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How to get the best out of flexible workers

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Flexible workers are a vital resource for the NHS. Victoria Hoban explains how to make the most of them

The relationship between flexible workers and permanent staff can be a difficult one. Ward staff may not relish accommodating workers who are unfamiliar with their systems, while flexible workers may struggle to feel included.

However, by giving time and thought to how flexible workers are deployed, an excellent working relationship can be established, benefiting everyone involved - including patients. After all, in today’s NHS, temporary staff are a necessary resource, so it makes sense to get the best from them.

How to get the best from flexible staff

• Provide thorough orientation - making time initially to orientate a flexible worker can save everyone time in the long run, as well as ensuring patient safety and increasing staff confidence. Ideally, offer induction shifts.

• Be welcoming - always say ‘Hello’ at the start of a shift and ‘Thank you’ at the end - and try not to automatically send the flexible worker for their break on their own or last.

• Use your Trust Liaison Coordinator - remember they are on site to address any issues you might have, including those around training or the booking process.

• Get involved in the NHSP interview process - all candidates are interviewed by a clinical staff member from their specialty. Getting involved in this will enable you to vet potential flexible workers and make your expectations clear.

• Be clear about what you need when booking - use the online booking system properly and be specific about the skills or level of experience you ideally want as well as what would be satisfactory if the ideal requirements cannot be met.

• Always double-check a flexible worker’s level of experience and skills on arrival - and never ask them to work outside their realm of competency.

• Forward-book flexible workers who have particularly impressed you - and invest in them by building a relationship and making them feel part of the team.

The first step is to ensure that bank workers receive proper orientation, covering matters such as ward layout, basic safety information and core duties, says Maria Nicholson, Head of Client Relations for NHS Professionals in London and Essex.

‘The NHSP online booking system enables you to see if the flexible worker you have booked is new to your area,’
she says.

‘If they are, welcome them by showing them where everything is and giving a proper handover.

‘However, the most important thing is to say “Hello” at the start of the shift and “Thank you for coming” at the end. It’s about making them feel part of the team.

‘Let them know where to get coffee and don’t automatically send them on a break on their own, or last. If you do this, they are far more likely to come back.’

NHSP enables trust staff to forward book requested workers. ‘This builds loyalty and means that they can become part of the team and will be more likely to help you out at short notice,’ Ms Nicholson points out.

It is also crucial to establish the skills and abilities of temporary staff to ensure that they are used efficiently and to safeguard patient care.

‘All NHSP staff are fully vetted to the highest standards and meet all requirements,’ Ms Nicholson stresses. ‘We provide a quality workforce, properly recruited. Patient safety is at the heart of everything we do.
She adds: ‘Workers are only assigned specific speciality codes if they have experience in that clinical area and can prove it - a CV alone is not enough. We carry out our own competency assessments to determine which codes are allocated.’

However, she stresses, it is the responsibility of the nurse booking the flexible worker to be specific about the skills needed, with the help of NHSP’s online booking system.

‘If you need something specific, such as someone trained in control and restraint or in giving IV drugs, make sure you specify that on the booking system.

‘When that worker arrives, you should then double-check. As ward manager or nurse in charge, it is still your responsibility to do that,’ Ms Nicholson points out.

When booking, if ward managers request an A&E nurse but state they could cope with a general nurse instead, Ms Nicholson cautions: ‘You must bear in mind that level of experience when allocating work to them and do so appropriately.’

None the less, it can be easy to focus on coping with a flexible worker’s limitations rather than uncovering and exploiting the wealth of experience that many possess.

‘NHSP does not recruit newly qualified nurses because we recognise the importance of preceptorship,’
Ms Nicholson emphasises. ‘The only exception to this is when a newly qualified nurse wants to work bank shifts solely in the area where she or he normally works.

‘Trust staff are often surprised at the range and level of experience that our flexible workers have, as am I. We offer a diverse workforce including RNs, team leaders, nurse managers, CPNs, health visitors, community nurses and care support workers.’

Chris Day, Director of Marketing and Communications at the special health authority, points out that its annual survey shows the average age of flexible workers has increased to the late 30s, bringing with it greater experience.

He believes that trust employees often limit the value they obtain from a flexible worker - both financial and practical - by hiring them for set shifts.

‘Sometimes, an extra pair of hands for an entire early, late, long-day or night shift doesn’t actually give you what you really need, when you really need it - and patients’ needs don’t necessarily match that pattern either,’ he says.
For example, a 7am start may not suit many flexible workers. So, if the clinical area becomes busy at 8am, they could be booked for a later start. Conversely, other workers may be happy to work an extra long night shift to help cover handover periods.

Above all, the best way to make the most of flexible workers is through good communication, Ms Nicholson says. ‘If they are not doing something right, tell them, just as you would a new permanent member of staff. Five minutes of explanation can make all the difference.’

She urges trust staff to remember that flexible workers are no different from their own employees, and the benefits of building a good working relationship with them can be just as valuable.

‘Remember,’ she says, ‘that flexible worker could be your future permanent staff member.’

Case Study: Peter James

Peter James, senior charge nurse at Worcestershire Acute Hospitals NHS Trust, regularly books flexible staff through NHS Professionals and arranges induction days to orientate new NHSP workers to the directorate.

‘We have booked a number of new faces from NHSP recently - all the nurses are excellent and work hard. But you can’t bring someone onto the ward and expect them to just run with it,’ he says.

‘Our induction shifts mean that flexible workers are expected to spend a minimum of four hours working an induction shift - although ideally they will do one early shift and one late shift.

‘All new starters are given an induction sheet to orientate them into the wards. They buddy up with an experienced flexible worker and work through the sheet with them.

‘It’s a very good system. We get a free shift but flexible staff also find it helpful - they have the comfort of a buddy and limited responsibilities so they are not intimidated by that “first shift”.’

However, Mr James stresses that orientation should not stop after that. ‘You need to nurture the relationship between your staff and the flexible workers. It is little things like being pleased to see them and monitoring how they are working alongside colleagues that promote harmony between all the staff,’ he says.

‘When I see a new name appear a few times, I come to the ward and introduce myself. It’s important to present a friendly face and show that people in authority are approachable. It also means that patients get the best treatment.

‘The Trust Liaison Coordinator is on site four days a week - if there are any problems, we can ring her. She also addresses training or other issues.’

An example of this has been negotiating the need for flexible workers to move to another ward within the same directorate on arrival if required.

‘If it transpired there was a greater need on another ward, I would expect a flexible worker to move. However, in the past regular flexible staff liked to pick their wards and moving them became difficult,’ says Mr James.

‘Having discussed the issue with NHSP, we now make sure that issue is part of the interview process. Once flexible workers are aware up front of what is expected, they are very good at responding to the trust’s needs.’



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