NHS Flex For The Future: how we’re helping tackle the workforce crisis

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.

A new model that equips teams to drive change

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.

A six-month programme of education, exploration and development

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.

Increased understanding and confidence, and tailored roadmaps for change

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%.

The view from the frontline: highlights from a case study

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.

Building on the success of the model, within and outside the NHS

 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

In July 2021, we published the report into our Construction Pioneers Pilot, and it caused quite a stir. The 18-month programme was carried out in partnership with Build UK and four pioneer firms – BAM Construct, BAM Nuttall, Skanska UK and Wilmot Dixon – and set out to challenge the concept that frontline site-based roles were incompatible with flexible working. The outcomes were clear; and overnight, some long-held assumptions were overturned.

The pilot demonstrated that flexible working CAN be implemented on construction sites, without negatively affecting budgets or delivery. It highlighted the positive impact of flexible working on workers’ sense of well-being and work-life balance. It also set out the benefits of taking a team-based approach to working patterns, and demonstrated that a culture which accepts, and champions, flexible workers, is better for everyone involved.

But for us, and for our pilot colleagues, that wasn’t the end of the story. Flexible working is a long-term change; it takes time to embed it within an organisation, and progress needs to be tracked to get a clear picture of what works.

So we agreed to come back after a year and review the situation. Were the positive outcomes sustainable, and has anything else changed for the better? What still needs to be tackled? And what can the rest of the industry learn from all this? Our One Year On Review holds the answers.

The key findings from our review

To start with, the continuing positive impact on employees is clear. All four firms agreed that even small changes to ways of working were helping their staff better manage the challenges of day-to-day life, taking away potential problems that could increase stress.

The employees we interviewed also felt that they were more trusted and better understood, and that it was easier to discuss flexible working and make changes in a collaborative way with their managers. The managers themselves felt they were more open to trying out new ways of working, recognising that if it benefits their teams, it benefits the business too. That’s quite a culture shift.

And critically there was new evidence, from interviews and HR feedback, of a reduction in sickness absence. This is particularly notable in comparison to the rest of the construction industry, in which sickness absence is on the rise. All four participating firms believe that flexible working has contributed to this reduction, and given that one of our initial aims was to tackle the industry’s poor mental health and well-being record, it’s a welcome development.

Additionally, the firms have reported increased productivity levels, which they feel is the result of having a happier workforce who are better able to manage their commitments outside of work. And all this is still being delivered without any negative impact on either budget or delivery.

A further positive outcome is that our pioneer firms are now so confident about the value of flexible working that they have felt able to offer it from the point of hire. This is rare within construction, and likely to seriously improve the industry’s gender pay gap.

Next steps for our Construction Pioneers

The review also noted some areas where there is more work to be done. There’s still a need for more consistency in management practice across the firms, and more time needs to be spent exploring other forms of flexible working. Part-time work, in particular, is still rare to the point of invisibility, particularly for on-site roles.

It also highlighted the as-yet-missed opportunity of influencing other parts of the supply chain; these new attitudes towards flexible working need to ripple downwards to sub-contracted workers, and upwards to clients too.

This pilot and review model benefits the whole industry

Overall, the evidence clearly suggests that our pioneers are reaping the rewards of their flexible working trial. They are also benefitting from this review, which has given them a forum to reflect on what’s working, within and across the four firms, and refine their plans accordingly.

What’s more, this model offers real benefits for the whole sector. Why? Because our initial pilot, and this one year on review, provide a clear roadmap for change. They set out what needs to be done, offer proof of concept for flexible working, and show what’s up for grabs for others who are willing to trial it for themselves.

It’s already gathering momentum; following our initial report a year ago, we’ve been engaged by a number of other firms who are keen to move forwards with flexible working, including Sir Robert McAlpine, Kier and Balfour Beatty. It’s our expectation that the further proof provided by this review will see even more firms taking action.

And why wouldn’t they? The evidence from this programme is pretty conclusive; it’s also backed up by our own cross-sector research, which has indicated that a flexible working trial which reduces sickness absence by one day per person per year generates a positive ROI.

In the words of Suzannah Nichol MBE, CEO of Build UK, “With such positive results, particularly around diversity and well-being, Build UK will continue to champion flexible working and I would encourage other industry organisations to do so too. If you aren’t already having the flexible working conversation within your business, it is definitely one worth starting – I promise you won’t regret it.”

Published July 2022

In the summer of 2021, we published the report on our Construction Pioneers Programme; and people across the industry sat up and took notice. The programme demonstrated beyond any doubt that it IS possible to introduce flexible working for on-site roles, and that the benefits of doing so are clear.

One year on, we have gone back to our Construction Pioneers to review their progress; and the good news is, flexible working is continuing to be a success story for all four firms. They have rolled out and built further on the learnings from the programme, with no detrimental effect on budgets or timelines and with plenty of positive impact on staff well-being and performance.

Additionally, our Pioneers believe that that flexible working has been a key contributor to a huge reduction in sickness absence – by over one third in two of the firms. They are also reporting increased productivity levels through the use of hybrid working, which they feel is the result of having a happier workforce better able to manage their commitments outside of work.

This review explores our Pioneers’ progress against the recommendations from our 2021 report. It highlights the impact of the changes they have made, and shares insights from leaders about what works. And it also sets out what needs to happen to cascade these learnings across the industry as a whole.

Published July 2022

By Muriel Tersago, Principal Consultant

Debates around the crisis in teacher recruitment and retention aren’t new – but the pandemic appears to have made things even worse. April 2022 research from the National Education Union suggests that 44% of teachers are planning to leave within five years, and that it’s getting harder to fill vacancies, with a knock-on effect on workloads for remaining staff.

Teachers’ reasons for leaving are many and varied, and include issues around workload, wellbeing and stress; all of which could be mitigated if flexible working in schools was more widely available. Indeed, NFER research has shown that some teachers leave because they can’t access flexible working, and that many secondary school teachers who do leave reduce their hours when they do.

It’s for this reason that we have spent the last 16 months working on a Teaching Pioneers Programme with three MATs, across eight schools, piloting how best to champion and deliver flexible working within schools. And our findings are clear: yes, it’s complex, but it’s not impossible, and there is a return on investment for doing so. As one deputy headteacher put it: “Find the commitment and shift in mindset, and you can tackle the operational issues.”

The challenges for schools – and how we set out to tackle them

Clearly, introducing flexible working into teaching is less straightforward than in office-based roles. Complications around timetabling and culture, the frontline nature of the role and the intensity of the school day all play their part.

But our Teaching Pioneer MATs (Academies Enterprise Trust, GLF Schools and The Kemnal Academies Trust) recognised that these challenges should, and could, be overcome. They agreed about the benefits of flexible working in schools, and saw our pilot as an opportunity to focus on how to go wider and deeper with the changes that were needed.

Our team worked closely with central HR teams and headteachers from the eight schools to explore five core areas, providing support including workshops, coaching sessions, timetabling masterclasses and train-the-trainer materials, and sharing learnings across the group at each stage.

What we learned – and what it means for schools

So what was the outcome? There were a number of key learnings, which our Teaching Pioneers have already begun to implement – and which can be adopted by other schools and academy trusts who are keen to get better at flexible working. Here are some of the highlights:

• Flexible working must be tackled at a whole-school level

Many schools currently operate on a request-response model, in which people (usually women coming back from maternity leave) formally ask for reduced hours. This pigeonholes flex as something that needs to be earned, and isn’t applicable to all, creating an unspoken sense that there are a limited number of arrangements possible.

A far better way forward is to implement a proactive whole-school approach, which opens up opportunities for flexibility across all roles. This is facilitated by regular, open discussions about what people’s flexible needs might be, how to create opportunities to support these, and how to build these into the timetabling and workforce planning processes.

• Schools need to reframe what flexible working means

A knock-on effect of the request response model is that flexible working in schools has become synonymous with part-time. However, there are many other flexible options that schools can consider, such as timetabling PPA at the beginning or end of the day and allowing staff to do that work from home, or delivering CPD and meetings remotely.

Many schools trialled some of these approaches during lockdown, and some have continued with them; but what’s often missing is a strategic approach to their implementation, underpinned by dialogue about when, where and how work can be done, which gives people a sense of input and control.

The point is to have open minds and discussions, and see what is possible within each role and team. In the words of one principal: “We can’t guarantee the same outcomes… but the process is the same for all – open conversations, trying out different ideas and trying to make it work.”

• The attitude of the headteacher is mission critical

Clearly, such substantial operational and culture changes require committed leadership. So it’s vital that headteachers are not just vaguely supportive of flexible working, but committed to it in principle, and driven to make it work. This commitment is all the more powerful when heads role model working flexibly themselves.

They also need to be willing to pass on some of the responsibility to others. With a whole-school approach, the implications and execution of what’s needed and what’s possible are discussed at an individual, team and school level, rather than simply being approved or declined by the head.

The pilot also highlighted the importance of clear communication, explored solutions for the thorny issue of timetabling, focused on training and empowerment of line managers and noted the positive impact on students.

The view from our Teaching Pioneers – and next steps

Sixteen months on from the start of the project, what’s been the impact on our Teaching Pioneers? Our post-pilot evaluation showed that a majority of teachers surveyed felt more confident about discussing flexible working, and that different reasons were considered more acceptable; they also noted that their schools were increasingly supportive of flexible working.

Qualitative feedback also highlights the impact the programme has had. Comments include: “There is so much goodwill in return for the trust and understanding we are given”, and “Thinking proactively is liberating… we engage more people to explore what’s possible and come up with more creative ideas that can work for both sides.”

One principal noted “Our absenteeism has dropped through the floor”, which highlights the return on investment that flexible working can deliver. Our own research has showed that, for a MAT with 100 teaching staff, one fewer sick day per teacher per year for three years would cover the cost of a flexible working pilot. On every level, that’s an investment worth making.

It’s our hope that more schools and MATs will use the findings from this pilot to develop their own whole school approach to flexible working, and reap these rewards. We’ve also partnered with the Department for Education to develop a programme of insights and resources to train school leaders in flexible working; to date 682 schools and 103 business institutions across the country have taken part. We’ll be watching with interest to see how the educational landscape changes as a result.

You can download the Teaching Pioneers Programme report here.

Published June 2022

It’s no exaggeration to say that the teaching profession is in the middle of a staffing crisis. Research from the National Education Union suggests the 44% of teachers are planning to leave within five years, and that it’s getting harder to fill vacancies, with a knock-on effect on workloads and wellbeing for remaining staff.

Introducing flexible working in teaching is less straightforward than in office-based roles, for a range of reasons. Complications around timetabling and culture, the frontline nature of the role and the intensity of the school day all play their part.

But all the evidence suggests that the positive impact it has on staff retention and recruitment makes it well worth the investment. The reasons why schools should implement flexible working are clear; what’s been less certain, until now, is how do it well.

Our Teaching Pioneers Programme sought to close this knowledge gap. Working with eight secondary schools, within three MATs, we spent 16 months exploring how best to champion and deliver flexible working within the profession.

Our learnings from the programme, and the implications for schools, academy trusts and policymakers, are set out in a full report, which you can download below. You can also download a guide, based on what we learned, which provides practical support for headteachers.

Published June 2022