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Top tips for working flexibly

The traditional route of full-time clinical training with direct progression to a full-time consultant post may not work for everyone. Top tips for physicians at different stages of their career and advice on discussing flexible working with their employers are provided below.

For all

For trainees

For consultants

When negotiating job plans with organisations:

  • ensure a minimum of 25% (England and Northern Ireland) and 30% (Wales) SPAs for a typical full-time post
  • use 6-month trials of new work patterns
  • use e-job planning


  • Drive change by role modelling flexible working and supporting clear lines of responsibility, good handover practice, leaving on time.
  • Support portfolio careers. The RCP Medicine Jobs website has clinical and other opportunities for physicians.

For those considering retirement

Have a discussion at the age of 55 to: plan the next 10 years, use departmental job planning, look at complementary roles.[1] Succession planning and appointment of a successor will take longer than expected.

For those who have left

Suggestions for discussions with your employer

1. Reinforce that your champion of flexible working should have protected time to fulfil the role and should:

  • have a presence at inductions
  • email all, not just those working LTFT, to introduce themselves
  • have a good working relationship with Human Resources, the directors of medical education and the guardian of safe working.

2. Refer them to NHS Employers resources on flexible working

3. Ask whether they will offer pre-earned ‘sabbatical’ leave. For example: 1 extra DDC, per month, for 5 years resulting in an 8-week period of extra paid leave.

4. Ask if they will support career exchanges: The RCP offers the opportunity to spend some time with another RCP fellow in a different trust or other part of the worldwide network of RCP fellows; suggestion is to use 2 weeks of study leave.

5. Suggest they could support portfolio careers by setting up a jobs board with opportunities for healthcare professionals outside of the trust.

6. Ask if they will ‘keep the door open’. NHS employees can have an unpaid employment break for 3 months every 5 years. Your employer should be supportive and aim to retain employees who would otherwise leave permanently.

7. Encourage support and creativity in the adjustments, or redeployment, options for doctors with changes in their health to retain their skills.

8. Ask if they will support flexible retirement options

Suggestions for discussing flexible working at appraisal

  • Trusts’ needs should be ignored for the first 30 minutes and you (the appraisee) should be allowed to guide conversation.
  • Discuss your personal and professional objectives over the next year.
  • Think about how your talents can be used best within your organisation.
  • Discuss how the service can be improved and what is done well and badly.

And finally...

  • One size does not fit all; the take it or leave it policy from employers does not work.
  • Shared parental leave should be available for all, including SAS doctors.
  • Employers should support initiatives to prevent burnout, such as pre-earned leave and career exchanges with international colleagues.
  • Suggest step-on, step-off training routes.
  • Employers should support doctors with ill health through creating ‘ill health retirement’ policy that supports doctors who could later return to work and that does not penalise them.

Ensure that your work schedule enables you to be: well; healthy; effective in your work and able to sustain your contribution to high-quality patient care.[1]


  1. Royal College of Physicians. Later careers: Stemming the drain of expertise and skills from the profession. London: RCP, 2018. www.rcplondon.ac.uk/projects/outputs/later-careers-stemming-drain-expert... (Accessed December 2019)
  2. General Medical Council. Caring for doctors, caring for patients. How to transform UK healthcare environments to support doctors and medical students to care for patients. https://www.gmc-uk.org/-/media/documents/caring-for-doctors-caring-for-p... (Accessed 23 January 2020)