Over the past five years, around 43,000 nurses have left the NHS.
My decision to train as a nurse 20 years ago was driven by a fierce desire to help and care for those most in need. That hasn’t changed. But since I first put on a set of scrubs, I have watched nursing as a profession alter beyond recognition.
I’ve sadly seen countless colleagues forced out of the careers they love by a lack of flexibility and soaring levels of burnout. However, I’ve also seen how flexible working – when implemented effectively – can easily help this crisis be resolved.
Rigid rotas, relentless 12-hour shifts and a lack of control over how and when these are assigned are currently making it impossible for many nurses to manage the demands of work alongside home life. Studies show these factors are leading them down a well-trodden path to burnout.
Left untended, this burnout is costing us a generation of talented nursing staff, and intensifying the pressures left on those who remain. Over the past five years, around 43,000 nurses have left the NHS, and more than two-thirds of those leaving were under the age of 45. Burnout – alongside a lack of work-life balance – repeatedly tops the reasons given for their departure.
This is not simply a product of the pandemic. Long before Covid came along, inflexibility and lack of choice over shift patterns underpinned nursing careers in the UK.
I discovered this first-hand towards the very beginning of my own career. Having travelled abroad to work for five years in Australia, I was struck upon my return to the NHS by the stark difference in workplace flexibility and support.
Down under, I’d been working at a healthcare organisation where staff were empowered to have a say in how and when their shifts were scheduled. Work could be organised in a way that accommodated external commitments such as childcare and professional development. In contrast, when I returned to the NHS I ended up facing more inconsistent, rigid shift patterns that left me powerless to maintain a healthy work-life balance.
For some nurses, working long shifts over a shorter number of days, and having the rest of the week off, works. For others, a more traditional 5-day shift pattern is needed to fit with their external commitments and needs. But the NHS’s one-size-fits-all approach to rota coordination means we’re constantly forced to retrofit our lives to incompatible shift patterns and sacrifice control over our home lives and wellbeing.
When I had my daughter, this became impossible to sustain. I moved to an agency as a temporary worker so that I could pick my own shifts and so that my husband and I could balance childcare while both continuing to work. This level of flexibility helped, but agency work wasn’t a viable solution for my family long-term. I wanted the same freedom and choice in my shift patterns, but with the security of being employed by an NHS Trust.
Soon after, the chance arose for me to join a pioneering NHS digital staff bank at St Helens and Whiston Hospitals. I leapt at the opportunity. As part of the staff bank – which enables the Trust to easily broadcast available shifts to its own pool of approved temporary workers – I was able to view and select available shifts that worked for me using an app called Patchwork Health. This enabled me to plan my shifts around our childcare needs, while accessing the benefits of being employed directly by a Trust, such as accumulating leave entitlement and building up my NHS pension.
Meanwhile, the staff bank supports the Trust itself to more easily source staff from its own internal pool of approved nurses to fill staffing gaps – without having to rely on more costly agencies. They can plan staffing more sustainably, keeping wards safely staffed, while giving me and my colleagues the level of flexibility we so desperately need to remain in our roles.
Now our daughter is grown up and our childcare needs are not as demanding, I have been able to take a full time job to enhance and develop my career. In this new job I have a fixed working week which suits our life and enables me to still pick up shifts as and when I desire through Patchwork Health.
Despite the commitments to flexible working laid out in the latest NHS People Plan, for so many of my colleagues at other ICBs across the UK, access to genuine flexibility like this still does not exist. And they are voting with their feet.
To turn the tide on the nursing exodus and boost long-term retention, ICBs must acknowledge that one size does not fit all. Flexibility is essential to nurturing a sustainable, happy and healthy nursing workforce. And this does not have to come at the expense of maintaining safe staffing levels or meeting patient demand. Quite the opposite: deploying innovative, flexible working tools – like digital staff banks – can support Trusts to unlock true flexibility for their employees while making it easier to fill staffing gaps and keep wards safely staffed.
Nurses join the NHS to care for and support those in need. But without the right flexibility and support to help us work healthily and sustainably, too many of us are left with no choice but to leave. Flexible working is possible in the NHS, and it’s mutually beneficial for the ICBs deploying it. For nursing to have a sustainable future, it must – and absolutely can – be flexible.