Intended for healthcare professionals


Improving flexible working in the NHS

BMJ 2023; 380 doi: (Published 23 March 2023) Cite this as: BMJ 2023;380:p618
  1. Gareth Iacobucci, assistant news editor
  1. The BMJ, London, UK

Flexible working is still too often inflexible in the NHS. Gareth Iacobucci reports on the problem and how the health service needs to tackle it

At the Nuffield Trust’s 2023 summit in early March, The BMJ hosted a roundtable discussion examining the NHS’s institutional intolerance towards flexible working. Participants discussed the damaging effect this is having on retention and what the service needs to do to become a truly flexible employer.

The panellists

  • Rachel Hutchings: fellow at the Nuffield Trust, and co-author of the report Future Proof, which explored the impact of parental and caring responsibilities on surgical careers

  • Farzana Hussain: GP in Newham, east London

  • Thea Stein: chief executive of Leeds Community Healthcare Trust and trustee of the Nuffield Trust

  • Sarah Sweeney: interim chief executive of National Voices, a coalition of health and care charities

Where is the NHS going wrong on flexible working?


Panellist Rachel Hutchings, a fellow at the Nuffield Trust and co-author of a report on the challenges of combining a career in surgery with parenting,12 kicked off the discussion. She said that although surgery had a particular problem with inflexibility, the “negative culture” around working less than full time that she and colleagues documented also exists more generally in the NHS. Perceptions that people who work less than full time are “less dedicated or less committed to their career” often permeate conversations around flexible working, she said.

Employers often fail to provide sufficient information to people about flexible working in terms of what they can request and what they might be entitled to, she added. “People feel that if they ask for something like an amended working pattern during pregnancy, for example, they will be perceived as weak [and] unable to do their job,” she said.

“I think that’s just really shocking. We shouldn’t have a situation where people aren’t asking for things …

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