NHS Staff Survey: what's the picture of flex in the NHS today?

Barry Hutchinson, Senior National Officer, Employment Relations at the Royal College of Nursing, reflects on what the latest NHS Staff Survey results tell us about flexible working in the NHS today.

The annual NHS Staff Survey is one of the largest employee surveys worldwide. It helps to improve staff experience and tracks progress against the NHS People Promise (which includes a commitment to flexible working).

In 2025, over three quarters of a million NHS employees* representing 238 NHS organisations completed the survey.

The results help us to understand the reality of flexible working for NHS staff and opportunities to improve flex so everyone can enjoy a positive and consistent experience.

Here’s my key takeaways…

1. We’re seeing progress on flex and work-life balance across the NHS

NHS staff answer four questions about support for work-life balance and flexible working and the results are combined to give a ‘We work flexibly’ score. This score has increased since 2021 (from 6.05 to 6.31) but remains unchanged since the last survey in 2024.

Across the four flex questions there’s some encouraging signs:

• In 2025, over half of staff (56.63%) said they achieve a good balance between their work life and home life.
• And nearly six in ten (57.66%) were satisfied with the opportunities they have for flexible working patterns – up from 54.05% in 2021.
• Seven in ten people (71.75%) reported that they can approach their immediate manager to talk openly about flexible working.
• BUT fewer than half (49.77%) said their organisation is committed to helping them balance their work and home life.

More is needed to make a meaningful difference for the 1.5 million people employed by the NHS across the UK – particularly from employers – to create a true flexible working culture. Our Get Ahead on Flex pledge includes a commitment from employers to ‘Lead the Conversation’ to help make flexible working the norm for all.

2. …But it’s not fast enough…

Access to flexible working helps to improve staff retention, health and wellbeing, increase productivity and attract talent – and all of this adds up to better patient care and cost efficiencies.

These are strong reasons why we should be seeing a real push to drive up flexible working scores – not small increments of 0.01%.

Why aren’t all NHS employees getting the benefits of flexible working envisioned in the NHS People Promise? Contractual rights to flexible working are set out in the NHS Terms and Conditions of Service Handbook – so why do more than half of staff not believe that their employer is committed to helping them enjoy a positive work life balance?

3. …And it’s not fair or consistent

While for some NHS staff flexible working is clearly a reality, it’s simply not right that for many more flexible working doesn’t seem to be on the table, or something they can even talk about to their manager (3 in 10 NHS workers still don’t feel able to approach their manager to talk about flex).

Flexible working makes the NHS better for everyone, so when access to flexible working is restricted, the benefits of flex are restricted too.

The 2025 staff survey results show inconsistency across employer types and different occupation groups.

• Satisfaction with opportunities for flexible working increased for staff at Acute and Acute & Community Trusts in 2025 but decreased or stayed the same in other settings) and for different occupation groups.
• More than half of allied health professionals, healthcare scientists and scientific and technical staff were satisfied with flexible working opportunities (a five-year high at 57.97%), while only 35.5% of operational ambulance staff are satisfied with the flexible working opportunities available to them.

The results we’ve shared here represent the national view, but it’s almost certain we’ll see variance and inequity at local levels too. NHS staff shouldn’t face a postcode lottery when it comes to flex, and access to flex shouldn’t depend on where you work.

Take a look at the staff survey local reports to understand the results for your employer or local trust or foundation. Results for bank only workers are reported separately.

4. Now is the time to Get Ahead on Flex

The results of the staff survey highlight just how far we have to go, for every NHS employer to fulfil the flexible working element of the NHS People Promise – and every person working in the NHS to enjoy the benefits of flex.

Progress has stalled – when we consider the flexible working sub score in isolation (6.25) it has dropped since 2024 (6.26). Meanwhile other employers are offering more, and the Employment Rights Act has raised the bar in other sectors.

There’s a real risk that without focused action, the NHS will fall behind. That’s why the NHS unions are calling on employers to sign the Get Ahead on Flex pledge and commit to working in partnership with staff sides to:

• Lead the conversation
• Set a target
• Train for flex

Tell us, how do these national results compare to your own experience of flex in the NHS? If you agree there is more to be done to improve flexible working in the NHS, make sure to ask your employer to sign the Get Ahead on Flex pledge.

 

* 766,286 NHS staff completed the survey, a response rate of 49%