provide a useful opportunity to discuss flexible working, as well as your appraisal and one-to-one discussions with your line manager. 

You can raise a flexible working request formally or informally at any time.

For more information you can read guidance from the NHS Staff Council on contractual issues arising from certain forms of flexible working.

Requests for flexible working as a reasonable adjustment

A flexible working request from a disabled worker may be treated as a reasonable adjustment if it removes a barrier they face to being able to do their job. This is different to a non-disabled employee’s flexible working request and should not follow the same process. For further guidance you can refer to the TUC’s report.

Step 1:  Identify changes that may improve your work-life balance

Reflecting on your current working pattern, are there changes you would like to make? Are you happy with the way you currently work, or would you like any elements of your work life balance to be different? Make a list of the differences between how you work now and how you’d like to work and consider what could move you closer to your ideal. Try and be specific in your thinking about what would make a difference to you. Is it picking up your children from school a couple of times a week, creating the time for exercise / a hobby, or avoiding commuting at rush hour? You do not have to justify your request with a reason, but it helps to think about what matters to you in advance of any conversation with your line manager.

Think about whether you want a flexible working arrangement for a time limited or longer period. If you are an unpaid carer, this might also be a good time to raise the possibility of having a discussion using the working carer’s passport. This can help you frame conversations around flexible working and other support available to you, to help you balance your work and caring responsibilities. 

If you have additional protections from the Equality Act 2010 (for example, to meet childcare needs, as an adjustment to support a disability or to meet religious requirements), make sure you mention this in your conversation.

Step 2:  Explore the most common flexible working patterns

The second step is to be clear on the different kinds of flexible working that are available. It may be that some choices aren’t possible in your role, so a good place to start would be to look at which options would work within the balance of patient/service user experience, service delivery and the work-life balance of you and your colleagues. Take a look at some examples of the different kinds of flexible working.

Our flexible working infographic highlights the range of possibilities available to NHS staff and may help with your decision-making.

Step 3: Understand the difference between formal and informal flexibility

Some types of flexible working, such as occasional home working, can be agreed locally with your manager. Others, particularly those that affect your contract or pay, may require a formal flexible working application. It is also possible to have a combination of both. For example, you might decide to formally reduce your working hours, but also work from home from time to time with agreement from your line manager. Your organisation will have a flexible working policy that clearly outlines the processes you will need to follow for a formal application.

Step 4:  Closing the gap between your current and ideal balance

In most cases, it’s likely you’ll have concluded that you want to rebalance work and life in some way and make room for the other elements of your life. 

To begin with you could do a quick exercise that breaks your work time down into smaller chunks of activity such as commuting, key tasks, meetings and administration, etc. 

You can then weigh up whether flexible working could help you change these elements. For example, would changing your start and finish times reduce your commute time? You will also need to consider the impact on your workload.

Your manager can help you explore what might be possible in accordance with your organisation’s flexible working policy, including seeking advice from HR (or equivalent personnel) and trade union representatives on any wider options that may be available.

Step 5: Making flex work for your team and organisation

Having explored how the different kinds of flexible working might work for you, it’s time to consider how you could make them work in practice. Experience has shown us that flexibility works best when it works both ways. So, it’s important to think through what your organisation needs from your role, as well as what you need. The best, most sustainable flexible working options are those in which both sets of needs are met. 

Create a shortlist of any working patterns that feel feasible, think of the benefits as well as the challenges and reflect on these themes: 

• What changes (if any) would you need to make to your workload to make this pattern work?
• How would this impact on your patients and/or stakeholders?
• What would the effect be on your team and wider colleagues?
• If you are a manager, how would it impact your direct reports?

Imperial College Healthcare NHS Trust made flexible working for clinical staff a reality, watch the full video above to find out how.

Phase 1: Identify the benefits

Start by outlining how your preferred way of working could be beneficial to both you and your team and/or organisation. List as many benefits as you can and be as specific as you can. 

If you are struggling to turn one of your points into a benefit, try working through the so what? test. For example: 

A) Working from home two days a week will save me six hours of commuting. 

So what? 

B) This means I can be flexible about my timings, either starting earlier in the day or working until later in the day. 

So what? 

C) This will give our team better coverage for dealing with incoming enquiries and calls. 

This approach will ensure you articulate the benefits of your proposal to the organisation, as well as how it helps you. These conversations can feel hard, so it’s useful to stay objective.

Phase 2: Handle potential objections

Next, list any concerns that your manager might have about your proposed changes, and think about possible solutions for overcoming them. 

It’s important to be honest with yourself about the elements of your role that will be hard to flex and come up with some alternative suggestions. You don’t have to do this alone. If you’re considering how changes to your working pattern might impact on your colleagues, why not talk to them in advance and see what may or may not be possible? 

Reflect on how any new flexible working arrangement would impact on those you work most closely with, then present this as positively as possible. If you work shifts and are part of a rota, think about how your new working arrangements would be organised as part of creating the monthly rota. 

If you are contemplating reducing your hours, think about how it will impact your delivery, as well as where or with whom the remaining work would sit. Could this be an opportunity for a colleague to upskill, or for you to share work with a colleague who also wishes to reduce their working hours? 

If you can, include examples of similar arrangements that have worked well, either internally (such as how work is covered during holidays or unplanned absences) or externally (such as how other teams make it work).

Phase 3: Be prepared to be flexible in return

Being willing to compromise will make it more likely that you’ll find a pattern that works for you and your manager. We’d encourage you to think creatively to find a form of flexibility that works for you, your team and the delivery of your service. 

Your manager will need to consider the health and wellbeing of the whole team. Not every flexible working option is suitable for all roles all of the time. They will also need to make sure that your request won’t adversely affect the delivery of the service or make it unsafe. 

That’s why it’s important for you to be practical and realistic when making requests for flexible working. By speaking to your colleagues about the possibilities, being open to different options and being prepared to reach a compromise with your manager, you are more likely to be successful in getting your flexible working request agreed. 

If you are considering some form of remote working, think about which of your activities would be best suited to this arrangement, whether you would have the technology to support it, and how you will stay connected to your team.

For example, do you always need the same non-working day, or can you change it with notice for a day when your team is short staffed? If you’re needed at a meeting when you’re working remotely, can you dial in?

Phase 4: Make a plan for communicating

It may help to allay any concerns your manager has if you are able to show how you will communicate with your team or manager, and suggest practical steps to make this work smoothly. 

Explain the process you will put in place to clarify your availability. This could include sharing your calendar, providing updates to the rota/ward manager or adapting your email signature and voicemail so stakeholders know when you’ll be back and who else they can contact in your absence. Be transparent about when you are working (and when you are not working). Set out how you will maintain regular contact with your manager, team and wider stakeholders and how you will respond quickly and efficiently to any feedback about the arrangement. 

If you are a manager and working flexibly, think about how you will give your team clarity on how you will be working, how to escalate issues when you are not available, and your willingness to be contacted in an emergency.

In many organisations, new arrangements are agreed for an initial trial period. This is a good way to show that you can make it work before making a formal change.

Phase 5: Manage performance expectations

You will also need to factor in a discussion about how your performance will be measured. If you are planning to reduce your hours, you may want to suggest how your targets or output measures could be reduced to reflect this. You’ll also need to remember this when it comes to your annual appraisal and in setting clear, SMART objectives. 

It’s important to be realistic and to plan the most positive way to present your suggestions. And remember to support others to make a success of their flexible working. Whether that’s helping cover for someone, or encouraging them to leave on time, we can all play a part in creating a more flexible working culture.

Phase 6: Plan in regular reviews

Inevitably, circumstances will change and needs will evolve on both sides. Let your manager know that you will regularly review your new working pattern, look to overcome any new hurdles and make any adjustments that are needed. Remember to raise any issues or changes with your line manager sooner rather than later, to allow time to come up with new ideas and solutions.

Phase 7: Plan for your career progression

Timewise research tells us that flexible workers, particularly those on reduced hours, can miss out on development opportunities due to prioritising the needs of their day job rather than their own personal development. 

It is worth talking to your line manager about how you will access time for formal and informal training and development. Some of the informal networking and coaching opportunities that are seen as nice to do are actually crucial to building skills, confidence, support and sponsorship for your career progression, and will make you a stronger member of your team, so think about how you will build them in.

Your health and wellbeing conversations provide the opportunity to discuss any flexible working requirements, but remember you can check in on ways of working during an appraisal, job plan or one-to-one discussion.

Read the health and wellbeing conservations guidance to help you plan your approach.

Working part-time or reduced working hours

Working fewer hours than you were initially contracted to work.

Job-sharing

A form of part-time working where one full-time role is shared between two members of staff. Salary and benefits are divided according to the hours worked

Average hours eg annualised hours

Contractual hours are averaged out over a set time period for example quarterly, every six months or over 12 months. This can allow staff to work more hours at some times of the month or year and fewer or no hours at others - for example working more in the winter months and less in summer.

Set working pattern

Fixed hours and days to give certainty that other commitments can be fitted around work.

Staggered working hours

Where staff work a set number of hours during the day but with different start and finish times.

Compressed working week

Working your contracted weekly hours over fewer days per week. For example, working your hours over four days instead of five.

Term-time working

Usually favoured by working parents to work 39 weeks per year within term-time and use their annual leave entitlement, plus additional unpaid leave, to have school holidays off work.

Flexi-time

Allows you to vary your working hours on a daily basis (which may include your start and finish times) to suit your individual circumstances whilst ensuring you meet your contractual working hours over an agreed period.

Contact

If you have any questions, please contact us at staffexperience@nhsemployers.org.