Flexing the NHS in the wake of Covid

The NHS has undergone the greatest challenge of its existence over the last 18 months and pressure on staff is still high as they seek to address the huge back log the pandemic has left in its wake. Will that pressure and the importance of retaining experienced staff bring greater change when it comes to flexible working? Kate Jarman feels it will.

Kate is co-founder of Flex NHS. The campaign started in 2018 when Kate, Director of Corporate Affairs at Milton Keynes University Hospital, and Aasha Cowey, Strategic Transformation Lead at Surrey and Borders Partnership NHS Foundation Trust, met via Twitter and started discussing their various challenges as working mums. Their passion is to make the NHS as flexible as it can be for all staff.

Flex NHS works fairly closely with Jane Galloway, Head of Flexible Working for NHS England, whose role is more focused on policy formulation and people planning. “We provide grassroots information about people’s experience on the ground,” says Kate. “We are advocates for staff and reflect their stories to the policy centre. There is often a disconnect between what organisations think is happening and what the real experience is. We can close that loop.”

Flex NHS, as a lobbying group, is also less constrained by organisational politics and can provide a constructive critique of policy initiatives, although Kate emphasises that it is about supporting positive change.

She adds that there is a great diversity of experience in the staff who contact Flex NHS, with many having worked from home during the pandemic while others have not been able to. Asked about the challenge of ensuring there is not a flexible working divide between those in jobs that require physical presence and those who can work from home, Jane is keen to stress that flexible working is much more than just remote working.

Clinical staff, she says, can be offered different kinds of flexibility, such as flexible hours, flexible start and finish times and flexibility around major life events or if they are feeling burnt out. And she adds that remote working has its challenges. Many of those who have been working from home are now having to adapt to hybrid working and Kate says it is vital that those who regularly work away from the workplace don’t miss out on organisational support.

She is also very aware of people’s sensitivities about ‘back to the office’ messages and about not undermining how NHS workers have got through the last months, however they have been working. While many in the NHS have been going to their workplace throughout and risking Covid infection, those who have been working from home have often been working extremely long hours. Those physically at work have sometimes faced traumatic situations, but those at home may have felt very isolated or under extreme pressure to balance work and caring responsibilities.

The case for flex

Asked if staff shortages and all the pressures on the NHS mean it will make it harder for people to work flexibly, Kate says that it is not in the NHS’ interest for staff to burn out and be unable to work effectively. “We risk losing people altogether if we are not flexible,” she says. “That would be self-defeating.” She adds: “We know the pressures will continue, and not just on the NHS, so we need to ensure that our staff are well and productive. We don’t have an unlimited pot of money to employ new staff and new staff take time to embed in the NHS. We have to think longer term about the workforce. Now is a critical time for wellbeing and support.”

She adds that recognising that people are more than their jobs is important and makes for better employees. “Helping people to balance their lives helps to keep them in the workforce,” she says, adding that the average member of NHS clinical staff represents a 500K pound investment in terms of training. “Losing them means losing that financial investment and starting afresh,” says Kate.

Talking about the actual experience of the last months, particularly for working parents, she says that the pandemic and associated stresses and challenges have kept changing all the time, meaning work policies have had to be very flexible, for instance, to ensure staff whose children were sent home from school due to Covid could work at home where possible and so were not financially penalised by having to isolate. As key workers NHS staff could send their children to school and nursery, but for some that was a cause of anxiety. Kate’s own son wrote her a letter saying he was worried she was going to die because she worked in the NHS.

The NHS has organised lots of counselling and support for staff, but Kate says that what is needed at some point is time to reflect on what people have been through. The pace at which things have shifted has been so fast that that has not been possible yet. “Before the pandemic most crises we have faced have been short-lived and they haven’t affected our whole lives. All our normal coping mechanisms have not been there,” says Kate.

Mental health

The focus for the campaign now is on the long term mental health challenges, how to get hybrid working right, how to ensure working from home doesn’t end up with women exhausting themselves by having to do work and life simultaneously due to childcare issues and how to make sure the positive aspects of pandemic working are retained.

Whatever happens, Kate knows that flexible working will continue to be central. She says that will require teams being open to trialling new ways of working and to having conversations within their teams about how to support both the team and its individual members best. “It has to be about honest, adult conversations and the art of the possible,” says Kate.

She believes a continual education programme is necessary to show people the benefits of being open to different ways of working. “In the end, our people want the same thing: an effective NHS,” she states. “We are all working to the same end, but we have different obligations outside work. Both people and organisations need to be willing to be flexible. The more we talk about flexible working the less emotional it will be, the less people will feel judged and the more we will normalise it.”

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