Flexible Working Actions

Flexible Working
Overview and Resources
October 2023

Find out more about how flexible working can benefit your organisation, team, patients and service users.

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The NHS People Promise 

We work flexibly states that staff should not have to sacrifice their family, friends or their interests for work and should have predictable and flexible working patterns.

If staff need to take time off they will be supported to do so.

There are many options for flexible working, both informal and formal, including:

  • Job sharing (two staff members sharing one job).
  • Working from home (some or all of the work done from home or another location).
  • Part time working (working fewer days or shorter days).
  • Compressed hours (working full time over fewer days).
  • Flexitime (varied, flexible start and finish time, covering core hours).
  • Monthly/annualised hours (an agreed number of hours worked in a month/year, the staff member choosing when the hours are worked, this could include an agreement to work some core hours).
  • Term-time working.
  • Flexible Retirement (staff in the NHS pension scheme have an increasing number of options when considering retirement).
  • Flexible shift arrangements (swapping shifts, mixed shifts, rotating shifts, split shifts).
  • Time off in lieu.
“I moved to this team because of the flexible shift patterns, my previous employer was not able to offer this. It makes such a difference to be able to pick my child up from school once a week”

Why does it matter?

Flexible working matters more now than ever before. Staff can request to work flexibly from day one of their employment and flexibility should be offered at all career stages.

As a line manager or leader, it may not always seem easy to successfully accommodate flexible working in your teams but successful flexible working can balance the needs of staff with three organisational needs:

  • A better experience for staff, their families/carers and patients and service users.
  • Safe, high quality, efficient services are provided with appropriate staffing.
  • Staff achieve a work-life balance.
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How will this benefit my…

  • Flexible working enables staff to balance their work and career with the demands of family and/or other commitments and responsibilities, helping them to stay working in the NHS.
  • Flexible working attracts new staff as roles are seen as accessible for those who can’t work standard shift patterns.
  • Job satisfaction – staff feel valued and morale and staff engagement improves.
  • Improved staff health and wellbeing reduces stress at work.
  • Reduced sickness absence – as a result of the benefits above. Flexibility can enable staff with disabilities and long-term conditions work differently and return to work sooner. 
  • Staff with opportunities to balance their work and home commitments are more likely to stay working in the NHS.
  • Increased productivity – People supported to work flexibly are more satisfied at work and feel more committed to the job, as a result they are more likely to be productive.
  • Staff who feel valued and listened to provide better patient outcomes. They have a more positive attitude and are more likely to foster positivity in the people around them. 
  • Flexible working can provide extended hours for services making them more accessible for service users outside the normal 9-5 working hours.

Top Tips for Implementing

You don’t need to worry about completing all of the tips. Pick a few that feel achievable to you as a starting point.
You can then revisit them later.

  • Read through the Flexible Working: Raising the standards for the NHS which outlines a definition and set of principles for flexible working.
  • Read through the Supporting your team to work flexibly – A line manager’s guide created by NHS England in collaboration with Timewise and the NHS Staff Council. The guide covers why flexible working is important, successful flexible job design, the when, where and how and how to find help and support to lead a flexible team.
  • The Flexible Working section in the NHS Employers Improving Staff Retention – A guide for line managers and employers is also a useful starting point. NHS Employers – How to Embed Flexible Working for Nurses provides more detailed information and guidance.
  • Share the accompanying guide Flexible working in the NHS – A toolkit for individuals with your team.
  • Familiarise yourself with your organisation’s flexible working policy which should now be in line with the Flexible Working: Raising the standards for the NHS, and ask your HR department for up-to-date advice. Legislation regarding flexible working is under review and subject to change.
  • Creating a culture in your team where flexible working can succeed is key. Start with a positive mindset.
  • Make sure you consider the Principles for Flexible working. Think yes rather than an immediate no. As demands on NHS services increase it may feel counterproductive to let staff reduce their hours or work differently but the benefits mean that it is worth trying to accommodate every request in some way.
  • You don’t have to say yes to every request. Sometimes the needs of the service cannot support a request. There may not be a ‘one size fits all’ answer, but consider whether you can accommodate everyone’s needs. Is there a compromise that can be made or can the request be supported by another team or service? For example, someone requesting to work no weekends due to childcare commitments in a small team delivering a seven-day service may not be able to accommodate this. Perhaps a temporary reduction in the number of weekends would be possible or a move to a bigger team or team that does not require regular weekend working may be possible.
  • Listen to the person making the request. Talk openly and honestly about what is and isn’t possible and explain why. Consider the impact on them, your team and service.


  • If you are unsure whether flexible working will work, give it a try. Agree a set trial period to enable you to see the impact. 
  • Review flexible working arrangements in your team regularly; circumstances change so be prepared to adapt when needed.
  • Review the data available on flexible working in your organisation and team. You might need to speak to your organisation about how to access data; this might be a Data Analyst or your HR department.
  • Accessing Model Health System will provide you with useful data. You can register for an account if you don’t already have one.
  • The Understanding your Data section in the NHS Employers Improving Staff Retention – A guide for line managers and employers is also a useful starting point.
  • You can access your NHS Staff Survey results on the NHS Staff Survey Co-ordination Centre. There are specific questions around flexible working.
  • The National Quarterly Pulse Survey, NHS People Pulse Survey and ESR Exit Questionnaire will also provide you with useful information on flexible working. Your organisation may not yet use the NHS People Pulse Survey or ESR Exit Questionnaire so it is worth considering who you could speak to about using them in the future, such as your HR department.
  • When looking at the data, you may identify trends in who has a flexible working arrangement or if staff are choosing not to stay due to a lack of flexible working or work-life balance. How can you change this?
  • Make sure you also take into account any informal flexible working arrangements that may not be recorded on ESR or your e-rostering platform.
  • Consider how e-rostering can help you manage your team’s flexible working by reading NHS England’s Nursing and Midwifery e-rostering: a good practice guide and NHS England’s E-rostering the clinical workforce guidance.
  • Consider using NHS England’s Flexible Working Dashboard to track your team’s flexible working request.
  • Explore how many of your team’s roles are currently advertised as flexible. There are options on NHS Jobs and TRAC to clearly identify how a role might be carried out flexibly making it easier for potential applicants to identify what flexible opportunities are available.
  • Join NHS England’s Flexible Working Network and encourage your staff to do so. It is aimed at those working in the NHS with an interest in flexible working.
  • Use NHS England’s Flexible Working Cost Calculators to identify the financial benefits flexible working might for your team.  The calculator identifies potential cost savings and return on investment.
  • Access and share the resources on NHS England’s FutureNHS Flexible Working channel with your team.
  • Try the Team activities in the Ways to Stay guidebook.
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How will I measure the impact?

  • Consider what you are hoping to achieve and establish a baseline. Information that may be useful includes leaver and retention data, activity data, staff morale and health and wellbeing and sickness absence rates. Develop a survey for staff to understand their ideas on flexible working. Ask for views on the flexible working options listed above. It’s helpful to understand whether flexible working would encourage staff to stay in your team/organisation. Microsoft Forms is an easy application to use for a survey.
  • Consider the number and type of flexible working requests received, how many have been fully or partially approved, or declined. Are the individual requests or a change to the team operating model?
  • For team/service wide changes, evaluate the changes regularly using Plan Do Study Act (PDSA) cycles. Be prepared to learn and adapt your approach.
  • For individual flexible working agreements, check in with staff regularly through 1-1s. Find out the impact on them and on the team/service.
  • Collect stories from staff to illustrate the impact of the change.

Case Studies

Midlands Partnership University NHS Foundation Trust

Rachel Bailey and Hannah Copeland discuss the benefits staff have experienced from flexible working in community care.

Watch the video here >
Grey Flexible

Birmingham Women’s and Children’s NHS
Foundation Trust

Improving nursing’s work-life balance by implementing a team-based rostering system for their nursing staff.

Read more here >
Grey Flexible

United Lincolnshire Hospitals NHS Trust

Improving retention at all stages of nurses’ careers by developing an action plan to reduce turnover rates. The trust set up a retention project team in July 2018 and developed a framework that helped bring focus to the retention initiatives.

Read more in the NHS Employers Article >