Improving flexible working in the NHS

  1. gareth lacobucciassistant news editor
  1. The BMJ, London, UK
  2. [email protected]

Flexible working is still too often inflexible on the NHS. gareth lacobucci reports on the problem and how the health service should address it

At the 2023 Nuffield Trust summit in early March, the bmj organized a panel discussion to examine the NHS’s institutional intolerance of 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 panelists

  • Rachel Hutchings: Member of the Nuffield Trust and co-author of the report future proofwhich explored the impact of parental and caregiving responsibilities on surgical careers

  • Farzana Hussain: GP in Newham, East London

  • Thea Stein – Chief Executive of the Leeds Community Healthcare Trust and Trustee of the Nuffield Trust

  • Sarah Sweeney: Interim CEO of National Voices, a coalition of health and care charities

Where is the NHS going wrong on flexible working?


Panelist Rachel Hutchings, a member of the Nuffield Trust and co-author of a report on the challenges of combining a career in surgery with parenting,12 started the discussion. She said that although the surgery had a particular problem with inflexibility, the “negative culture” around working less than full-time that she and her 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 about flexible work, she said.

Employers often don’t give people enough information about flexible working in terms of what they can request and what they might be entitled to, he added. “People feel that if they ask for something like a modified work pattern during pregnancy, for example, they will be perceived as weak (and) unable to do their job,” she said.

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


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