Is Flexible Working Feasible For An Understaffed Nursing Workforce?

Since September 2021, Nurses employed by the NHS in England and Wales can request flexible working from their first day in post.

Results from the 2021 RCN employment survey showed 57% of respondents were either thinking about leaving their job or actively planning to leave.

It is hoped the new approach to flexible working could help address issues around recruitment and retention in the NHS.

A study conducted by the National Institute for Health Research in 2015 established that Nurses who work shifts of 12 hours or more were 50% more likely than those who work 8 hour shifts to experience emotional exhaustion and burnout, and consequentially were more likely to be desirous of leaving their jobs.

A more recent survey from 2020, undertaken by the Nursing Standard in conjunction with the University of Southampton found that working shifts of 12 hours or longer was the stated preference of only a third of respondents. This despite over half of all respondents reporting working shifts of that length.

‘I doubt anyone will want to work a 12-hour shift per se because it’s really fatiguing,’ exclaimed one of the Southampton researchers, and lecturer in nursing workforce Chiara Dall’Ora.

Would flexible working allow for greater control over the length of shift Nurses can be required to work? And if so, could such flexibility be sustained in an under-resourced working environment?

The Nursing Standard argued that changes to the rules around flexible working, coupled with open and honest consultations between staff and managers, could transform the NHS into a flexible and supportive employer better able to retain its workforce.

“It’s about changing the culture…We know that many nursing staff are still being told ‘no we don’t do flexible working here’. Too often, there’s a perception that things have always been run in a particular way and that’s the only possible option. But it’s a very outdated way of thinking” explained Gill Morgan, National Officer at the RCN.

“As well as current staff wanting and needing to work differently, we have a new generation of staff coming into the NHS who very clearly expect to work differently” she continued.

“If you work for the NHS in England, Scotland and Wales, there’s now no qualifying period before you can ask to work flexibly” RCN National Officer Gill Morgan

Will having flexible working from day one be an inducement that will attract more Nurses into the NHS? And what effect do you think such arrangements would have on retention levels for existing staff?

Under the new rules, employers are expected to lay out flexible working options at the point of recruitment as well as in ongoing consultations, appraisals, and team meetings. However, Nurses have recounted difficulties in accessing flexible working patterns, with some being told ‘not to bother asking’ as teams are too short-staffed.

Senior nurse lead for the national retention programme at NHS England and NHS Improvement Kerry Jones said that offering flexible working (which fulfils one of the 7 NHS People Promises) can be a key feature of retaining valuable staff who need a different working pattern.

‘The retention landscape is complex. It’s simple things that can trigger a disconnection. There are existing challenges, like planning a rota with shortages. But we know that flexibility is key and that strategically it works for retention.’ she said.

Do you think that increasing demands on the NHS coupled with ongoing staffing problems will mean that flexible working, however desirable, will end up being discarded out of necessity?

Related research from the Chartered Institute of Personnel and Development (CIPD) highlighted the marked irregularity between employers more generally when it came to offering flexible working practices. Nearly half (46%) of employees reported not having flexible working arrangements in their current role.

The CIPD argued that incorporating flexible working arrangements supported peoples’ wellbeing and productivity, as well as providing opportunities to people who are otherwise unable to work standard-hour weeks or get to a place of work.

It is also the CIPD’s opinion that ensuring equal access to flexible working opportunities promotes workforce cohesion.

Do you agree that providing equal and fair access to flexible working opportunities would enhance workforce cohesion, as well as workers’ productivity? If so, to what extent could these conclusions be applied to the nursing workforce specifically?

TUC general secretary Frances O'Grady said that flexible working "should be a right" to everyone from their first day in the job.

"But these [new rules] won't be the game changer ministers claim, as employers can still turn down any or all requests for flexible working," she continued.

Please let us know what you think in the comments. Will the reality of NHS understaffing mean that intentions of offering flexible working to Nurses will not be implementable or sustainable?

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