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Invited to run the largest ever flexible working change project within the NHS, we implemented a model that is upskilling teams, shifting attitudes and driving change on the ground.
By Amy Butterworth, Consultancy Director, Timewise
“We cannot afford to lose any more of our people.” As these words taken from the NHS People Plan make clear, the workforce crisis in our health service is now at an acute level. Recruitment and retention are more challenging than ever; data from earlier this year suggested that one in 10 nursing positions, and one in 17 doctors’ jobs, were unfilled. And in the last quarter of 2021, at least 400 NHS staff in England left their posts every single week due to inadequate work-life balance.
Faced with a mountain to climb, and believing that flexible working is a key part of the solution, NHS England and Improvement sought our help. They commissioned us to create a model for introducing and embedding flexible working practices, and to implement it at scale. The result was NHS Flex For The Future, the largest ever flexible working change project within the NHS, involving teams from 93 NHS trusts and organisations.
So what did we do? Well, as we know from our previous work within the NHS and elsewhere, there really is no one-size-fits all solution for an organisation of this size. We therefore began by tasking each trust to create their own change team, a group of at least five members of staff who knew what their specific challenges, barriers and issues around implementing flexible working would be.
We encouraged them to make sure that the change teams were representative of their trusts, and included frontline staff (such as nurses or midwives) as well as HR and OD professionals. This was critical, not only because they had first-person insights into how things work in practice, but also to ensure that any solutions were seen to be delivered from the ground up, not imposed from the top. We also asked each team to nominate an executive-level Senior Responsible Officer, who could fast-track any issues and decisions to the board, and hold senior colleagues accountable for supporting the programme and its outcomes.
Once the change teams were established, we worked to educate and upskill them through a six-month programme of workshops and advice. This included access to specialist speakers, real-time examples of innovative practice and case studies, as well as practical tools and templates to support the process. We also set up smaller, regionally based group clinics, where they could share ideas, challenges and progress with their local peers, supported by flexible working experts from Timewise and NHS England and Improvement.
Because of its scale, the programme also provided a valuable opportunity to gather information and insights that participants and the wider NHS could learn from. For example, we discovered a real disparity in data gathering around different flexible working patterns, which has a serious knock-on effect on reporting and planning within some trusts. Similarly, we discovered that while some trusts were advertising 100% of their jobs as flexible, others weren’t advertising any in this way. Towards the end of the programme, the change teams began to put what they had learned into practice by developing a business case with which to engage their leadership teams, and a tailored action plan that proposed the right solutions for their particular trust.
Of course, driving change within such large organisations is a marathon, not a sprint, and NHS Flex for the Future was very much the start of the process. Nevertheless, we are already seeing real shifts in attitude and approach from our 93 participant trusts and organisations.
70% of participants told us they have developed an action plan which was supported by their leadership teams. And as one participant put it: “The programme has helped me influence the board and not just start the conversation, but get an organisational objective on our 22/23 business plan.” There were also clear examples within our post-programme survey of how participants’ confidence and understanding has increased. When asked to respond to the statement, “I am clear as to the ways to increase the number of quality flexible roles in my NHS organisation” agreement increased to 69% (compared to 20% at the beginning of the programme). And for the statement “I understand how to design jobs with greater flexibility”, agreement increased from 30% to 74%.
We’ve also collated more detailed feedback about the impact of the programme through a set of case studies, which have really highlighted the positive impact of our work. To pick just one example, here are some insights from Fran Wilson, Lead Nurse for Attraction, Recruitment & Retention at Gloucestershire Hospitals NHS Foundation Trust:
I was already convinced that flexible working is an area that will increase staff attraction and retention, but now I have participated in the programme I have the insight, knowledge and resources to share with other people, which really helps.
We would never have got to present at trust board level without the programme, so it’s really helped raise the profile of flexible working… It’s also inspired us to start conversations from a point of yes, and how, rather than no!
It’s a big cultural change, so it isn’t going to happen overnight… but the progress we’re making is exciting… It’s been a great investment.
You can read Fran’s full case study here.
So, having educated and upskilled change teams from 93 NHS trusts and organisations, what’s next? The teams are continuing to develop and embed their action plans, and we are supporting some of them along this next stage of the journey. We’re also keen to help keep up the connections that were formed between teams from different NHS organisations, and will be looking to create more opportunities to convene organisations who are doing exciting things in this area – watch this space. In the meantime, having created and implemented this new model for change at scale, we’re eager to put it to good use, within the healthcare sector and elsewhere. If you are interested in starting a conversation with us about whether our change team model could work in your sector, please get in touch.
Published October 2022