NHS leaders must make flexible working the norm to deliver better patient care and help resolve the staffing crisis, say unions today (Friday).
A coalition of 18 unions* representing every part of the NHS workforce has launched a new initiative to promote more choice for staff over how, when and where they work.
The Get Ahead on Flex pledge is aimed at getting employers to speed up their progress on working arrangements that allow more freedom such as team-rostering and ‘any-hours’ contracts, offering staff the hours they want to work from the outset, say the NHS unions.
Those who sign up will commit to highlighting flexible working in every job advert, setting targets to increase the number of requests approved, publish data (such as the number of requests staff make) and train all managers on how to champion choice for workers.
Sussex Community NHS Foundation Trust and Milton Keynes University Hospital have already signed up to the pledge. It is also backed by equality campaigners including Kate Jarman, who champions flexible working the NHS, and Professor Alison Leary from London South Bank University.
At present, all NHS workers have the right to request flexible working from day one of employment and to make unlimited requests without providing a reason.
However, health unions say all too often accessing the flexibility they need is a struggle for staff, including those with childcare and other family commitments. The inconsistent approach by employers has created a postcode lottery across the NHS.
Some staff are being forced to accept less favourable contracts – or bank shifts, which are lower paid – in return for being granted flexible working. Employers often reject applications from workers who want to determine their own schedule and instead insist they must fit in with rigid shift patterns.
One health worker, who cares for her elderly mother, said: “I applied for flexible working twice, but it was declined both times.
“I used all my annual leave to have weekends off [to care for her mother]. It meant I had no holidays or time away for me for several years until we got a different manager.”
The health unions say flexible working should be adopted as standard to help attract and retain experienced staff. Tens of thousands of workers have already left the health service due to poor work-life balance, according to data**.
Get Ahead on Flex is also aimed at ensuring managers know how to handle requests in a way that benefits individual staff. The campaign encourages them to take the initiative to redesign jobs and services to better meet the needs of staff and patients.
The benefits of flexible working, such as increased performance and higher quality care for patients, are well-understood at the policy level. But the unions say financial and other pressures on the health service get in the way of real change.
In England, a new standard on flexible working is expected to be introduced for NHS employers in April as part of the government’s 10-year workforce plan.
Trusts who sign up and meet the commitments of the Get Ahead on Flex pledge will already have a head start on implementing the new standards, say the unions.
And in 2027 tougher statutory requirements on flexible working are due to come into force for all employers.
Chair of the NHS unions and UNISON head of health Helga Pile said: “Too many NHS staff are struggling to balance work with other parts of their life including caring commitments. This affects their health and well-being, and forces many to consider jobs elsewhere.
“The NHS has long talked about the importance of improving flexible working options. However, old-fashioned attitudes and rigid one-size-fits all shift patterns are still getting in the way.
“This pledge provides a real opportunity to improve working life for staff and give patients a better service.”
Campaign lead for the NHS unions on flexible working and Society of Radiographers head of industrial relations Leandre Archer said: “Flexible working shouldn’t depend on which employer you work for or who your manager happens to be.
“NHS staff deserve fair, consistent access to flexibility so they can deliver the best possible care without sacrificing their own wellbeing.
“The Get Ahead on Flex pledge is a vital step towards ending the postcode lottery and making flexible working a genuine reality across the NHS.”
Notes to editors:
–*Get Ahead on Flex pledge is part of the Let’s Talk About Flex campaign. The 18 unions behind the Get Ahead on Flex pledge together represent a health workforce of over a million. They are the Association of Laboratory Medicine, British Association of Occupational Therapists, British Dental Association, British Dietetic Association, British Medical Association, British Orthoptic Society, Chartered Society of Physiotherapy, GMB, Hospital Consultants and Specialists Association, Managers in Partnership, the Pharmacists’ Defence Association, Prisoner Officers’ Association, Royal College of Midwives, Royal College of Nursing, Royal College of Podiatry, Society of Radiographers, UNISON, and Unite.
–**Of those workers who left the NHS in 2024/25, around 12,000 (9%) blamed work-life balance, according to the King’s Fund. This represents nearly double the percentage who left for the same reason in 2012/13 (4%).
Media contacts:
Anthony Barnes M: 07834 864794 E: a.barnes@unison.co.uk
Mark Conrad M: 07809 623703 E: m.conrad@unison.co.uk
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