Leading an Agile Workforce in the NHS: Professional Intimacy as a key resource for leaders to support effectiveness and well-being in agile working

Emma Russell, Zahira Jaser and Jay McCloskey (2022)

Agile working is a liberation from traditional structures and patterns of work time, place and roles, to effectively meet organisational and personal goals using innovative and digital resources. Moving towards a culture of agile working is a central goal for the NHS as it executes its 2020 People Plan. Since March 2020, a wholescale mass testing of the agile working premise was operationalised across the NHS, as the Covid-19 pandemic necessitated workers changing when, how and where they worked, in response to rapidly changing priorities.

To manage an agile workforce, it is clear that NHS leaders are facing a range of new challenges as they attempt to empower, oversee and inspire distributed teams, provide appropriate work tools and infrastructure, plan and strategize, and engender a spirit of open communication, growth and collaboration. The recently published Messenger report (2022) indicates that in this new era of agile working, leaders need to apply a team-centric approach, to address the individual needs of their diverse and dispersed workforce. To do this effectively leaders need to be trained in and equipped with the knowledge and skills to lead with compassion and commitment. However, there is a notable lack of systematic information available that tells leaders what the resource needs of agile workers are. If leaders do not know what their agile workforces require to be effective, then they will be unable to respond to, provide for and nurture their teams. In this research study, we therefore ask the timely question “What is required to effectively lead an agile workforce in the NHS?”

To address this question, we undertook a qualitative research programme, which investigated: (i) what the resource and leadership needs of agile workers in the NHS are; (ii) what behaviours and characteristics typify effective agile leaders in the NHS; (iii) what support is required for agile leaders in the NHS to be effective; and, (iv) what recommendations could be implemented to enable effective leadership and meet agile workers’ resource needs. The study was undertaken between October 2021 and March 2022 and received Health Research Authority approval (IRAS: 293851). Interviews were held with 32 NHS employees from five South-East Trusts and a range of different occupations and pay bands. This was interpreted alongside organisation documents and the first author’s contextual knowledge. Data was analysed using reflexive thematic analysis and revealed that “Professional Intimacy” (PI) is a key resource for developing, supporting and managing an effective agile workforce within the NHS. PI is an interpersonal resource that allows workers to feel heard, acknowledged, appreciated and cared for. In this research, Participants reported that when leaders had PI with their teams reciprocal trust, a sense of camaraderie and dedication, empathy and compassion were enjoyed. When PI was reported to be absent, workers reported issues with lower well-being, mental health difficulties, a sense of isolation, and intentions to quit. Participants’ experiences of PI were represented by four broad themes: (1) Defining and expressing PI; (2) How leaders foster PI in agile working; (3) Barriers and paradoxes in developing and sustaining PI in agile working and (4) the “dark side” of PI. Each theme (and respective sub-themes) is described in detail in this report, with illustrative quotes from participants.

Overall, this research provides rich insights into NHS workers’ experiences of agile working. Work has changed for many, and new skills and resources are now required to effectively lead the NHS’s burgeoning agile workforce. Against this backdrop, PI appears to be a significant and important resource to foster a sense of belonging, shared responsibility and respect. Yet PI can be difficult to achieve, especially at times when leaders’ own resources, time and capacity are already stretched thin. As such, we end this report by providing recommendations for leaders to help them to develop and sustain PI with their workforces and teams. Additionally, we outline what support leaders will likely need to do this effectively. Finally, we end with some cautionary notes on how to interpret and implement our findings.

Share this: