Flexible working toolkit: line managers

About this toolkit

NHS Employers has developed this guide in partnership with NHS England, Timewise and the NHS Staff Council, to help managers consider flexible working options and opportunities, lead flexible teams, and put structures and processes in place to implement requests and deliver future-fit workplaces. 

About flexible working

The NHS defines 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.

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

Why flexible working?

Flexible working is a practical solution to meet the NHS workforce challenge, as outlined in the Ten Year Health Plan. Embracing flexible working will put the NHS front and centre as a modern, flexible employer of choice. It will drive progress and help the NHS to meet its ambitions to increase productivity, enhance workforce wellbeing, save on high turnover costs and reduce agency spending. 

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.  

It’s worth noting that flexible working is so much than a perk for employees, when correctly implemented it can help solve a number of core business issues including:

• attraction
• retention
• motivation
• inclusion and diversity
• productivity
• business costs (associated with high turnover and agency spend).

Equality, diversity and inclusion (EDI) considerations

Line managers should take into account potential cultural, racial, religious and gender factors when considering flexible working arrangements. Any decisions made should be continually reviewed to ensure there is no underlying bias/discrimination.

These provisions are designed to embed a positive culture of flexible working in the NHS and help address wellbeing and work-life balance for NHS staff. We also hope they will help to keep valuable and experienced staff working in the NHS while attracting new  people from a wide talent pool. As a line manager, you are encouraged to discuss flexible working with your direct reports during your regular health and wellbeing conversations, appraisals, job plans and/or your one-to-one discussions. 

Picking up conversations about flexible working in these more informal settings often enables solutions to be reached through exploration and dialogue. This may mean a formal request is not required, or if it is, some of the groundwork will have been laid in advance. This will require you to have a conversation to explore what’s important to the individual and what options might work based on their suggestions or any alternatives you identify together. The escalation stage is designed to help embed flexibility as a whole organisation effort and line managers have support to make this happen in their teams.

Take a look at guidance from the NHS Staff Council on contractual issues arising from certain forms of flexible working.

You can also find further support and information in the National flexible working people policy framework.

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.

What you can do as a manager

Supportive line management is critical to enabling a culture that promotes effective flexible working practices. 

As a line manager, consider how you can best support and facilitate flexible working for your staff. 

Things to think about.

• Start from a point of yes to explore what is possible.
• Listen, accommodate and respond with balance and compassion.
• Work with your staff to provide a solution that meets their needs and that of the service and the patients they support.
• Consider adapting the way individuals and teams work to accommodate the many options available.
• How you ensure all team members feel that they are making a valuable contribution. 

Coming to an appropriate solution can take time and you are not expected to have all the answers. You might find it useful to have conversations with colleagues (within and outside of your organisation) who have made flexible working work for them and their teams to explore ideas and the art of the possible. 

You will also still have to say no to some requests that cannot be accommodated. How can you do that with compassion having explored all options?

Flexible working should be available for all staff groups and you should particularly have due regard for applications where the individual has 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). 

In the NHS, flexible working arrangements may be informal or formal, be implemented in shift and non-shift-based roles and put in place on a short or long-term basis.

Many flexible working arrangements can be agreed informally, between you and a team member without the need for formal contractual changes. However, do seek the advice of your HR representative or equivalent management arrangement in line with your own policies and procedures. Remember some arrangements may require contractual variation.

Though some flexible working requests may start informally, it is helpful to formalise these practices through a flexible working request on ESR. This will mean that you can, as an organisation, capture data to assess consistency and equitable practice for staff accessing flexible working arrangements.

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

Getting it right

The key principle at the heart of getting flexible working right is finding a working pattern that works for the organisation/service, the team and the individual. You need to explore what your employee needs are, what your service needs are, and to identify options where they can both be met.

Consider 

• WHEN the work needs to be done.
• WHERE the work needs to be done.
• HOW work is planned and undertaken.

Each of these points will be covered in the next few sections. To start with, ask your team are there any changes we could make to your working patterns to help you manage commitments outside of work? 

Flexing the WHEN: finding a match

When-based flexibility refers to patterns in which the working day, week or year is adjusted. This includes patterns such as flexi-time, compressed hours and annualised hours. It could include working reduced hours, such as working fewer days, shorter days, term-time only, job sharing and job splitting. 

Flexibility around when people work their hours is a key enabler in terms of managing outside work interests and commitments. 

You can help individuals balance their work and personal needs by clearly defining your expectations and any fixed commitments for each role. 

Think about:

• What are the expectations of your patients/service users in terms of response time? Are there any important deadlines to be met?
• Are there core times when people need to attend key meetings or see patients?
• Can anyone else provide cover if the individual is unavailable at certain times?
• Can you use technology to support flexible working in different ways, and to keep people involved and informed?

Flexing the WHERE: agile working, hybrid, remotely or from home

While many NHS roles have to be undertaken in a fixed location, a surprising number of roles can embrace remote working – including working from home. It has become a new normal for many people and has provided some useful remote working principles and practices.

Things to think about.

• Who are your patients/colleagues and what do they need/expect by way of presence?
• What are the benefits to your patients from remote or virtual working? (eg they don’t need to travel to the service or take time away from their work/caring responsibilities).
• Which activities are suited to remote working and which require presence in a physical location such as an office, ward or GP practice?
• What equipment will staff working remotely need?
• Are there any health and safety considerations?
• How often does the whole team need to be physically together, in the same room? Double-check that this is based on reality, not on one person’s perception/comfort levels.
• How will the team communicate and share knowledge?
• What practices have you adopted/could you adopt which support team cohesion, health and wellbeing?
• How will you move away from presenteeism as a traditional measure of performance and towards measuring performance in an outcomes-based way?
• How can you ensure regular feedback and improvement focus, about performance, health and wellbeing and ways of working?

Managing agile or homeworking team members

Flexing the HOW: making it work across all roles

While many NHS roles can be done remotely or with flexible hours, patient-facing roles may require people to be present in specific locations at specific times. Managers are encouraged to be open minded when it comes to thinking of creative ways to allow flexibility. There may still be options for working different hours and working remotely for certain activities. Here are some productive examples we have seen in shift-based, patient-facing roles.

• Holding one-to-one appointments and clinics via phone or video conferencing, to allow patients to be seen remotely.
• Using e-rostering to allow teams greater choice and input into scheduling.
• Splitting shifts between two workers.
• Using technical, remote solutions for activities such as training and personal development.
• Removing some of the rules which have been applied locally to rostering but restrict individual choice eg to allow a nights only pattern or working most weekends.
• Creating a 10-2 shift, to provide cover during the busiest period on a ward, while also being an attractive shift for someone who wants to work part-time.

E-rostering

E-rostering is a system used to help organisations manage their workforce and deliver care. It can support staff wellbeing through fairer, more transparent scheduling and better work-life balance.

Effective and co-ordinated e-rostering can increase flexibility by giving staff more control over their shifts and enabling better planning against demand. 

Things to consider:

• Are all your clinical staff on an e-rostering system thereby offering equity in workforce planning?
• Do you have a mechanism for staff to input their working preferences and annual leave requirements?
• Are staff able to request shift swaps and book temporary work?
• Are you applying team-based planning principles, by making different working patterns visible? This can help teams accommodate a range of flexible arrangements while maintaining safe and effective service delivery.
• How does your e-rostering enable staff preferences to be considered fairly alongside service demand?
• Are clear and consistent rotas published in advance? This can help staff plan around personal commitments, which will reduce perceptions of unfairness when balancing multiple flexible working requests.

E‑rostering should support, not replace, regular conversations. Flexible working is enabled through ongoing dialogue about preferences, constraints and lived realities. Aligning rosters with actual patterns of demand, rather than historic shift structures, can also help flexibility to be built in more sustainably.

National e‑rostering standards provide an improvement framework that describes what good looks like over time. Line managers are not expected to manage these standards, but understanding their purpose can help place local rostering practice in a wider context. Further guidance and case studies are available on the FutureNHS workspace.

Where to find help

Sometimes, you will feel that you’ve explored all the angles and still can’t find a way to square the needs of your service and your team with what an individual member of staff wants. No one expects you to have all the answers and you shouldn’t feel it’s on you alone to solve things. Before you think about saying no to a request, do speak to your manager, your HR colleagues or other line managers for support and advice. 

Where the individual is covered by the NHS terms and conditions of service, your local policy should build in an escalation stage which should be used where you’ve not been able to agree a solution. The purpose of this stage is so you can get support to check for other possible solutions, including whether the form of flexibility the individual is seeking could be accommodated in a different team, location or role. How this is resourced will be covered in your local policy. It’s a good idea to check with the individual whether they would be open to looking wider than their current role/team, perhaps as a trial initially. It’s also useful where your discussions with them have come about through a formal request, to check at this stage whether they are willing to extend the timescales for managing the request to allow this wider exploration to happen. The individual must agree to a specific time period for an extension and the agreement must be recorded in writing. Make sure you have clear agreed notes of your conversations and the things you and the individual have considered. Keep them informed about what’s happening and when.

Useful resources

We hope that this toolkit has inspired you to embrace greater flexible working in your team. If you need further support to progress this agenda across your organisation, please use these further reading links and contact details:

• NHS Employer’s flexible working hub
• NHS England’s flexible working hub
• Timewise
• Home - Let's Talk About Flex
• NHS Futures e-rostering resources

Contacts

If you have any questions, please contact your local HR professional, or email staffexperience@nhsemployers.org