The pandemic has forced the NHS to treat its staff more flexibly. Klara Morsley hopes the organisation will carry some of this learning forward

Over the past few months we have seen unprecedented levels of change in the NHS, at an unprecedented speed. Many of these changes have affected patient flow and experience, and the fundamental structure of how our hospitals and community services operate. But the pandemic has also had profound effects on how staff work and how the NHS manages its staff. 

The loss of informal and formal childcare and the recognition of vulnerable or shielding individuals has led to a change in roles and ways of working for many people. While there has been a lot of focus on the negatives of this, we must also recognise the positive impacts. The NHS has been forced to deal with staff flexibly, on an individual basis, in a way that it’s rarely done before. It has no longer been possible to run a top-down system, with unseen managers dictating working hours and days, with no appreciation of their staff’s individual circumstances. 

A frequent frustration among doctors with caring responsibilities has been the inflexibility of the systems we work within and the expectation that the onus is always on us to change our family’s routines to meet our employer’s demands. Yet in recent months, childcare responsibilities have meant that many people have needed to work flexibly—managing hours between partners or working from home with children present. In the absence of alternative options, and with reduced childcare hours available, parents have been forced to prioritise their families over work—and, more radically and importantly, the NHS has been forced to recognise and accept that. 

We would never have dreamt just a few months ago that it would be acceptable to attend hospital management meetings, albeit remotely, with a baby on your knee. Junior doctors are all used to working more hours than our rostered shifts, but with no family or friends able to pick up the caring pieces, routinely working those unpaid extra hours has been no longer possible for many. 

While juggling those responsibilities has undoubtedly been challenging and stressful, I’m hopeful that this change in our way of working can lead to improvements. With the rapid acquisition of remote access to hospital computer systems, some work can be done at times convenient to the individual, rather than in the arbitrarily dictated timetable of a “normal working day,” opening up new opportunities to those previously struggling to balance work and home. The possibility of working from home also means no commute, which can free up extra hours for an individual—hours that they can use to engage in self-care activities, spend time with their family, or even do some of those interesting work projects that are always displaced by more urgent business. 

Rota managers have had to adapt rotas to fit around staff’s individual needs, taking into account whether they are single parents or have key worker partners who also work shifts. The involvement of staff in those discussions leads to more satisfied and motivated employees, who feel empowered within their role, rather than simply an anonymous cog in the machine. 

Most big businesses have been offering flexible working for quite some time—and seen the benefits. Companies that offer this have been found to have less absenteeism, increased staff retention, increased productivity, better staff morale, and lower stress levels. Mothers in particular are more likely to go back to work after having children if the option of flexible working is there. It has even been found to cut costs for businesses. The NHS has been resolutely bringing up the rear in failing to offer similar ways of working.

Of course, healthcare will always have a significant need for staff to be on site, and not all work can be done flexibly. But the NHS has a responsibility to learn from the changes we have been forced to make, looking at how we can carry those positive effects forward and implement them in our new way of working. It is my hope that our management do not forget that staff are individuals, with families and responsibilities. It should be possible to change our work to suit this reality, rather than the other way round.

Klara Morsley is an ST6 registrar training less than full time in rheumatology and GIM in the Thames Valley deanery. She has three children and has been working from home for much of the covid-19 pandemic while she was pregnant with her third child.

Competing interests: None declared.