NHS ConfedExpo 2023 Conference Keynotes

Panel session: Taking a flexible approach to 'one workforce'

As the largest provider of flexible workers to the NHS, NHS Professionals proudly hosted an expert panel session with a large audience of health and care professionals at the ConfedExpo in June 2023.

The session explored how flexibility and the flexible workforce play a key role in helping the NHS optimise the ‘total’ people talent across health and care systems, especially in times of high demand and workforce shortages.

Here we summarise the session’s key points including comments from members of our expert panel:

Dean Royles (Chair), Strategic Workforce Consultant, past President of the Healthcare People Management Association and former Chief Executive of NHS Employers

Karen Bonner, Chief Nurse and Director of Infection Prevention and Control, Buckingham Healthcare NHS Trust

Paul Renshaw, Executive Director of Workforce, NHS Devon

Nicola McQueen, Chief Executive Officer, NHS Professionals

 

Theme one: changing the perception of staff banks

Banks have long been part of the workforce mix and they can be used effectively across the NHS, commonly to plug a staff gap or as an overtime mechanism for substantive staff.

However, panel chair Dean Royles suggested there can be an underlying perception that banks and bank staff can be viewed as a reactive ‘distress purchase’ measure in times of need, rather than as a positive and essential component of ‘one workforce’. Times have changed and we need to see the contingent workforce as having the same value as substantively employed, he said.

Nicola McQueen said there was a misconception that people use bank just as a ‘top up’ mechanism only when needed. However, an increasing number of NHS Professionals bank members are ‘career flexible workers’ who work between 30 and 50 hours a week fully flexibly as their main career choice, specifically because it gives them more control, she said. In fact, the NHS Professionals bank delivers the equivalent of 100,000 FTEs across the NHS, making flexible workers a key part of ‘one workforce’ who need to be recognised for their important contribution.

Nicola said: “Flexible staff tell us they want to be listened to and have a vehicle to get their voice heard, such as the NHS Professionals bank. We need to change the perception of ‘bank’ workers and do more to really open up the opportunities that exist to engage flexible staff.”

Karen Bonner agreed that bank staff can be treated like a ‘top-up’ and feel excluded as a result. She said staff recognition and award schemes aimed largely at the full-time workforce should be extended to flexible workers, adding:

“Organisations need flexible work and temporary staffing, so we should be celebrating these essential people in the same way as substantive staff.” 

Paul Renshaw highlighted the importance of bank staff for NHS Devon but agreed there was room for improvement. He said one risk was that those working flexibly on the bank suffered an unfair reputation as lacking commitment and ambition. However, this needed to change for three reasons:

• The younger workforce now demand flexibility as a way of working
• Flexible working will become more important as people work into older age and look for different ways to stay in the workforce
• The nature of healthcare service delivery requires flexibility to operate efficiently

Paul pointed to work between NHS Devon and NHS Professionals to develop a collaborative bank solution across the Devon ICS – bringing together all staffing groups and driving down agency spend across the county. The wider use of bank helps staff to self-roster around their busy lives, leading to improvements in shift fill and retention, and reduced absenteeism rates.

He added: “Portfolio careers are here to stay and banks are a vehicle to attract talent who want this as an option as they move through their careers.”

A later question from the audience also prompted a discussion around the term ‘bank’ and its potentially confusing connotations with finance; alternatives such as career flexible worker or the flexible workforce were suggested as better alternatives.

Nicola McQueen highlighted research from NHS Professionals showing that younger bank members want a career pathway as well as flexibility, while more experienced members may look for variety in terms of skills and locations. There was also potential to bring more former frontline workers ‘back in’ to different roles.

The research suggested that training opportunities – beyond statutory and mandatory - are a key motivator in the flexible workforce above pay. Opening up access to longer-term work with advance shift bookings and more self-rostering can be strong motivators for the flexible workforce, Nicola said. Changes like this can provide assured work for months ahead, benefiting both the individual and the place or system in which they work.

She added: “Bank and flexible working in general is appropriate for all stages of careers. There is a changing narrative around the sentiment for flexible working, and the growth in bank working as a career option will improve access to people who want to work flexibly.”

 

Theme two: leading by example and a pro-flexible culture

Responding to a question from the audience about ways to overcome any middle management resistance to flexible working, Karen Bonner said leaders needed to understand the value of working differently. This involved looking at how teams feel when someone requests flexible work and managing any resentment by role-modelling flexible ways of working themselves. Karen said it was also about engaging flexible workers more broadly and embracing requests to move around a ‘place’ so they feel part of something bigger like a care system or profession, rather than being aligned to just one organisation or department.

“Being a professional in a system has the opportunity to be much more appealing and can support a sense of belonging. It’s not just the place you work in that’s important,” Karen said.

Paul Renshaw agreed there were opportunities to flex roles and workplaces within a larger system – for example, in his patch Devon - and encouraged senior leaders to think about how they could work more flexibly and inspire pro-flexible workplace cultures. Leaders needed to build teams and systems that created a better balance and the time to work differently.

He said: “The attitude to flexibility starts at the top…the NHS will continue to have a demand for people and making flexible work attractive and rewarding will help, as it continues to be hard to find and afford the right people.”

A pro-flexible workforce culture was also about ‘sweating the small stuff’, said Nicola McQueen. This meant attention to details like meeting and greeting flexible staff, showing them around unfamiliar wards and workplaces, and remembering basics such as where to find toilets and refreshments. Flexible staff valued these details highly because they help to create a sense of inclusion and belonging, said Nicola.

She also highlighted collaborative work during the pandemic where staff were deployed across systems wherever the patients were, and worked with some patients remotely. Options like allocating duties ‘on arrival’ can give Trusts and staff more flexibility to match available people to areas of need both locally and system-wide, and support a cultural shift towards increased flexible working.

“There are pockets of good practice at the moment, but we should adopt these ways of working again more widely…Bank, substantive and agency are all part of the same workforce and delivering for patients,” Nicola said.

Karen Bonner observed that people who choose to work flexibly are often very representative of diverse communities. Leaders should therefore approach the issue of belonging for all staff, including flexible, ‘with intention’.

Karen said: “We need to find a way to bring forward this sense of belonging for all our colleagues. Leaders must use this intention not just to empathise with the different situation for flexible workers but look for ways to alleviate issues. Flexible staff should not have to just fit in; they should be able to bring their true selves to work and be valued in their role as providing temporary work.”

 

Theme three: making use of technology and AI

A final theme of the panel session centred on the role of technology and AI in optimising workforce. Nicola McQueen pointed out that people are willing to work virtually, as some did for Test and Trace during the pandemic when technology enabled working with patients remotely.

She said training was important to help staff prepare for using more digital approaches in healthcare, such as onboarding and electronic patient records, adding: “We need to ensure our professionals feel more like digital natives in the workforce.”

Paul Renshaw said wearable technology was already being used in the NHS and it offered the potential to be also used in community and social care settings, allowing district nurses to support more people at home.

Karen Bonner felt there was an opportunity to use AI and technology to reduce ‘excessive pressure’ on the workforce – for example, using technology to handle administration so that clinicians can focus more on person-centred care.

She said: “It’s about finding a better balance between paperwork and the personal touch in care.”