Moving towards a four-day working week across the NHS could help tackle burnout and stem the exodus of exhausted health workers, campaigners argue in a new report.
The 4 Day Week Campaign, which recently oversaw a successful pilot involving more than 60 companies, is now urging public sector employers to experiment with a shorter working week.
“This year is the 75th birthday of the NHS. The government should mark this occasion by delivering a comprehensive workforce strategy that places work-time reduction at its core,” the report says.
The 12-hour shifts that are the norm across much of the health service are worked only by 14% of nurses across Europe, according to research highlighted in the report – most of them in the UK, Ireland or Poland.
In the short term, the campaign is calling for a pilot within the NHS of a 32-hour week, without a reduction in pay.
“As the NHS is a 24/7 environment, it is likely that some additional staff will be needed to cover the hours across the week. There will be a cost involved to train, recruit, onboard and pay these additional employees, and it will require a strategically managed rollout,” the report says.
“However, these additional costs must be measured alongside anticipated cost savings that will be made through reduced absenteeism, reduced reliance on more expensive agency staff and all-round improved job retention.”
Companies participating in the recent pilot reported reduced sickness rates and staff turnover during the trial, as well as lower levels of burnout.
Many NHS workers already work flexibly, but proponents of a four-day week argue that it is a way of ensuring the benefits of technology and innovative working practices trickle down to staff.
The report suggests better use of technology could help to free up some staff time. “Data collection, processing, and other bureaucratic tasks such as appointment scheduling and prescription management take up a considerable amount of working time but have the potential to be automated to some degree,” it says.
The report argues that NHS bosses should “lay out a clear pathway across five, 10, and 20-year horizons to have achieved a meaningful work-time reduction target well ahead of the centenary of the NHS in 2048”.
The proposal is backed by Prof John Ashton, a former president of the Faculty of Public Health, who said a shorter working week in the NHS could “reduce sickness absence and improve morale, which would improve the quality of what people are doing when they are working”.
Leaked projections from the government’s long-awaited workforce plan for the NHS suggest it could be short of 571,000 workers by 2036 unless current trends are reversed.
Analysing data from recent NHS staff surveys, the new report shows a growing proportion of those leaving are citing work-life balance as the reason. Almost half of NHS staff – 47% – said they had felt unwell as a result of work-related stress at some point in 2021, up from 29% in 2010.
Hundreds of thousands of NHS staff are being balloted on an enhanced pay offer after months of strikes that underlined staff shortages and rock bottom morale.
The Trades Union Congress (TUC) general secretary, Paul Nowak, said that “staff burnout is a huge problem in the NHS and has directly contributed to the recruitment and retention crisis”, adding: “The TUC has called for advances in technology to pave the way for a shorter working week. In the immediate term we need a proper, fully funded NHS and social care workforce strategy.”
The workforce plan for the NHS is believed to have been sent to ministers, but it is unclear whether the Treasury is willing to set aside additional funding to pay for training and retaining tens of thousands of extra health workers.
When he was chair of the Commons health and social care select committee, Jeremy Hunt – now the chancellor – was a firm advocate of a workforce strategy, but the Treasury has been reluctant to find additional money to fund the NHS pay offer.
