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Call for harder line on flexible hours

Nurse managers should challenge their staff over shift times, a study shared exclusively with Nursing Times has found.

Research by the Institute for Employment Studies said senior nurses often lack the ability to “challenge custom and practice” in relation to requests for more convenient shift patterns, staggered start times and holiday bookings.

Flexible Nursing, commissioned by NHS Professionals, highlights the need for nurse managers to receive better training in order to create more flexible, productive workforces.

It says: “It is evident that the productivity agenda will dominate policy and practice over the next few years, and will place greater focus on the need to contain staff costs… and enable ‘smarter’ frontline working.”

This will involve “a likely roll back” of some flexibilities that are “seen as primarily existing for the employee and which have a real impact on raising overall staff costs and/or impacting negatively on the quality agenda”.

For example, the right to request flexible working and the fact that most nurses are women has led to strong calls in many trusts for term time working, short shifts and staggered start times.

This has created staffing gaps and a greater reliance on temporary staff, the report says.

It states: “Nursing managers who were unsure of the exact demand and pattern of work of their ward or specialty often acceded to the demands for this type of flexible working, without always having a clear understanding of the likely implications for service delivery.”

E-rostering could help trusts get to grips with activity and staffing data, allowing managers to think “more laterally and creatively” about the most efficient work hours and shift patterns.

NHS Professionals workforce strategist Jenny Hargrave said: “Many nurse managers would complain that they get ample clinical training but inadequate training to manage the roster.”

Trusts could invest in workforce planning training, training in rostering, gathering data on activity and seasonal trends and the productive ward series, she said.

The report also suggests organisations could share staff by creating “talent banks” of permanently employed nurses working across a range of care settings.

Ms Hargrave said: “This would reduce the likelihood of short notice, high cost solutions such as expensive agencies.”

Readers' comments (36)

  • Natalie Jewell

    In my experience flexible working cuts both ways. When I was working a 3 day week I was regularly hauled in on my day off to help with service delivery. I did this gladly because the Trust was flexible with me on other days when I needed their support.

    I have recently been encouraged to work term time only. This was suggested in terms of being helpful to me with childcare but was not something I had been seeking. When I said I could not afford to reduce my hours like this just at the moment I was put under pressure and told that the drop in pay is not that much. Now a manager may not save much on their budget by dropping my salary but even a small drop in my salary would make a big difference to me.

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  • "Hauled in" ??? Surely you were asked if you could go in and you went of your own volition??? This type of emotive langauge is a classic example of how nurses can't see the wood for the trees !!!

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  • In my experience in the Community flexible working does not exist!
    Work patterns have been changed to provide 24 hour service, a recent request for a half hour later start time has been rejected - core hours of work have to be met. But...... when workload demands or a patient is ill I have to stay over time and have been told it is my choice to work over therfore no time back is allowed! As a nurse I felt unable to leave an ill 94 year old man with no family awaiting ambulance transfer to Hospital so worked 2 hours over .... my choice or part of being a caring professional nurse?

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  • Flexibility has to work both ways. In my current position my managers try to accomodate any changes I may need so in turn I am willing to work extra shifts as I am able, to help meet targets. I think this is down to good working relationships and mutual respect and consideration. It's not rocket science and I am aware that this rarely happens.

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  • Flexible working in the NHS, Many wards I have been on, you have 2 options start at 7.30am or 12.30 for a day shift and 19.30 for a night shift. How is that flexible ?

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  • Flexible working must be viewed alongside tghe rest of the staff off duty. Where I work we have so many staff on a set off duty that the rest off the staff have to have off duty to fit round them. When our ward manager was challenged it was stated that she was not aware of the impact it has on the staff !?! Due to staff having a flexible working pattern this then leaves the rest of the staff with few options when there is a need to change shift at short notice for family/personal reasons.A better balance has to be found. It can be better to not have a staff meber starty later because you have to stop what you are doing to give a handover when a shift has already been planned.

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  • I totally agree with Natalie, this works both ways.

    On the one hand, trusts/managers can be ridiculously unfair in expecting Nurses to work 24/7 with too little turnaround between shifts. A late then an early then a late then a night shift? Not uncommon. Then add all the unpaid hours, untaken breaks, etc etc. Something has to give. We are not machines. We have to have a life away from work too.

    However on the other side of the coin, there are far too many people demanding 9 - 5 weekdays, no weekends, lots of time off and refusing to do holidays because they have kids etc. There are far too many people who assume because I for example do not have kids and am not married that I will work every single summer/Easter/Christmas/New Year to accomodate these people and work my shifts around them. No, this isn't fair either.

    What is needed is a middle ground. But I do not see this happening any time soon.

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  • Now I am a nurse manager and can see both sides of the agenda. The NHS positively encourages flexible working under the "Improving Working Lives Initiative" how it is very difficult to run a ward to look after the patients 24/7 when all the part-timers want weekends and nights (this means that they still have a reasonable wage), and they also want Christmas and New Year off. This means that the full timers have to work around them. However, saying that my staff are very good at coming in to help out when we are short of staff. I have a lot of pregnant staff on the ward at the moment and this is going to be a headache when they all want to come back on reduced hours (Child care is horrendously expensive, I do sympathise with them over this, but the service requires nurses 24/7).

    If the NHS wants Nurses on the shop floor so to speak it needs to have more nurseries that are open to fit around NHS staff, it is no good closing at 18:30 hrs when the staff don't finish until 21:30.

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  • Flexible hours! What's that???!!!@£$

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    wake up nurses wake up and join the 21st century. keep the values and care for your patients

    Sod the old tradition we need to look after our patients now ,they need us. fulfil our obligations to them ,take care of them,

    Nurses of today need support from the management they should work with together sort out the financial problems ,be a team. management and nurse how good is that ,the goal is patient care.

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  • Flexible working is a two-way street! Change one direction and you affect the way it works in the other direction. The danger for Trusts is that they will end up having to use more and more agency nurses, because they have lost the goodwill and flexibility of their employed nurses.

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  • I would love a contract to work only during the school holidays - thus job sharing with someone who only wants to work term time - I have yet to see a post advertised and have been told that I need to apply to work via an agency.

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  • custom and practice also constitutes part of working terms and conditions where a pattern has been established over time. This can be robustly challenged with union backing and retained. We don't have to roll over just because an opinionated, capitalist Insitute says we ought to.
    Maybe we should determine the quality of care we give by what people voted and therefore deserve to be on the receiving end of?

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  • Katherine Wilkinson-Carr | 28-Jul-2010 1:42 pm I absolutely agree.

    I also think that you raised another good point about maternity leave and childcare. Nursing is still predominantly female, but the sheer amount of staff who go off on mat leave (I know quite a few who went off months after getting a job) are causing absolute difficulties.

    It isn't that I don't think they should have mat leave, I do (although I think it unfair that males get less paternity leave). It's the sheer fact that the shortages that these people leave are not filled, therefore leaving the ward short staffed. Something needs to be done about this.

    Also what about rewarding those who choose not to have kids and work? Just a thought!

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  • Also I think bloody agencies should be banned completely! They are ripping off the NHS and paying us a lot less than what we should be on.

    Wouldn't it make more sense just to hire more Nurses in the first bloody place? A few more full timers per ward, plus staff hired on say 6 month contracts to cover shortages/mat leave would work so much better for all concerned!

    How about all the wards with significant mat leave or sickness hiring all the newly qualifieds who are struggling to get jobs on short 6 or 12 month contracts as required, paying them a full wage, giving them their preceptorship and experience, and allowing them to move on to another post fully qualified with a preceptorship? Rather than hiring agency Nurses or struggling with less staff!

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  • “Nursing managers who were unsure of the exact demand and pattern of work of their ward or specialty often acceded to the demands for this type of flexible working, without always having a clear understanding of the likely implications for service delivery.”

    A classic case of appointing managers without considering their abilities manage.

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  • I agree with Katherine. I have also been a nurse manager and can see both sides of the agenda.
    On one hand the NHS positively encourages flexible working under the "Improving Working Lives Initiative", yet on the other it is very difficult to run a unit to look after the patients 24/7 when all the part-timers want weekends and nights (this means that they still have a reasonable wage), and those with kids want weekends off and they also want Christmas and New Year off. This means that the full timers and those without kids have to work around them and lose out.
    I have had nurses demand that it is their right to have this. No actually when requesting flexible working hours it also has to fit in with the needs of the service. Some of these nurses seem forget that they are employed to look after patients.
    I have also had nurses stand there in front of me and say they should have priority over flexible working choices as they have children and others dont with a total disregard for their colleagues.
    Thankfully I have also mostly had wonderfully dedicated staff who will cover shortfalls and work as a team and as a manager.
    It also doesn't help when HR and more senior managers up the line baulk when the mention of unions is raised when those selfish minded staff push for their 'rights'. Dont they realise that most managers are happy to be flexible if they are. It's a two way street!
    I worked for an organisation who paid the price for largely employing people who dictated their own narrow working hours when it first went live and it caused years of staffing problems and took years of HR problems and threatened and actual industrial tribunals before they sorted it out.

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  • every ward or department has characters who will demand what they feel are their 'rights' to flexibile working patterns (which ironically sometimes end up as rigid for the department) around family, and in a civilised and considerate society and workplace that wouldn't be so unreasonable. Neither would management or colleagues feel the need to resort to moral and emotional blackmail to get what they either want or need, personally or service delivery wise.
    The fact that we are being squeezed yet again helps to ramp up the tone of response to being caught between a rock and a hard place, knowing that whatever you choose to do with what you've got will be damned.
    People going off on mat leave do not leave unfilled vacancies behind them giving everyone else a headache, management create that all on their own.
    Where the pound signs are bigger and louder than a good or even satisfactory clinical outcome or dare I say it, a patient having had a good healthcare experience, care will always come second.
    The finance is one issue and the interpersonal skills of staff and management are just as important in the mix.

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  • yes here we go again money is tight we are worrying about our jobs so what do we do attack each other. If a ward was staffed appropriately there would be room for part time, term time, full time and this manager of a well resourced team would know that the part time wont be part time for ever.And their adaptability will be rewarded with loyal staff supermarkets do it and they do it well may be they recognize they has to be a work life balance.

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  • Anon 6:55
    Im sorry but I dont understand what you are saying when you say you work part time and then work extra time upaid to fulfil your obligation?
    Can someone explain to me why?

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