Want to find out how you can get the benefits of flex in your NHS career? Use the resources and links below to get started on your flex journey.
Many ways to flex
Flexible working can take many different forms. We’ve outlined some of the most common options below to kick-start your thinking, but this isn’t an exhaustive list. It’s important to think about your individual needs and discuss these, together with the needs of your role, with your line manager. There’s a form of flexible working to suit most people’s needs – whether that’s managing caring responsibilities, reducing stress, or improving your work-life balance.
Part-time hours
Working part-time can mean anything from fewer days a week, or fewer hours each day. Your salary and annual leave is calculated pro-rata, based on your hours.
Fixed working pattern
Used by those who need to work shifts, a fixed schedule can provide you with a routine and unchanging work timetable. For example, working 10am – 2pm every Monday, Tuesday and Wednesday. This can help to manage other personal commitments such as caring responsibilities.
Compressed hours
Compressed hours involves fitting full-time hours into fewer working days. For example, working longer days and having an additional day off each week or a fortnight.
Staggered hours
Staggered hours allow you to start and finish your working day at different times – while still working full-time hours. A common option for parents who want to drop off or pick up children from childcare.
Job sharing
Job sharing involves two people working part-time hours to fulfill a full-time role. It’s worth noting that you don’t have to find your job share partner yourself – your employer can advertise a job share role.
Partial retirement/retire and return
Now even retirement can be flexible! If you’re aged 55 or over, you can choose to take part or all of your pension benefits and still continue working in the NHS. This is sometimes also known as ‘drawdown’. You can also retire and then return to work in another role in the NHS. This is known as ‘retire and return’.
Flexi-time
Flexi-time policies often involve having a set of core hours (for example 10am – 4pm) while allowing flexibility around how you work around these hours. Flexi-time can offer a more informal approach, enabling you to vary your hours from day-to-day to suit your needs.
Remote working
The pandemic has taught us that work doesn’t always need to take place in the workplace! Even if you’re in a patient-facing role, there may be some tasks – such as admin or report writing – that you could complete at home or out of the workplace. Could working remotely for a day or half a day a week work for you?
Annualised hours
Annualised hours involve agreeing to work a set number of hours across a year. You could then agree with your line manager how you work these – for example, you may need to work some core hours but have flexibility around the rest.
Term-time working
Sometimes used by working parents, term-time working involves using a combination of annual leave and unpaid leave to work 39 weeks a year. You would have school holidays off work.
Finding an option that works for you
Can’t see an option that suits your needs? This doesn’t mean that flexible working isn’t for you – there are many more options available. It may be possible for you to agree a working arrangement that is very specific to your individual circumstances. The first and most important step is to think about what you need and to then have a chat with your line manager. There is a huge amount of information and support available. Take a look at our links and resources page which is packed full of useful links to get you started on your flex journey:
If you work for the NHS, you have a contractual right to request flexible working from day one of employment, rather than having to wait 26 weeks, and there is no limit to the number of requests you can make. This has been negotiated by the health unions through the NHS Staff Council and devolved structures.
If you’re not directly employed by the NHS, new legislation means that your rights are starting to catch up with those negotiated by the health unions for NHS staff. From April 2024, all UK employees will have enhanced rights to flexible working.
More information
With so much information about flexible working out there, it can be hard to navigate and find what you need. Here are some links that we think you might find useful. Please also remember that your local union representative will be more than willing to provide advice if you can’t find what you’re looking for.
Flexible working is a great way to help you manage your work-life balance and to help employers recruit and retain staff – it can be a win-win solution! With so many options to think through, we’ve pulled together some examples of flexible working for various NHS staff. Take a look at their stories to help inspire your flexible working plans.
What has your experience been of submitting a flexible working request? Get in touch and share your story. If your experience hasn’t been as positive as you would have liked, please remember that you can talk to your local union representative for advice. Our campaign is designed to encourage NHS employees, employers and unions to work together and make more use of flexible working options available to help make the NHS a better place to work.
Sunita – Radiographer
Returning to work part-time after maternity leave.
Sunita is a radiographer and is returning to work after maternity leave. While Sunita’s parents are helping to look after her daughter, she is still breastfeeding and doesn’t want to end this until she feels her daughter is ready. As a new mum, Sunita feels unsure how this could fit with her return to work. She knows that the department is really busy and that there are already a couple of people working part-time in the team. She feels a little nervous as she doesn’t think her manager will want more team members on part-time schedules.
Sunita prepares for a conversation with her manager. She explores flexible working options, using her union’s website and the NHS Staff Council flexible working toolkit. She follows their guide to making flexible working requests and sets out her ideal working pattern.
Her initial request is turned down by her manager, as they feel that it leaves resources too low to run a list on some days. Sunita checks in with her local union rep, who offers some valuable advice about how the arrangement could work in Sunita’s team and shares the Trust’s breastfeeding policy with her too.
Her rep also advises her that as an NHS employee, she can submit as many flexible working requests as she would like (as outlined in section 33 of the NHS Terms and Conditions Handbook). Following the advice, Sunita submits a revised request, which offers to work on a day that she knows the team is short-staffed. Sunita’s manager accepts the request and they agree to revisit the arrangement in a year.
Clarissa – Midwife
Self-rostering to manage shifts to fit with childcare.
After having her second child, Clarissa is ready to return to work as a midwife in a busy acute Trust.
Clarissa’s manager asks if she can be as flexible as possible to help cover the rota – including night shifts. However, even with a nursery place, a childminder, and Clarissa’s partner working staggered hours, they find it impossible to cover shifts outside of 07:00-18:00, Mondays – Fridays.
Clarissa checks her Trust’s flexible working policy and talks to her manager to explain that she can only do day shifts for now and submits a request for fixed early shifts, so that she has a routine that she can rely on.
Her manager is worried that if they allow Clarissa to only work day shifts, lots of others in the team will want the same and the department already struggles to fill the rota. In line with the Trust’s flexible working policy, her manager escalates the request, to be discussed within the clinical business unit leadership and HR support team.
Clarissa also talks to her union rep who shares a case study on self-rostering from another Trust, which led to improved work-life balance, wellbeing and smoother management of the roster.
Clarissa passes the case study on to her manager. The leadership team are very interested and suggest a self-rostering pilot in Clarissa’s team. They set up a working group to help plan how it could work.
Once implemented, the pilot proves popular. Clarissa and the team find that there are fewer gaps in the rota and scheduling seems to be easier. People feel they have a much better work-life balance and are in control of when they work.
Using staggered hours to manage caring responsibilities.
Martin’s dad recently suffered another fall and so Martin wants to make time to help care for him more. In particular, Martin needs to check in on his father first thing in the mornings, to make sure he is taking his medication as directed by the doctor.
Martin wants to work more flexibly to allow him to fit this in alongside his full-time job as a porter at a large hospital. He’s quite new at the facilities management company that employs him as a contractor at the hospital. Martin isn’t sure what his options are, or what flexibility his company or the hospital could offer. Ideally, he doesn’t want to reduce his hours and would like to start work later and finish later.
Martin’s union rep informs him that although Martin is not covered by NHS Terms and Conditions as he is a contractor, from April 2024, new statutory rights mean that anyone can request flexible working from day one of their employment.
Martin finds out that staggered hours is a well-used flexible working option used by lots of people with caring responsibilities. Using the forms in the NHS Staff Council flexible working toolkit, he prepares his flexible working request. Together, Martin and his manager work out a schedule that suits Martin and also meets the needs of his role.
Jared – Staff nurse
Time-limited arrangements to enable study for a masters degree.
Jared is a paediatric nurse. He would like to study for a masters degree, with a view to becoming a consultant nurse specialist in the future. The department is short-staffed and Jared and his colleagues have been working endless shifts.
However, Jared knows that he wants to progress and feels that if he doesn’t start his course now, he never will. After attending an event focused on improving wellbeing, Jared finds out about time-limited arrangements, which enable people to work flexibly for an agreed period of time. He speaks to his manager about the course and asks that he has every Wednesday off for a limited amount of time.
They work together to explore how Jared could fit in some extra hours in the week to help ease the workload across the department. He offers to work more late shifts as he knows that these shifts are always harder to fill. Jared’s manager agrees to him doing the course and having every Wednesday off to study for a fixed period until the course is finished.
Jenny – Finance officer
Partial retirement and job sharing.
Jenny is 60 and is counting down the days to her retirement – she plans to take a photography course and spend more time with her friends.
However, Jenny is keen to have some extra income to help fund all the activities she has planned and she also wants some structure to her week. She feels a little nervous leaving work entirely – she loves the team she works in.
She sees a feature in her union’s monthly newsletter on partial retirement – where people draw on some of their pension but can also work part-time. Jenny finds out more about how partial retirement works, through NHS Pensions and NHS Employers. Her union rep also advises her to seek independent financial advice.
After deciding it suits her needs, Jenny speaks to her manager. They decide on a job share to help cover the full-time role, which means Jenny gets to stay in her team, and her manager is pleased that she doesn’t lose Jenny’s experience – she’s been brilliant at dealing with all the different departments and their budgets.
They advertise for a part-time role as a job share and Jenny is joined by second Finance officer. Jenny enjoys inducting her new colleague and showing her the ropes.
Chris is a parent to two teenage boys going through GCSEs and A-levels. Chris works in a busy hospital trust in a community role, treating patients in their homes.
Chris’ partner has taken on a more demanding role and so they have both discussed how to best support their two boys. Chris has been wanting to reduce their hours for a while now and feels like this would be the right time. Ideally, they would like to drop to four days a week and spend more time at home.
Inspired by the scenarios and tips they find on their union’s website, Chris uses the NHS Staff Council’s flexible working toolkit and checks the Trust’s flexible working policy. They also speak to their union rep for advice.
Chris then meets their manager to discuss their request. Their manager is concerned about approving a request to reduce hours as she has also received a similar request from Chris’ colleague, Lisa, who is returning from maternity leave. She feels that the requests will impact the clinic’s ability to run the service as normal and so she escalates the requests as per the Trust’s flexible working policy.
The senior leadership team discuss the issue and are keen to support as much as possible as they don’t want to lose either Lisa or Chris’ skills and experience. The leadership team propose changing the structure of the team slightly. They suggest adding another part-time role at three days a week, using the savings from Chris and Lisa reducing their hours.
While it takes a while to approve the business case, the post is finally approved and both Chris and Lisa are able to work part-time. They are joined by another physiotherapist who has also been looking for a part-time role.
Career break and reduced hours to improve work-life balance and wellbeing.
Aisha has been a junior doctor for 15 years. While she loves her career as a registrar in dermatology, Aisha feels as though she has dedicated much of her life to medicine. She feels tired and in need of a break. Recently, Aisha’s been reflecting on how much more she wants to do and isn’t keen on waiting until she retires!
Aisha wants to achieve more of a work-life balance. She feels she needs to take a short career break first, to set aside time to reflect and re-evaluate. She would like to return to work on reduced hours.
Aisha does some research and makes a plan for her career break – she thinks three months would work well. She makes her application for an Out of Programme Career Break (OOPC) and gets this approved. She also sets out her ideal working pattern for when she returns. She submits her flexible working request but while her manager is happy to accommodate the career break, she is reluctant to allow her to return working at 60% of full-time hours and rejects the request.
Aisha talks to her union representative for help to appeal this decision. Although Aisha is covered by a separate contract to the Agenda for Change terms and conditions, the relevant section in the staff handbook (section 33) applies to junior doctors under their contract as well.
The union is able to help pull together examples of the flexibility afforded to other colleagues, and highlight the agreement between NHS Employers and BMA as part of the Enhancing Junior Doctors Working Lives group that supports registrar doctors being able to undertake less-than-full-time (LTFT) working arrangements. They also help Aisha to set out the impact on her wellbeing of having to fill lots of gaps in the rota at short notice.
The union support Aisha’s appeal at every step and the request is eventually agreed, allowing her to continue in the role she loves while also managing her wellbeing.
Term-time working to balance work and parenting commitments.
Tom has recently separated from his wife and has sole custody of their ten-year-old child. Tom is worried about how he will balance parenting and the needs of his job. While he has after-school clubs, it’s the school holidays that prove to be the most difficult to manage.
After an informal chat with his union rep, Tom finds out about term-time contracts.
He reviews his Trust’s flexible working policy and pulls together an outline of what he needs. He realises that a term-time contract would suit his needs well.
Tom completes a request to work 39 weeks (equivalent to 1,443 hours) across the year, and to use a combination of annual leave and unpaid leave to cover the rest. Tom sits down with his manager to discuss how this could work. They discuss transferring some of his role to another member of the team who is looking to develop, as well as committing to a clear plan of work across the year. He understands that he will be paid on a pro-rata basis but feels this arrangement is the best option for the next few years.
Kate - Paramedic
Reducing working hours to make more time for other commitments.
Kate is a paramedic with a very busy home life. Over the past few years, she feels as though she is constantly pulled in different directions. Kate cares for her children, which includes everything from homework to lifts, as well as a mountain of school admin! Her mum, who was once able to help out lots with childcare, is now unable to do so and now calls on Kate for help. Her husband runs a small business and Kate often helps with the business admin as well as packing and shipping orders.
Kate feels there aren’t enough hours in the day and decides to reduce her hours at work. She knew her manager would be reluctant, so spent time going through the Trust’s flexible working policy and sought valuable advice from her union rep before completing a flexible working request. Kate suggested a number of ways the new arrangement could work and with support from her union branch at every stage, her manager and the Trust agreed to the request. They also managed to keep her on her rota line, with another paramedic able to pick up the “dropped shifts”.
Jay – Senior audiologist
Fixed working pattern to accommodate health appointments.
Jay has been offered a new role at a large teaching hospital and is very excited. However, he wants to ensure that the Trust is able to adapt his working environment and schedule as discussed at interview. Jay has spina bifida and so needs to easily access areas with his wheelchair. As well as areas in the main building, he wants assurances that the clinic area and his desk are configured correctly.
Jay needs to work a specific pattern to enable him to attend his physiotherapy appointments every other Thursday as agreed when he was offered his role. Jay meets with his new manager to complete a disability passport, which acts as a really useful tool to capture all his needs. His manager explains that Jay can have time off for his appointments and doesn’t need to submit a flexible working request, as this is covered by his reasonable adjustments.
Jay’s new manager works closely with HR, occupational health and the facilities teams to ensure everything is in place ahead of his start date. They book in regular check-ins, to ensure they have time set aside to review what’s working well and what needs improving to ensure Jay’s working arrangements fully support him to carry out his role.
Start your conversation about flex
Ready to get going? Then it’s time to #TalkAboutFlex!
If you feel flexible working could work for you, use these handy tips and resources to help start your conversation.
Think about your needs. Do you feel like you need a better work-life balance? Do you want to make more time for other personal commitments, such as caring responsibilities? Use the helpful template in the NHS Staff Council flexible working toolkit to help you map out your needs.
Look through the various options available. We have listed some of the forms that flexible working can take, to kick-start your thinking. Remember this is just a ‘starter for ten’. There may be other options that better suit your needs. You can also look at case studies produced by the NHS Staff Council.
Think through the needs of your role. Which option would work best to meet your needs and the needs of your role?
Take a look at your Trust’s flexible working policy and brush up on your flexible working rights in the NHS.
Take a look at the step-by-step guide to making a flexible working request as set out in the NHS Staff Council flexible working toolkit.
Complete a flexible working request and book some time in to discuss with your manager. Remember your local union rep is always on hand if you need any advice.
Leading flex
Get inspired and start reaping the benefits of flex for you and your team
Getting started
As a manager in the health service, flexibility is one of key ways in which you can support your teams, especially when workloads are high and budgets are tight. Offering more flexibility can help to attract staff, create a better work-life balance, reduce stress and improve wellbeing. This can lead to more job satisfaction, better productivity, and higher staff retention rates.
You might be keen to offer flexibility in theory, but struggling with the reality of covering shifts or recruiting additional staff, or worried about losing funding for a full-time post when someone reduces their hours. Or you might not be sure where to start with building a culture of flexibility in your team.
We’ve outlined some key information and tips to help get you started, as well as examples and inspiration to help you find creative ways of making flex work.
Flexible working rights
Through the NHS Staff Council and devolved structures, health unions negotiated certain contractual rights for all NHS employees:
theright to request flexible working from day one of employment
no limit to the number of requests
the right to have your requests considered, whatever the reason
In addition, new legislationmeans that from April 2024, all UK employees will have enhanced rights to flexible working.
As a manager, it’s important that you’re up to speed with your organisation’s flexible working policy and that you follow local guidelines on handling and recording flexible working requests.
Tips for managers
Polish up your flexible working knowledge
There are lots of resources available to help you and your team navigate the options and find inspiration. Check out the material on this site and our resources page for toolkits, case studies and guidelines targeted at NHS managers and staff.
Promote a culture that supports flexibility
Set out clearly in job adverts, candidate packs and interviews what flexible working arrangements could work for the role – for example, you could list some of the ways people in the team work flexibly.
Invite your HR business partner to a team meeting to present all the different forms of flexible working on offer.
Encourage team members to include their working hours in their email signatures, to help manage their inboxes, so that they don’t feel overwhelmed by emails received on their non-working days/hours.
Ask your team to only hold meetings during core hours, to better facilitate flexi-time or staggered hours.
Book anchor days, team days or team meetings well in advance (even if they are regular) – this enables people to plan ahead and make alternative arrangements when needed.
Ask someone who already works flexibly to share their story with the team, helping to bring to life the difference it can make.
Share different examples of flexible working, to help tackle the myth that flexible working is only for parents and carers.
Include flexible working as a topic in your ongoing personal development conversations.
Ask for your teams to share ideas on how you/the organisation can improve flexibility within the team – this can lead to innovation and improved ways of working.
Are you able to facilitate home working for a day a week for those who want it? Are there specific tasks that could be carried out at home?
Remember that flexible working is an option for everyone, including you! It’s a great way for you and other leaders to role model a healthy work-life balance and to show that it’s possible for everyone to find a flexible working approach that suits them.
Responding to a flexible working request
Book in a specific meeting to discuss an individual’s flexible working request, rather than tagging it onto the back of your regular 1:1s. This way, you won’t be rushed and can take the time to work together to agree the best solution.
Talk to the individual to make sure that you fully understand their needs. This will help you to work with them to agree the most appropriate working arrangement for them and for the organisation.
Before you make a decision, you might find it helpful to set out very clearly what is required in the role and when (daily, weekly, and monthly), so that you can work in partnership with the individual to ensure that any new working pattern doesn’t impact the core requirements of the role.
Innovate! Could you explore new ways of working to support the request? Take a look at the case studies for examples of how teams have made flex work in a variety of NHS settings. Redesigning processes can help you to think outside of the usual set working patterns/shifts.
If you think it isn’t possible to accommodate the request, you’ll need to consult directly with the individual and explain why, providing a clear and strong reason. Try to think creatively, and accommodate some of the request, even if you can’t accept it in full. Ask yourself: Are there any parts of the proposal that are workable? What alternatives could you put forward for them to consider? Remember that refusing a request could risk the individual leaving the team all together.
Look at the workforce plan across the team as a whole. How does work flow? What needs to happen and when to help manage the work effectively? Understanding the overall workload, flow and responsibilities as a team can lead to clearer and more productive conversations with individual team members.
Remember that if you can’t see a way to be able to grant the request, the NHS Terms and Conditions provide for an ‘escalation stage’. This means before you reject a request you can refer it on for additional support and consideration of any options that might exist outside your team – see this flow chart and the NHS Staff Council guide for line managers.
Get inspired to lead flex
We’ve pulled together some examples of managers responding to flexible working requests and challenges. These are based on real people working in the NHS, but we’ve changed the names of individuals and organisations. Take a look at their stories to help inspire you in leading flexible working in your team.
Have you got a great example of making flex work? Or are you struggling with a challenge we haven’t tackled here? We’d love to hear from you – get in touch and share your flex story. Our campaign is designed to encourage NHS employees, employers and unions to work together and make more use of flexible working options available to help make the NHS a better place to work.
Andrea and Matt - Head of Strategy and Communications and Deputy Head of Strategy and Communications
Compressed fortnights to improve work-life balance and promote a culture of flexibility.
Andrea is the Head of Strategy and Communications at a large Trust, with Matthew as her deputy. They run a very busy unit of 40 people. They deal with reactive work (media queries, social media) as well as more planned work, such as monitoring the Trust’s progress against various targets. Following the latest results in the staff survey, Andrea and Matt have been trying to change what has been a culture of working long hours in the team. They also want a better work-life balance themselves.
They each submit flexible working requests, asking to change their pattern of working, to role-model a healthier balance to the team. They both ask for compressed fortnights, making sure that their day off is on alternate weeks, so that between them, there is always senior cover.
They also look at how they can start to build a flexible working culture within the team. They schedule emails to be sent within working hours, to help set the right tone. They invite their HR business partner to talk to the team about all the different forms of flexible working, encouraging people to explore how they can achieve a better work-life balance.
They work with their teams to identify which tasks can be carried out while working at home and develop a home-working schedule for the team, to helppeople cut down on their weekly commutes. Over the next year, through flexi-time, remote working, compressed hours and a new job share, the team succeed in creating a much healthier working culture and balance.
Kiera - Manager, Physiotherapy Unit
Restructuring a team to accommodate several part-time roles.
Kiera runs a physiotherapy unit in a busy hospital trust. As well as an in-patient clinic, Kiera manages a community service, providing treatment to patients predominantly in their homes. She feels lucky that she has such a great team and proud of the service they all provide to patients.
Two individuals in the community team have recently asked to reduce their hours to part-time roles. Kiera is worried that they won’t be able to deliver the service if she grants the requests, so she escalates the issue to the senior leadership team, in line with the Trust’s flexible working policy.
The leadership team are keen to accommodate the requests, and avoid losing team members with significant clinical skills and experience, as well as excellent knowledge and relationships in the community. They’re also aware that the community physio team have demonstrated huge flexibility to help fill gaps when needed and want to show their support in return.
They suggest exploring ways to restructure the team to fit with the changes in hours. With help from her finance business partner, Kiera puts together a business case for a new part-time post. The business case demonstrates that this would not cost the Trust much more, due to the savings from two existing members of staff reducing their hours.
She highlights the possible impact of not creating the additional part-time post could be losing their experienced staff. This would impact patient care in the short-term and incur costs for recruitment and agency staff cover. Waiting lists would also be impacted if Kiera grants the requests but doesn’t recruit to fill the gaps.
She shows the benefits that recruiting the role and granting the flexible working requests could bring, including improving staff wellbeing, increasing resilience in the team and demonstrating that they are a flexible employer. After lots of back and forth, the proposal is approved and Kiera is delighted to be able to tell both Chris and Lisa that their flexible working requests have been approved.