In a pilot with three hospitals, and supported by the Burdett Trust for Nursing, Timewise explored whether a team-based approach to the roster could give nurses greater control of their working patterns. The goal was to improve nurses’ work-life balance, with a view to alleviating the NHS staffing crisis.
Getting and keeping staff is now the number one challenge for the NHS. And the NHS Long Term Plan recognises that poor work-life balance is a key underlying reason.
From our work across many sectors, Timewise knows that work-life balance is a key element of any ‘great place to work’. But how can hard-pressed ward managers, trying to provide 24-hour patient care with limited resources and at the same time satisfy clinical requirements for particular skills on particular shifts, also facilitate work-life balance for nurses?
Timewise set up a pilot to explore one way of addressing this problem. We worked with 240 nurses in seven wards in three hospitals, to test whether a team-based rostering system could improve nurses’ work-life balance. The aim was to increase nurses’ input into their own working patterns.
Nursing has been highlighted as ‘the most urgent challenge’ in the Interim NHS People Plan. Our year-long pilot has focused on improving nurses’ work-life balance by addressing their working patterns. And it’s delivered three key recommendations to tackle the nursing shortage head-on.
It’s well-known that the NHS is struggling to find and keep enough staff, but the numbers relating to nursing shortages are no less shocking for their familiarity. Nurse resignations for poor work-life balance have increased by a staggering 169% between 2011-12 and 2017-18, according to analysis for the Labour party. And the Interim NHS People Plan notes that the organisation will need to recruit 40,000 extra nurses in the next five years just to stand still.
As we know from our work in other sectors, offering flexible working is a sure-fire way to improve work-life balance. But in a shift-based, skills-driven, 24-hour environment like an NHS ward, it’s complex to introduce. As a result, most wards operate on a two-tier system in which a few, fortunate individuals have an agreed flexible working arrangement (FWA), usually for childcare reasons. Everyone else then has to fit around them, with minimal input and even less predictability.
Over the last year, we have been supported by the Burdett Trust for Nursing to explore potential solutions for making work-life balance available for all, and not just those with a FWA.
Our belief was that by increasing the fit between nurses’ working pattern preferences and their actual working patterns, more of them would stay. At the same time, we were mindful that any solution would need to work within the KPIs and mix of skills that ward managers needed to deliver.
So, building on academic research, and following a series of focus groups with participating hospitals, we piloted a team-based approach to rostering , with the aim of increasing the amount of input that nurses have into their working patterns, whilst taking into account the operational constraints of life on the ward.
A sizeable piece of action research, this two-stage project involved 240 nurses in seven wards across three NHS trusts. We ran the first, six-month stage at Birmingham Women and Children’s Hospital (BWCH), and used our findings to inform the second stage at Nottingham University Hospitals (NUH) and University Hospital Southampton (UHS).
We began at BWCH by creating and training a lead team for each ward who were responsible for creating the roster (previously undertaken by the ward manager). Each lead team were allocated a subgroup of nurses and tasked with finding out their long-term preferences.
The lead team members then worked together to create the roster based on their colleagues’ input, making sure that unpopular shifts were spread fairly and that each shift had the right number of nurses with particular skills.
Following the completion of the first pilot at BWCH, we fed our learnings into the second six-month stage, across all three hospitals, and finished with a formal evaluation.
Our evaluation indicated that there were three main benefits to team-based rostering. A comparison of pre- and post-pilot data showed:
Other important findings include: the critical role played by the ward manager in making the new approach work; the need to choose the lead team members carefully, to ensure the right balance of skills; and the extra time (and so budget) required to train the teams and deliver the roster.
Overall, then, we are cautiously positive about the potential of team-based rostering; indeed, the teams who worked with us are continuing to create their rosters in this way. However, there’s no question that more work is needed so that other teams and NHS Trusts can benefit from what we have learned. And, given that most of the guidelines on flexible working in the NHS are not adapted for shift-based roles, it’s also clear that bespoke definitions need to be developed.
We are therefore making the following recommendations to bring about widespread change:
It won’t be a quick fix; these kind of changes take time, money and serious collaboration. But by taking action, we stand to gain a happier, healthier workforce who will stay within the NHS for longer. And given that nursing shortages are already at critical levels, there’s no time to waste.
Published September 2019
Across the UK, policy makers with ambitious plans for regeneration and growth are keen to ensure that no one in their community is left behind. But the lack of good flexible jobs means that key groups of people (such as parents and carers, people with disabilities or older workers) are often trapped in low-paid roles or locked out of the jobs market altogether.
Timewise has been commissioned by some of the UK’s most forward-looking local authorities and policy makers to report on the availability of flexible roles within their regions. The research we’ve carried out so far has shown clearly that the demand for flexible roles dramatically outstrips the supply, and has provided the evidence to support the creation of strategies for systemic change.
However, gathering the evidence is just the first step. We’re also working closely with local leaders to bring these strategies to life, unlock their jobs markets to quality flexible roles, and so tackle issues of social mobility, gender and diversity, as well as a lack of career progression.
We are currently partnering with over 25 councils and other major public sector employers, who are acting as champions for change, both as employers and influencers. We’re also working with metro mayors and anchor institutions to support the drive for more flexible jobs, through social consultancy and job design programmes.
As the Social Mobility Commission highlighted in their recent report, local leaders have a key role to play in building routes out of low-paying roles and into higher, skilled positions, by thinking creatively about interventions that could help address career progression. The lack of good, flexible jobs is holding communities back; if you are a regional policy maker who is looking to develop an innovative strategy for inclusive growth, please get in touch.
Download our latest Regional Flexible Jobs Index, for West Yorkshire
To raise family living standards in the UK, the number of ‘quality’ part-time and flexible jobs needs to be increased. This study quantified the impact such an increase might have. It also analysed supply versus demand, and suggested that businesses are currently under-utilising a proportion of the skilled candidate market.
Published January 2016
Returner programmes are becoming increasingly popular with employers who want to recruit talented, experienced people, growing from just three in 2014 to over 40 last year.
For employees, the benefits of these programmes are obvious. They usually include training and mentoring to boost the returner’s confidence, and to help fill any skills and knowledge gaps. And they often lead to a permanent role, either straight away or at the end of the programme, if both sides are agreeable.
How returner programmes deliver for business
But what’s perhaps less well-known is the advantages they can deliver to an organisation. As well as being a cost-effective way to recruit experienced hires, returner programmes can help employers:
To help employers make the most of these advantages, we have created a set of Best Practice Guidelines for Returner Programmes, in collaboration with Women Returners and the Government Equalities Office. They offer a step-by-step guide to what returner programmes are, how to set them up, how to incorporate flexible working and how to deliver them successfully.
Download pdf Guidelines for Returner ProgrammesI hope you find the guidelines useful, and if Timewise can be of any further help, do please get in touch.
Please call 020 7633 4444 or email info@annie-hacketttimewise-co-uk
Published June 2018
The staffing crisis in the NHS is in the news more often than any of us would like. From the fact that more nurses are leaving the profession than joining, and the drop in the number of EU nurses registering to work in the UK to the potential impact of British expat pensioners returning home, there’s little doubt that something needs to be done to attract more people into the profession – and to keep the nurses we already have.
So the time really is right for a root-and-branch look at how nursing works in practice, in terms of workload, scheduling and nurses’ ability to balance work with other responsibilities. Our new FlexAbility in Nursing project, which we’re running in conjunction with three leading hospital trusts (Birmingham Women’s & Children’s Hospital, Nottingham University Hospital and University Hospital Southampton), will deliver exactly that.
The project, which is supported by funding from the Burdett Trust, is a piece of action research into how flexible working could bring about the change the profession needs.
The first stage of the project is now complete. It involved a literature review and a series of focus group sessions, designed to understand how flexible working is defined within the NHS, what the barriers are, and how to overcome them. One of the key learnings to come out of this stage is that flexibility means very different things to different stakeholders.
So, from the employer’s point of view, flexibility is seen as a way to achieve efficiency and save costs – particularly bank and agency costs. In an ideal world, all staff would be ‘fully flexible’, and able to fill rota gaps at short notice, so that the right staff are in the right place at the right time.
But many nurses are coming at it from a different direction. When rotas vary wildly from one week to the next, it’s difficult to plan a life. So for them, flexible working means working within an agreed, predictable framework and, in some cases, working fewer hours. For example, nurses who are parents may want to work fewer shifts a week, and need these to be on the same day and same time each week so they can arrange childcare. Flexibility, for nurses, needs to be fixed.
It’s clear then, that the gap between what employers and employees require from a flexible working solution is a tough one to bridge. And the way it’s organised now isn’t working for anyone.
The current variable rota system doesn’t give many nurses with other responsibilities the fixed working arrangement they need; in the words of one nurse who we spoke to: “If you have kids, you need a partner who’s flexible, or a family who can do care. If you don’t have that, you can’t be a nurse.” Other nurses are equally disillusioned, feeling that they get given an unfair amount of the unsocial hours.
Nor does it give managers enough choice about how to organise their shifts; as one told us: “Once you’ve done the skill mixes and the formal flexible working arrangements, it leaves no choice about who does the other shifts.”
It’s no wonder, given this mismatch of needs, that the profession is struggling to attract and recruit enough staff. So the next step in our programme is to find a new approach that works for everyone: giving nurses the right kind of flexibility to suit their work-life balance needs and keep them in the profession, whilst allowing managers to deliver efficient and effective resourcing. And of course, as a result, encouraging more people to become nurses.
We’ll do this by designing a team based approach to scheduling rotas, and then piloting it. We’re working on the design right now; once it’s finalised we’ll pilot it first with three wards at Birmingham Children’s Hospital early next year. We’ll share our learnings at both stages of the process, so if you’re in the nursing profession – or if it matters to you that the NHS is properly staffed – watch this space.
To find out more about the innovative research opportunities we offer, contact info@timewise.co.uk or call 020 7633 4444
Published November 2017
By Karen Mattison, Co-Founder
Having spent more than 10 years in the flexible sphere, I’m aware of the perception that it’s mainly women, and particularly mums, who want and need to work flexibly. But I’ve long been convinced that focusing on flexible working as a female issue isn’t necessarily serving women well.
So, knowing that the best way to encourage employers to open up a wider range of roles to flexibility would be to prove the demand, I commissioned an in-depth piece of research focusing on who wants to work flexibly and why in 2017. And the results were more clear-cut than even I was expecting.
Our research revealed that a staggering 87% of the UK’s full-time workforce either work flexibly already or wish they could. The numbers are similar for men (84%) and women (91%), and they cut across the generations, with 92% of Generation Y, 88% of Generation X and even 72% of the baby boomers preferring this way of working.
For people who aren’t currently working, the numbers are equally high; 93% want to find a job that allows them to work part-time or flexibly in some way.
And the reasons vary too; it’s certainly not just about childcare. The most common one mentioned was to have more control over work/life balance (57%), followed by finding it generally useful or convenient (50%) and cutting down on commuting time (30%).
So there’s no room for doubt here: in 2017, flexible working isn’t just for mums. But the problem is that, despite this huge demand, only 1 in 10 jobs are currently advertised as being flexible at the point of hire. As a result, the 84% of male and 91% of female full-timers cited above have few flexible options if they want to move jobs.
The onus, then, has to be on employers to start thinking more broadly about who might want to work flexibly, and to change their hiring and job design practices accordingly. That means, for example, thinking creatively about how to design jobs to make them work on a flexible basis, and making sure that the technology is in place to support it.
We’re hoping that the research will lead to a shift in the way employers approach flexible working, and we’re keen to help make it happen. Our expert team offer training and consultancy services that are second to none; let’s work together to crack this issue and provide truly flexible roles for all.
To find out more about our consultancy and training services, contact info@timewise.co.uk
Published October 2017
Businesses have been warning about an impending skills shortage for some time now; and the evidence suggests that it’s really starting to bite. According to a new survey of 400 firms by the Open University, many UK employers have had to pay well above market rate to attract employees over the past year. And the university suggests that the annual cost of this to business could be as much as £2bn.
But for all of us at Timewise, this approach shows a startling lack of originality. Of course, potential employees are unlikely to refuse a higher salary; but by the same logic, a further cash incentive could easily persuade them to move on elsewhere. Whereas if you really want to attract a loyal, motivated and productive employee, there’s a much better way – offer them flexibility.
Thanks to advances in technology and flex-friendly government legislation, flexible working is becoming more common – and no longer just a way to entice women back from maternity leave. 92% of Millennials identify flexibility as a top priority when job hunting and, at the other end of the workforce, the Centre for Ageing Better argues that it could be a key factor in helping the growing number of over 50s work for longer.
It’s not just about what employees want either; the business case for flexibility is sound, and well-documented. For example, remote working champions tend to have less people in the building at once, allowing them to reduce their office space and so their business overheads. A survey by BT indicated that the productivity of flexible workers increased by 30%. And in a CIPD survey, 73% of employees said that flexible working improves staff motivation – and, critically, 75% said it has a positive effect on retention[1].
In short, then, flexible working makes sense for employers and appeals to employees. Yet, despite the fact that there are around 8.7 million people in the UK who would like to work flexibly, less than 1 in 10 jobs adverts currently offer this up front. So an employer who offered flexibility as part of the package – and even better, could demonstrate a flexible pathway for career progression – would immediately have the edge over one who doesn’t.
Our aim here at Timewise is for the offer of flexibility to become the norm; to be just another part of every job description, like holiday entitlement. We offer consultancy and training to organisations who share our aim, and we’re working at every level to bring about this change.
But in the meantime, for employers, offering flexibility at the point of hire is something that will make you really stand out. It will certainly increase your chances of catching the best talent – and unlike mere money, it’s likely to help you hold on to them too.
To find out more about our consultancy and training services, call 020 7633 4444 or email info@timewise.co.uk
Published July 2017
[1] CIPD 2012: “Flexible Working Provision and Uptake”
Getting back into work after a career break can feel a bit daunting. In aid of understanding what women returners want, we surveyed over a thousand potential “women returners” who had taken a career break of a year or more, and were seeking flexible work. We found that while there is a high demand for “women returner programmes” among those who have taken a long career break, the overwhelming majority are looking to return to part-time or flexible work.
The context
Of the women we surveyed:
What do women returners want?
Of the women we surveyed:
As there is little interest in returning to full-time work, employers should open up to flexible hiring, so they can offer appropriate flexible working arrangements. More specifically, employers should consider whether a 4 day working week can be accommodated, as this is the most preferred working pattern.
Published October 2015
Download full research report
The high prevalence of flexible working amongst Britain’s SMEs seems to have grown, in the first instance, out of necessity. Workload is often volatile and finances precarious, so a permanent staff working 5 days a week just isn’t helpful. It works better to keep staff time closely pegged to output.
Jenny Vadevalloo of Timewise Jobs, reports that her clients from smaller businesses frequently look to hire quality part-time staff: “Let’s face it, when a new business reaches the point where it needs a Marketing Director for the first time, it rarely needs that level of seniority for more than a few days a week. And it certainly can’t afford the full-time salary the role would demand.”
Jenny adds, “SMEs can do very well through part-time and flexible recruitment. They can access top skills for the pro rata salary that’s within their budget.”
Adam Marshall, Executive Director of Policy and External Affairs at the British Chambers of Commerce, agrees. He adds that by hiring people into part-time or flexible roles, a small business can also expect to reach a larger talent pool and attract experienced candidates, including those with a ‘portfolio career’ or family commitments. “You can often get skills and talents that you might not otherwise be able to get in your workforce, and you also have the potential to attract individuals to your business you might not be able to take on for full-time, nine to five work,” he says.
To a large extent, flexible working grew out of small business, as a way for entrepreneurs to balance other commitments during the startup phase. Linda Aitchison, Managing Director at the Marketing Room, resists the ‘mumpreneur’ label, but says it seemed natural to work flexibly when she was juggling bringing up a family with launching the West Midlands-based creative marketing agency 10 years ago.
“All but two of our team are mums of children now aged from seven to 16, so we have worked hard to create opportunities for flexible working,” Aitchison says. “Being widowed means that I have more responsibilities within my family on a practical level than before, so I finish early on certain days to be at home with my children after school, but I make these hours up at the weekend.”
Flexible working can take many forms, including part-time, job-sharing or splitting, home and teleworking, or freelance work. Some people work staggered hours, enabling them to work full-time, but with different start and finish times; others work compressed hours, fitting in the standard contractual hours over fewer days.
“Not everyone will undertake a revolutionary redesign of the way they fill vacancies and the way they approach work, for some it’s as basic as allowing individuals to work at home as and when they need to,” says Marshall. “The majority of small businesses that operate flexible working do so because it makes good sense for their business and enables them to get the best out of their workforce.”
As small businesses grow, it can be easy for them to retain a strong culture of flexible working, as they’ve grown up with it and understand its benefits.
Simon La Fosse’s technology search firm, La Fosse Associates, has a staff of 70 and has been fourth in the Sunday Times Best 100 Companies to Work For for the past two years.
Allowing staff to do things in the way they want to do, that fits around their work schedule and family commitments inevitably reaps results, he argues. “Nobody came to work to do a bad job and you have got to remember that, so it’s easier to just give as an employer, and you find it comes back in spades,” he says. “The person who knows they are being trusted by you to do the right thing, invariably will do the right thing.”
A more flexible approach and even different skills are needed to manage teams who work flexibly, with a focus on employee effectiveness and output rather than simply clocking in and out. But La Fosse believes that this is a vital part of a successful business, anyway. “Any company that hasn’t got systems in place to measure output is a company that’s totally out of control,” he says. “Just making sure everyone turns up at the right time and stays late is lazy, rubbish management, really. It encourages presenteeism, which I think is appalling.”
It’s precisely this kind of culture change that small business owners and their employees are best placed to lead, Marshall insists. “Where we see it being a business and employer-led proposition, flexibility works fantastically,” he says. “Employers and employees are perfectly capable of coming together to develop different ways of working that allow both to get maximum benefit.”
Published June 2014
