Quality Matters: Flexible working in the NHS

Published as part of our Quality Matters magazine


Although flexible working is a less structured way of working, bank jobs within the NHS still require a standard of professionalism because of the nature of working in a hospital setting. This is true for admin and clerical bank jobs as well as HCA’s and nursing.

“Every patient, nurse and care facility are different, so providing the right nursing care for patients is not simply a matter of applying standard nurse to patient ratios. The skill of the nurse, the complexity of the patient’s needs, and the physical environment of care will all influence nursing requirements”




How flexible should a bank member be?

When you choose to work a shift or assignment, the arrangement between the trust and NHS Professionals is that you will then work that particular shift or assignment.

As you will know, trusts have to manage an ever-changing set of demands to deliver services that are consistently safe and of high quality. Sometimes to meet clinical needs and where demand is most, the trust will make short term, highly responsive decisions. This may mean that a bank member will be required to move to a different ward/area than the one they were originally assigned to meet pressing patient needs – being flexible. The NHS Professionals Code of Behaviour for bank members puts it this way –“Move to a different area during your assignment if asked to do so by the Trust due to patient need, making the Trust aware if you are concerned that you may not be competent to work in the new area.”

Workers who refuse to move, against the best interests of patients, are likely to be in breach of the NHS Professionals Code of Behaviour. This means that they are potentially subject to disciplinary action. Where the bank member is a registrant of a professional regulatory body, such as the Nursing and Midwifery Council (NMC), it is likely that a refusal to act in the patients’ best interests will also be a breach of the professional code of that body. NHSP may then consider making a referral to the appropriate body for a breach of professional conduct.

However, most of our bank members will readily move to a different clinical area in such circumstances, recognising patient need as the priority. They will also recognise that, as a temporary member of the team, they are frequently the most appropriate person to move to another area.


What if there is a change requested due to non-direct patient care reasons?

Where a booked assignment reasonably involves movement to other areas for short periods such as providing cover for meal or other breaks, or where the bank member escorts a patient to another department for tests or treatment – then NHS Professionals supports this and expects its bank members to undertake such moves as part of the assignment.


What are the trusts responsibilities?

The trust should establish whether the bank member has the appropriate skills and training to work in the different area and to undertake the new role competently. If this is not the case, then the trust is expected to provide the necessary supervision and support during the assignment. In the first instance the bank member should discuss with the nurse in charge if they have any concerns about their competency to work in the new area. Equally, if the bank member has not worked in the area before, then a full induction should be requested at the earliest possible opportunity. It is important to remember that if the bank member is moved to a new area where a handover has already taken place, then they must request a handover from the nurse in charge. NHS Professionals recommends that whoever is making the request for a bank member to move should also check with NHSP and the bank member concerned, to see if they are not excluded from a specific area for any particular reason.


What is NHS Professionals position and role in this?

It’s important to know that NHSP does not consider it acceptable for a trust to knowingly book an extra bank member to an area, having the intention of asking that bank member to then move to another area. There are areas for assignments which are sometimes known to be difficult to fill or are unpopular due to location and so on. NHS Professionals monitors this in its ongoing liaison with trusts and raises it as an issue if any pattern begins to emerge. NHS Professionals will always look at each case individually and examine the merits of both the request and any refusal. It has also prepared a position statement in order to clarify its view which incorporates the information here and is made available to all Trusts. If a bank member is asked to move to a different clinical area for the majority of the period for which the bank member was engaged, then NHS Professionals considers this to be a change of assignment. If the assignment is changed in this way, the NHS Professionals Service Centre must be informed and the bank member’s eTimesheet amended and authorised appropriately to delays in processing and payment.


What if flexible means moving to a different site/location?

A trust must be reasonable in its approach to moving an assignment to a different location. For example, community and mental health services are usually spread over wide geographical areas so there may well be occasions where a bank member is asked to go to a different site. It is expected that the Trust will only make such a request for transfer within a reasonable travelling distance, and that transport to the new site will be provided.


What if a bank member refuses to move to another area or site?

Where a bank member refuses to move to a different site for reasons such as; having to travel an unreasonable distance, not being provided with transport or that going to work at another site would have a negative impact on their carer or dependent responsibilities – then that case will be managed by NHSP on an individual basis.

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