How can the NHS get more from flexible working?

Lizzie Buxton

Written By Lizzie Buxton

4th February 2019

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HR leaders in the NHS understand the health service’s challenges better than anyone – so the promise of improved recruitment, productivity, wellbeing and morale should be welcome.

But with safe staffing levels to deliver, an estimated one in eleven posts unfilled and agency costs soaring, it’s understandable if some NHS teams view flexible working as adding another layer of difficulty to an already complicated job.

This is perhaps why – despite officially having some of the UK’s most progressive working policies – the NHS has yet to fully reap the benefits of flexible approaches to work. Managers rightly point to the need to see patients in person, have access to equipment, and ensure staffing rotas are safely filled.

Compassionate care for all

Suzanne has worked at Calderdale and Huddersfield for a year and she sees an important difference in the NHS compared to other sectors.

Smiling nurse holding a clipboard in hospital ward

She says: “I’m really proud to work for the NHS. I have never met so many committed and compassionate people focused on the patient. My job, and that of others in HR, is to make sure that colleagues feel as cared for as our patients, that they are ‘well in work’ and that they don’t feel selfish for looking after their own health and wellbeing. We talk about compassionate care for patients all the time, but sometimes we as leaders and our own people can put themselves second.

“Before Christmas, one of my director colleagues had to tell three people in the same day that they had non-curable cancer. And our paediatricians often have to tell parents their children have an illness that will shorten their life.

“It’s inevitable that this kind of experience will have an impact on their own wellbeing – and sometimes we need to remind ourselves that it’s OK. We’re all human beings; the work we do is going to affect us.”

The high cost of NHS stress

On the face of it, Suzanne’s motto that “a great employee experience leads to a great patient experience” might seem obvious, but that’s easier said than done.

Staff are extremely dedicated and have a real self-sacrifice approach but that can only be sustained for so long; ultimately, there’s a personal as well as business cost. The sickness absence rate across the NHS in England has risen to, at times, more than 5%. It’s a vicious circle where those absences lead in turn to more demands, more pressure, and more sickness through stress.

“At Calderdale and Huddersfield, we’ve seen our sickness absence improve in the last year, but even so we’re averaging 14.5 days per person per year. When you look at other sectors, you can see there’s potential to do much better.

“We need to be better at making that explicit link: if we look after you, you’re going to be in a better state to look after patients.”

Flexible working: getting the balance right

Here at AdviserPlus, we’re delighted to be working with Suzanne and her colleagues at Calderdale and Huddersfield, to help safeguard the mental health and wellbeing of hardworking staff.

Part of the picture is enabling people to open up about the emotional and social aspects of their work. But flexible working is proving its worth too.

Some aspects are relatively straightforward to implement – like using the trust’s bank staff arrangements to give people more control over their own working hours.

Suzanne explains: “Having a bank of staff who can sign up for extra shifts works really well in the NHS. More than 80% of our bank staff use a mobile app to manage when they work.

Smiling medical team in a line isolated on a white background

“We have career bank staff, that is colleagues who choose only work bank, because it suits their lifestyle – they can work around their family circumstances and care responsibilities. We can learn from that approach with our substantive staff; when it works for the organisation and the individual in equal measure, we’ll have got the balance just right.”

New technology opens possibilities

Suzanne is also optimistic about the potential to reduce the reliance on meetings at fixed central locations and simultaneously using face-to-face dialogue through technology such as video conferencing – creating flexible working opportunities, while also making life more convenient for patients.

“There are some things that have to be done in person at set locations, but the technology is out there to make things safer and better for our colleagues and our patients,” she says.

“We have an outpatient transformation programme that’s really testing the boundaries of what needs to be done face-to-face at traditional fixed locations such as hospital locations. Patients are telling us they don’t always want to come all the way in, fight to park, if it’s for a test result and it’s OK; often, a call or Skype would be fine.”

And while technology can’t directly overcome the need to meet safe staffing ratios, it can make this process easier by improving productivity elsewhere – minimising the time spent away from patients doing administrative work.

“We’re investigating ways to review how we work all the time, while still keeping confidentiality and compassion,” Suzanne says. “For example, we’re hoping to use things like voice recognition to save the time people spend typing up notes and navigating our electronic patient record so that they can focus on more patient facing activity.

“We’ve also found video conferencing works really well, enabling people on different sites to work together productively, in what would have been lost time otherwise.”

Improvements in recruitment

As an added bonus, the ability to work flexibly – and growing confidence with video conferencing – has significantly increased Calderdale and Huddersfield’s effective catchment area for recruiting new staff – easing the pressure of unfilled roles.

Suzanne says: “We have people who live well outside what we would have considered a commutable area, but they’re able to work through that by moving shifts, using technology or working from different places.

“People miss teamwork; they like having work and home clearly separated and sometimes they struggle with the blurring with that line. So, I’m a big fan of using facilities closer to home – like community hubs – which can give the best of both worlds.”

People and services first; policies second

This is an example of the approach Suzanne believes is key when balancing the needs of the individual employee and the NHS trust – working alongside individuals to find improvements and make them happen, rather than taking a blanket approach.

Side view of young female surgeon using digital tablet in front of computer at desk in clinic“HR in the NHS is quite administrative – we need to get the right people in to keep patients safe – but we also need to get better at what makes people tick. The people doing the job hold the key. It’s not without challenge, but on the whole when you engage with people, they know how to find improvements – and that includes flexible working.

“You can’t have a corporate edict; ward managers and decision makers in the community need to know people and their circumstances. Some will have a fear about ensuring fairness, but the NHS as a whole is generally very good at that kind of thing.

“Find what works for the service and what works for the individual, then create the policy to fit – not the other way around.”

The trust is now piloting new technology and approaches to broaden the impact still further.

She concludes: “It’s a pleasure to work with people – and at an organisation – that has the same values as me. It’s all about helping people, especially when they’re vulnerable. This is my local hospital and community service – so I have a vested interest in making this a really good place to be.”

Unlock the potential of your people

At AdviserPlus, we work with forward-thinking HR leaders – combining data, technology and experience to help you get the most from your people. If you’re thinking about flexible working, or if you have an issue with sickness absence, we’d love to chat about some approaches.

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