Why flexible working is an active career choice within the NHS
More nurses are choosing to work flexibly nowadays, for professional as well as personal reasons, says Ingrid Torjesen
Bank nurses used to be people who wanted to do the occasional extra shift in the evenings or at weekends to earn extra money. Many had full-time nursing posts, and those who did not were rarely the main family breadwinner.
How times have changed. Increasingly, nurses are choosing flexible working as a career, either because of their domestic circumstances or because they want more variety. Some permanent staff are using bank work as a way to gain experience of working in a different area of nursing or type of hospital to help them decide whether they want to change direction or to gain additional experience to help with a job application.
In 2008, NHS Professionals surveyed 20,000 flexible workers and compared the results with those of a similar survey conducted in 2005. What this revealed were startling changes in the way in which bank nurses view flexible working and what they now demand from it.
While the proportion of women flexible workers has remained relatively constant at around nine out of 10, many more have children or are responsible for caring for an adult compared with three years ago.
A greater proportion say they are the family breadwinner compared with four years ago. Almost half (47%) of bank workers are now the main breadwinner in their family - a rise of 10% on 2005’s figure.
Chris Day, Director of Marketing and Communications at NHSP, says that this dramatic increase was highly unexpected because working flexibly has always been presumed to be a secondary form of income.
One reason is that almost one-third of bank workers (32%) are single parents - an increase of 4% on 2005. Their childcare responsibilities have given them little choice other than to work flexibly because they simply cannot fit into the usual three-shift pattern or work over seven days.
Only one-quarter of single parents had been offered any suitable work other than through NHS Professionals, and almost all of these were offered term-time contracts that were not flexible enough.
Overall, 79% of bank workers are responsible for school-age children, up from 71% in 2005. Childcare is the main reason that 64% of bank workers want to work flexibly, compared with 57% in 2005. A further 21% - up from 15% in 2005 - cite responsibility for caring for an adult.
Mr Day says: ‘Flexibility in the past was always seen as a means to an end to earn extra money. Flexibility now seems more of a lifestyle choice. People are actually choosing to work flexibly because they have no other way of working in the NHS.’
While traditionally bank workers have tended to fill evening and weekend shifts, many people who are choosing to work flexibly full time are doing so on weekdays, through term-time contracts and contracted or shortened weeks.
This pattern of working has become increasingly common in recent years in other sectors, so employers can retain experienced workers who have personal commitments or who do not want or need a full-time job. However, flexible working has not been offered seriously in the NHS until now.
‘In the NHS, it was almost frowned upon five or six years ago,’ Mr Day says. ‘People were seen to be not team players, not people who were willing to put in the extra effort, whereas now it seems that the way that employers will attract good people is to provide that support.’
Over half of flexible workers have worked in health care for more than 10 years and 43% for over 15 (Fig 1). One-quarter have a degree or equivalent qualification other than a nursing diploma - up a massive 18% on 2005, reflecting the move to a graduate profession.
As the NHS workforce is ageing, so is its flexible workforce, with many people seemingly seeking flexibility as they enter their late 30s and early 40s.
The average age of a bank worker is 40 compared with 33 in 2005. The increase in age is most noticeable in primary care and community services, where the average age has risen from 34 to 44 over the past three years. In the acute sector, the average age has risen from 33 to 37.
Mr Day says in the past younger workers tended to opt to work flexibly and would take a permanent post later when they wanted career development opportunities. NHSP now offers managed programmes to cater for these people so they can continue to work flexibly while extending skills.
‘People want more from flexibility - they don’t just want a shift here and there,’ he explains. ‘They want training, they want support and the ability to set the agenda for when and how they work. That is a big change for us, a big change from 2005.’
As well as career development opportunities, staff working full-time for the organisation qualify for NHS pensions and statutory sickness benefits (see Fig 2).
Another benefit of NHSP is that workers have the opportunity to experience a variety of settings. This is something that appeals not only to full-time flexible workers but also to nurses with full-time jobs.
Nurses can test out a working environment by doing some shifts before making a firm decision to change direction and apply for a permanent post. It also gives them invaluable experience in that setting, which is an advantage when they do apply.
Mr Day explains: ‘We offer the opportunity for people to effectively go and taste new environments so, if you work in general medicine, we can offer supported development to go and work in A&E with trust support. People can try a new ward environment before they have to commit to it.’
This ‘try before you buy’ approach has advantages both for nurses, who still have their existing job, and the trust employing them as a bank nurse.
‘The trust has less risk because, if it does not work out, they have only got two or three shifts to worry about rather than somebody in the wrong job,’ Mr Day says.
He adds: ‘Although there are a huge number of people who rely on us as a career choice, there is another group of workers emerging who actually use NHS Professionals as a means to get extra skills or extra exposure in another environment in order to secure a full-time role. It’s a small group of people but it is increasing.’
For example, if someone applied for a job in A&E and was unsuccessful because another applicant had more experience, they could work some shifts in A&E through NHSP then try again.
Mr Day acknowledges that most trust managers still believe that the majority of bank workers are just doing a few additional shifts to earn extra money rather than pursuing a flexible career.
He says that to make the most of the workforce, employers need to improve what they offer flexible workers, including thinking beyond the usual three-shift pattern, because this format is not helpful for workers with children.
He says: ‘People say: “I really want flexibility as a career but what I would really like is a little bit of guarantee that you have got work available when I can work and I will commit myself to working that way with you”.’
Mr Day adds: ‘We are trying to get the idea of guaranteed flexibility, so that you have guaranteed work available when you have got the opportunity to work. That is the way in which we are encouraging our partner trusts to work now.’