Flexible working scenarios

Scenario 1

Devin is a housekeeper/domestic and works set shift patterns to support when and where the wards need to be cleaned, and these have been in place for several years. Devin would like to work more flexibly to give them a better work-life balance, so they can collect their grandchildren from school and attend social events during the day. Devin and their manager Bethany explore the types of shifts that might suit. Together they then review the types of shifts available. Bethany asks what flexibility Devin might have, such as working more weekends, evenings or nights. As these will give Devin the flexibility they need during weekdays, but provide a win-win for the department as these shifts are usually hard to cover. Devin and Bethany then discuss the proposed plans with the whole team, ensuring that the communication is open and people can take ownership and contribute to filling the team rosters. Other team members are also happy to re-set some of their shifts, so they work more weekdays. This means they have fewer weekends and nights to work, giving them a better work-life balance with their families. A review process is agreed to check how well the arrangements are working for everyone.

By enabling this flexible working request, Devin can still work within the current shift/timings; however, by re-setting the shifts they work to weekends, more evenings and nights, and less weekday shifts, they can go to their midday exercise classes and pick their grandchildren up from school. This also leads to other team members having the chance to work more in the week and less at night and at the weekend, something they never thought they would be able to do.

Scenario 2

Aaliyah is a registered nurse who works in a ward caring for older adults. They currently work a range of shifts over a six weeks rota.  The patterns of the shifts are unpredictable, but the shifts lengths, start and finish times are rigid and thought to be inflexible. Aaliyah has had a bereavement,  meaning that they can no longer work nights, as this will leave their children unattended at home overnight. They are thinking about handing in their notice and picking up bank shifts that suit their childcare requirements. Their ward manager Marshall, noticing that they seem under more stress than usual, holds a wellbeing conversation, asking them how things are. During the discussion, Aaliyah shares the personal life event and how this is making them worry. Marshall asks whether anything can be looked at from a work perspective to support them, such as flexible working. Aaliyah then shares that they were about to hand in their notice because they thought they would never be able to work flexibly and is relieved that the manager brought up the topic first.

Together they explore what shifts they can make work based on Aaliyah’s current childcare arrangements, and then, Aaliyah gave permission to discuss this in a team meeting. The team review the shifts they are short for and discuss whether any of the team would prefer to work them. Once the team meeting has been held, and Marshall is confident that the service needs can be met and this would support the health and wellbeing of both the team and Aaliyah. They propose that Aaliyah comes off the night shifts, and works a more predictable shift pattern, to support when they have childcare. They agreed that this should be a temporary arrangement for six months, with a review to be held at month five.  This review will again discuss how it is working and whether anything has changed, such as childcare or the team’s availability.

Moira is sister on a busy endoscopy ward, who has two deputy sisters that help create the team rosters. The three of them take it in turn to do each month. Some team members complain when it is Moira’s turn, as they feel like they are treated unfairly. The team has constant arguments about people being treated differently and that the three managers on the ward are not consistent in their approach. Moira would like the team to be more involved in creating the rotas as this will give them ownership, support their development, and allow for flexibility among the whole team. Moira discusses with the team and initiates a new process where the team will self-roster before inputting the roster into the electronic roster.

Firstly, as a team, they set team ground rules on basic expectations which include;

4 x nights per month

2 x weekend days

2 late's per week

25 per cent of shifts can be non-negotiable requests.

The remaining shifts left will be inputted by the ward management team collectively.

Shift-swaps between team members after rota finalised must be agreed upon by the electronic roster team.

Priority for non-negotiable requests will be based on an alphabetical list that will be rotated each month.

Moira then created a blank roster, inputting those already on a pre-agreed flexible working pattern. This was shared with the team, and each team member was then able to add in their proposed days off and shifts based on the above ground rules. Meaning that the team were able to choose a large portion of their shifts, providing they had met the minimum expectations that the team had all agreed.  Where there were gaps, the three managers would then fill these in with the staff available.  Once the rota has been finalised Moira uploads it to the electronic record system.

Kumar has been the manager of a new team for about three months. Since then, their organisation has been promoting flexible working as a benefit for all staff. As a team in HR, they traditionally work office hours - Monday to Friday 9am-5pm. Before the pandemic, they worked solely on site in an office location. This led to Kumar receiving flexible working requests in the last week from four of their team members.

Kumar made sure that they reviewed each request based on its merit and noticed similarities and differences to what was being asked. As a manager they needed to ensure that the work was being completed and wanted to establish what activities had to be in the office or could be completed from home to ensure work is effectively and appropriately delivered.

Kumar held exploratory meetings with each of the team members, checking how flexible they could each be. They explained that as a minimum, one person from the team must be in the office on-site each day, and another person would need to be available to support this, which could be remotely. All of the team members agreed to discuss this as a team to see how they could best cover what was required and ensure that they could all work more flexibly.

Reena and Tim both wanted every Friday off and to work compressed hours over the other four days. Kumar was able to agree to the compressed week, but with a compromise that as they were both supervisors, they couldn't both have a Friday off, as this left the team unsupported. Reena and Tim agreed between them, to alternate every Friday and to have a Monday off instead, the next week, which would give each of them a long weekend.

Naveen worked Monday to Friday and wanted to work remotely. Homeworking would enable Naveen to do the school run. Kumar agreed that home working most days would be agreeable and that working hours could be flexed to accommodate time to do the school run. They would still need to come to the office on a rotation with the other team members, so that everyone covers the in-office requirement fairly over a month. Kumar also asked that they make themselves available for team meetings quarterly, should they need to be face to face. Naveen was happy to compromise so that they did their fair share of the office cover.

Karen was a person with a disability that made it difficult for them to perform well in the morning due to their medication, so Karen expressed a preference to start work later, and finish later (11am-7pm). They had much higher energy levels in the afternoon and evening. Kumar wanted to accommodate the request as much as possible, as it was a simple reasonable adjustment that would make Karen’s worklife so much better and reduce the amount of sickness that they were taking. Kumar agreed that the timings would still enable the relevant tasks to be undertaken. As Karen was a new starter, it was agreed with Naveen that they would be available to support Karen on their flexi-time days between 5pm-7pm.

Scenario 1

Due to a recently diagnosed medical condition Sam, a nurse within the emergency department, was advised by their doctor not to work any more night shifts because it made their medical condition worse. They were referred to occupational health, who agreed that this was a reasonable adjustment relating to a disability. The manager Sita, using the recommendation from occupational health (OH), ensuring that going forward, Sam was no longer put on night shifts within the rota. Night shifts, which can be popular, as they carry enhancements, were then offered to existing staff as either a swap or an additional shift. To be proactive and ensure that there were no rota gaps, Sita discussed this with the matron and the HR support team, and they agreed to recruit for flexible staff on the bank for the department in case the existing shifts weren’t covered by existing staff as well as check on the status of other open vacancies.

Sita, as part of ongoing wellbeing conversations, also checked whether any other adjustments might be needed for Sam.

Scenario 2

David likes to work nights as it suits their lifestyle and the increased enhancements are important to them. They were on a rota where nights were split evenly across the team for fairness. However, a lot of the team had children and it was known within the team that night shifts were always the hardest to arrange childcare for.

David put in a flexible working request to their manager to request that they work permanent nights. They explained that this would suit their personal needs and ensure that there was reliable cover for the night shifts and give their colleagues more of the sought after early and day shifts.

Valerie the unit manager, arranged an exploratory meeting to discuss the request. Though Valerie wanted to support David, there were some initial concerns around David keeping their competencies and registration up to date.  Especially if requiring supervision and being able to attend training that usually runs during the day.

Valerie and David were able to agree that if team training had been arranged, David would work days, and that in one week in the six-week rota rotation, David would work a blend of shifts. Valerie explained that this would ensure that five out of six weeks David would have the permanent nights they wanted. However, one out of six weeks David would work a combination of day and night shifts. It would mean an extra two to three day shifts available for the rest of the team, and potentially decrease the absence levels on the night shifts.

Being on-call forms part of the employment contract and is a necessary part of the service that’s delivered to patients. Requesting to come off call could cause significant shortfalls and pressures to the rota and colleagues. Therefore, this is one of the more challenging elements of flexible-working to accommodate.

Below, we have a couple of real-life examples where a solution was found because the request was explored in full. It is important to note that each request should be treated on its own merits, which may mean that the initial request is not possible.

In most cases, where on-call is part of the job plan, then looking at how you can make your on-call duties work for you and the team as a whole is a sensible solution. Things to consider that could change might be your working pattern, how frequent the duties are, or whether the role you are currently doing is suited to your individual circumstances at this time. If on-call duties form part of the job-plan and changes may involve a consultation process such a job-plan review for each of the individuals impacted by the changes.

Removal from the on-call register as a flexible working arrangement

Scenario 1

Kelly is a consultant and has recently split up from their partner, leaving them with solo parenting responsibilities. Part of their agreed job plan is that they have an on-call element which requires 1 in 14 on-call weekdays/nights and 1 in 10 weekends. Whilst this was workable before, they are now in a different position with no one to take care of the children overnight. Kelly requests to come off the on-call rota for 12 months while they navigate their new situation. The line manager Pete, feels like this request is impossible to accommodate. As being on-call forms part of the job plan and fears that this will set a precedent, where other consultants would want to ‘not be on-call’ and could cause unrest within the team.

Pete checks the local flexible working policy and reads that where they, as a manager, are finding it hard to agree to a flexible working request, they should escalate this within their management structure, to help them look for alternative solutions. The manager discusses this with their clinical business unit leadership team and HR support team. The group look at the positive and negative impacts including of the request, on the individual on the team and on the service. In exploring these, they decided that accommodating the request for a temporary period of time would give Kelly the time and space needed to organise childcare and provide them with some space and time to recharge from a difficult time in their life. They agreed that Kelly could come off the on-call rota for four months and agreed to review this at month three, when they can reassess the situation for Kelly, the service and the team. They agree to engage a locum, who was already working with them, for a fixed term contract over this period, to cover any shortfall. 

Scenario 2

Stephanie is a community midwife who works within a small team covering local clinics and inpatient shifts on the local labour wards. They work on-call as part of their rota, which leads to getting frequent call-outs at night.  They are finding the night shifts draining and would prefer not to work them. Jos is the manager of the team, and at the moment, they are short-staffed, which means there is little flexibility in the rota, two of their team already work part-time, and this means that those in the team that are full-time feel like they do more than their fair share of on-call. Jos initiates a health and wellbeing conversation during their one-to-one with Stephanie. Stephanie share how they are feeling, they have low energy and blame the two on-call shifts they do every week. Jos listens and acknowledges how they are feeling. Jos proactively agrees to hold a team meeting to look at how the team is working and what options are there to be more flexible and support everybody’s wellbeing, while continuing to make sure they can deliver excellent patient care.

During the team meeting, it becomes apparent that the whole team feel the same way, and being tired and drained is a common theme. Jos shares that they are currently one whole-time equivalent (WTE) person down and have interviews planned this week. This should alleviate and share some of the burdens and reduce the number of on-calls that everyone has to do. This is received positively. During the meeting, it becomes apparent that it isn't the on-calls that are the actual issue, rather than their timing. Currently, they do two together. Jos acts on this feedback, and as a team, they agree to trial for two rota periods that their on-calls are not back to back. This outcome means Stephanie feels valued and heard, and the whole team comes up with a solution that will suit everyone. Jos also knows recruiting into the team is a key priority to support the team going forward.

Yamuna is a porter and notices an advert on NHS Jobs. It is a change of department, but would be an excellent opportunity for them, as the location is closer to their home address. Yamuna currently works term-time only hours, meaning that they do not work during the 13 weeks school holidays. They get paid the same every month, as their pay is annualised over the year. The post they want to apply for is posted at 37.5 hours, which is full time. Yamuna is worried whether they should apply as they want to stay on term-time only hours. Yamuna speaks to their staff side representative Dee, and shares their concerns. Dee, reassures them that as of the 13 September 2021, every employee has a day one right to request flexible working and that they should make contact with the hiring manager to discuss.

Yamuna calls Tina, the hiring manager, and explains that they are interested in the role and currently do the same position, but at a different site. They ask about the full-time hours, explaining that they work term-time only and would like that to continue. The hiring manager encourages them to apply for the role, following the organisation recruitment process. There are several positions available which will make it easier to accommodate preferred individual work patterns, and as an organisation, they encourage people to work flexibly.

Yumana then shares how their current team makes it work highlighting that the weeks that they are not available can be inputted into the rotas over a year in advance, which works well in their current team. Tina confirms they are open to adopting this practice and agrees that a term-time pattern can be considered in conjunction with the application. This type of flexibility was new to Tina’s team, so they reached out to other teams where term-time only working was embedded to gain insight and good-practice principles.

Following the discussion with Yamuna, Tina realises that the way they advertise their vacancies might be impacting the candidates they attract. Currently the are only appealing to those that can work full-time, which means they have a smaller pool of candidates. Tina discusses this with the recruitment lead and asks that all adverts state 'happy to talk flexible working' and that the day one right is listed as a benefit. Tina also ask they adverts reflects that there are several positions available and posts can be full or part-time.

Paramedic

Alison is a paramedic and works three 13-hour shifts within a rota. They are set by the planning team, with no say on how and when they fall. Annual leave must be prebooked, and if a shift can't be worked, they currently rely on their colleagues to swap shifts. Alison is working towards a degree at night college on a Tuesday night, and likes to use the day afterwards to study. Alison has been relying on their colleagues' goodwill every week, which has caused a lot of stress and worry. Line manager Chris notices that something is not right and arranges a wellbeing check-in.  Alison shares that the unpredictability with the rota is causing them stress and explains about their studies.  They discuss a different pattern of working and Chris encourages Alison to put a formal flexible working request in. They agree to meet again in a week to explore in more detail. Before the exploratory meeting, the manager develops some draft rotas, which includes two days off a week on a Tuesday and Wednesday. Chris brings these into the meeting with Alison, explaining that in order to guarantee these two shifts off, Alison would need to cover more weekend shifts otherwise they would not meet their contracted hours. Chris checked whether this was what they wanted, or would  they also prefer to reduce their hours too.  Alison explained that they would like to trial for six months, having a fixed Tuesday and Wednesday off and the other days as allocated as they would prefer not to drop their hours. This was discussed with the team and agreed. Chris and Alison agreed to put in a review in at months three and five, to check-in and make sure that arrangement was working.

Community roles

Rae works in a community role, meaning that they often have their working diaries planned for them by outside agencies. This can mean that though they have a degree of flexibility, their work days are determined by when set things occur or when clinics are running. These are also booked during traditional office daytime hours. Rae also cares for their elderly mother, who has dementia.  There is a need for them to be there in the morning to let the carers in, and take their mother to various health appointments. These are also in the day and quite often clash with the work appointments. Rae feels like she now has to choose between caring for her mother and her patients, which is causing anxiety and upset. Rae feels like there is nowhere to turn and is thinking about taking early retirement or unpaid carers leave.

Joe, Rae’s team manager, has recently found out that the organisation has a carers network, and wants to share this information with the team. Joe also mentions that the organisation are encouraging the use of the Working Carers Passport as a way to explore what further support might be available. Joe shares, during a team meeting, how you can record your cCarer status on the ESR system and that the network is available to support carers in the organisation. Joe encourages anyone with caring responsibilities to use the resources provided and to put some time aside for a one-to-one chat.

Following on from this meeting, Rae reaches out to their manager, sharing the stress that they have been under.  Joe asks whether looking at how they can work more flexibly would help relieve some of the pressure. Together they talk about the current pattern of work. They looked at the morning issue. Rae explains that they see their mother first thing in the morning and then arrive in the office at 9am to check emails before visiting in the community from 10am onwards.

Joe queries whether they need to be in the office to check their emails and suggests that Rae works remotely until 10am and then attends visits as they usually do. They also explore some of Rae’s face-to-face meetings because Rae has to travel extensively between appointments. Joe puts it to Rae to consider whether some of the meetings could be held virtually using the remote working software. This makes Rae nervous as they dont feel very technically competent with remote working techniques, and wouldn't know how to do this. Joe agrees to offer some digital education training, removing this as a potential barrier to a more agile way of working.

They then explore having to attend medical appointments and how these impact Rae’s day. They explored two options.

Option one being that Rae works compressed hours four days a week – working 9.5 hours each day – extending their finish time until later in the evening.

Option two staying on a 7.5-hour day, but only working four days a week, so reducing their hours to 30 hours a week.

Outpatients' clinic

Rhys works in outpatients as a healthcare support worker (HCSW) and works set hours. These are based on the times the clinics they work within run, which are Monday to Friday 9am until 5pm. To support their mental health, Rhys would like to have some time in the week to themselves. As it feels like they never get a break. Rhys is the primary earner in the family and doesn't want to reduce their working hours as this will impact on their household income significantly. A discussion is had with their manager, Helen.  Rhys shares how they are feeling and that they ideally would like a day off in the week, but not reduce their hours at all.

Helen struggles to find a way to support a request for a different working pattern, due to the nature of the clinics. By wanting to work flexibly without reducing any working hours, the clinics fixed times mean that flexible working request like these are difficult to accommodate.

Helen suggests that they escalate this, as per the flexible working policy, with the divisional leadership team to see if there are other ideas to support this. In senior leadership team meeting it is shared that there are some discussions already happening with a view to extend clinic hours, to suit patient needs. This may include offering evening appointments, and some weekends. They explain that current staff may be put into consultation to discuss the different shifts available, giving opportunities to support individuals in the team who prefer more variety in their shift pattern which could suit Rhys.

They also look at other departments in the division that already offer a more flexible shift rotation, sharing that there are vacancies in three different departments for HCSW, and these offer a variety of shifts but will allow them to maintain their hours.  Helen shares with Rhys the options explored:

• Option one - Wait to see if the new changes in the department happen, though time frames could not be guaranteed.
• Option two - Helen offered to support Rhys to apply for any of the other roles HCSW that will provide them with the flexibility they require right now.

Rhys, though happy in outpatients could see that having more flexibility right now would be the best option and a transfer to an other department within the division would be the right decision.