Making change stick

Aliya Rehman is the Staff Experience Programme Lead at NHS Employers. She supports employers to enhance all aspects of NHS staff experience – vital for retention and central to patient care. With a background in organisational psychology, Aliya is passionate about driving improvements through culture change for enhanced flexible working.

For the NHS to remain an employer of choice, it must create the conditions for staff to work flexibly as described in the NHS People Promise. The pandemic acted as an unexpected catalyst for the NHS to explore different ways of working. Changes to the NHS Terms and Conditions, secured through working with NHS unions, have led the way in providing contractual rights to flexibility by default and from day one, which have since been reflected in statutory legislation. The NHS Long Term Workforce Plan sets a clear ambition to give our NHS people greater choice over their working patterns, helping them to achieve a better work-life balance.

Together, these provide a strong policy foundation for change. But the real work begins at local level and now our focus turns to implementation. With this in mind the question we ask is:

How can local leaders foster positive change that is not only meaningful but lasting?

Here are some practical tips for implementing change based on NHS trusts who have been able to turn the dial and shift cultures to make flexible working a reality for their teams.

Lead the way

Senior leaders can help to provoke cultural change, challenge the status quo and enable the principle of flexibility by default. Engaging a board level champion for flexible working, who can help to ensure flexibility is considered a key part of strategic priorities and planning for the organisation. Securing board level buy-in can also help to role model effective flexible working practices, and encourage other leaders across the organisation to be more open to trying new ideas/ways of working.

Listen to staff and take a data-led approach

Talk to staff and use data to find out what they want in terms of flexibility. Seek to understand the reasons behind flexible working requests to identify areas for improvement and what is working well. Regularly monitor and measure the effectiveness of flexible working practices to demonstrate its positive impact on patients and colleagues. Sharing stories about successful flexible working will help win hearts and minds.

Policy and process

Ensure your policy and processes are up to date and are easily accessible by staff. Check to see if there are any existing policies in place that need to be reviewed. Simplify the process for requesting a flexible working arrangement with short and clear forms. Remove any restrictions on when individuals can make requests and ensure that the process is clearly signposted to employees.

Supportive line management

Line managers are absolutely key to the successful roll out of flexible working. It’s important to, equip them to have supportive conversations about flexible working – this will empower them to explore possibilities, and be more supportive of their teams to work more flexibly, whilst maintaining safe and effective services. Managers should be given the ‘permission’, protected time, training, and the tools to support them to deal effectively with flexible working requests and to try new ways of working to embed a flexible working culture.

Be innovative when planning for the future of flexible working

We need to think boldly and innovatively about the future of flexible working in the NHS. Specifically, enhancing equity in flexible working opportunities for both non-clinical and clinical staff groups. This means adopting a test and learn mindset, piloting innovative ways of working flexibly, and redesigning job roles with flexibility in mind. Asking why not rather than why. Technological solutions also present new opportunities – for example, to e-rostering and flexible practice.

A truly innovative example showcasing a flexible working initiative has recently been successfully rolled out at Imperial College Healthcare NHS Trust, who have been one of the first trusts to enable diagnostic radiographers to work from home, through a remote scanning pilot. You can find out more via the NHS Employers website.

A strong communications strategy

Making sure staff understand their contractual rights through the Terms and Conditions flexible working provisions is a key part of embedding a flexible working culture. Work with your communications team to help raise awareness among staff and managers alike, so that people know about all the different options available. Introduce flexible working ambassadors, share case studies and make existing staff who are working flexibly more visible within the organisation.

Why not download our editable template of flexible working options which can be adapted to suit your organisation’s needs.

Be inclusive and challenge misconceptions

Ultimately we need to break down out-of-date stereotypes and myths, and challenge gender norms by demonstrating that flexible working is an important issue for everyone.

Employers need to actively dispel any negative perceptions that people who want to work flexibly are less serious about their careers. Make sure that your flexible working policy has an equality impact assessment to ensure it’s inclusive and gender neutral. Engage and collaborate with your local staff networks and trade union representatives to understand the specific flexible working needs and barriers different staff groups are facing. Collaboration is the key to making this work!

More information

If you’d like to find out more, you can also access the NHS Employers Flexible working – enablers for change guidance for more information on how to lead and deliver positive change in relation to flexible working.

You may also want to take a look at our change in action infographic which incorporates nine steps (based on Kotter’s steps for change) to help you to make culture change stick in your organisation.

NHS Employers is the employers’ organisation for the NHS in England. NHS unions work with NHS Employers through the NHS Staff Council.