Nurses of the Future: working flexibly, to achieve a healthy work-life balance

On March 2021, 12 months into the Covid pandemic there were some 681,527 nurses on the Nursing and Midwifery Council (NMC) permanent register. This was a rise of nearly 12,000 new registrations than the year previously. University data shows an increase of 32% in the number of applications for nursing degree places. However, right now, there are still 38,000 nurse vacancies across the NHS.

The last year has shown just what a vital role the profession has played in treating and caring for large numbers of some of the sickest patients many nurses will ever see in their lifetime. These nurses were often there to provide care, and be with, those patients who due to the restrictions, were on their own at the end of their lives. Some 16 months on, addressing the staggeringly high number of patients now on a waiting list for treatment continues to add pressure to an already exhausted workforce. Looking after the wellbeing of our staff has to be our highest priority.

Of course, during the pandemic it wasn’t just nurses who made a difference. For example, whilst I do want to come back to nurses in moment, last week I heard stories of the contribution cleaners made to keeping everyone safe. Many a time they were to be found undertaking deep cleans of clinical areas throughout the night. Managers too, often worked 14 hour days, 7 days a week keeping services going. There was a small army of volunteers, many who were retired health and care workers, but there were many folk too, who came to stand shoulder to shoulder with others in dealing with the challenges of the pandemic. 

Some interesting things emerged from addressing these challenges. Decision making became faster, agile working was introduced, and there was a step change in collaboration and partnership working. Technology came into its own, compassionate leadership came to the fore, and innovation was encouraged and fostered. Whilst there was a high degree of necessary flexibility in all areas to be seen, it was the commitment and sheer hard work of so many people that prevented the NHS from falling over. It certainly wasn’t political leadership that made a difference.  Sadly, no one back in March 2020 could have imagined that over a year later we would still be in a world challenged by the virus.  

Back to nurses. Last week I read the story of Gemma Dobson. In 2017, she was dismissed from her job as a community nurse by North Cumbria Integrated Care NHS Foundation Trust. The reason for her dismissal appears rather sad. The Trust had introduced a requirement for community nurses to work flexibly, which included working some weekends. Gemma found she couldn’t do so because of childcare commitments. Gemma had previously worked fixed shifts to make it easier to care for her 3 children, 2 of which have disabilities. Following her dismissal, Gemma took her case to an Employment Tribunal claiming unfair dismissal and indirect sex discrimination. She lost her case.

Last week, an Employment Appeal Tribunal took a look at the original decision to reject her claim of unfair dismissal, and found in her favour. I found the outcome very interesting, (you can read the full judgement here) and it has many implications for the future. The appeal tribunal found that Employment Tribunals must, in the future, where appropriate, take into account ‘childcare disparity’ into account when making a decision over unfair dismissal claims. Importantly, this ruling recognised that many women still bear a disproportionate responsibility for childcare than men. As such, women should not be penalised if they are unable to work flexibly because of these responsibilities. Gemma’s case will now go back to the Employment Tribunal for a reconsideration of her claim of unfair dismissal and indirect sex discrimination.

In fairness, I should perhaps point out that the North Cumbria Integrated Care NHS Foundation Trust was only formed in 2019, from two other hospitals coming together. I don’t know which of these Gemma worked for. Her case predates the formation of the current Trust. 

However, leaving the important judgement about ‘childcare disparity’ to one side, I do find it strange that there appeared to be so little recognition on the part of the Trust, over flexible working. Cumbria is a beautiful place; indeed, I was there yesterday walking in the hills. Although it may be beautiful, it can be an expensive place to live, and many parts of Cumbria are geographically remote. I imagine, (and of course I might be very wrong) that recruiting health care professionals could be very difficult.

Prior to the pandemic, other big employers like Tesco, Sainsburys and so on recognised the value of recruiting staff on a highly flexible basis, with hours that suited individuals. Many parts of the NHS have been slow to do so. The pandemic has shown us that as we transform future ways of working and providing health care, we need to also think more seriously about how employment practices might facilitate these changes. That said, I was heartened by reading on the North Cumbria Integrated Care web site, their absolute commitment to ‘reshape our workforce using innovative models, and value our staff by being a great place to work and embedding the right culture’. This is how we will ensure a healthy work-life balance is achieved, and happy staff mean happy patients.