Creating a healthier economy: A rapid evidence review of inequalities in flexible working arrangements in the UK

Objectives Flexible working – the control people have over work scheduling to meet wellbeing needs – is one way to help create a healthier economy. We sought to identify and summarise evidence about inequalities in access to flexible working arrangements in the UK and implications for health and wellbeing to inform policy development. Study design Rapid evidence review Methods A rapid review of peer-reviewed articles and reports from trusted sources was completed on inequalities in access to UK flexible working arrangements to inform regional and local policy development. Published articles were identified through database searches (OVID-Embase, Scopus, Cochrane, Assia-Proquest) in September-October 2024. Data was extracted directly into a table and findings synthesised narratively by theme. Results Evidence identified was limited in detail, but consistent in reporting inequalities in access to flexible working by occupational status, with some evidence of inequalities by gender, disability, geography and ethnicity; with implications for health promotion. There was limited detail on specific health outcomes or pathways to impacts, though the significance of flexible working for women’s well-being and Disabled people was highlighted. Included evidence noted systemic issues in the UK economy (e.g. occupational hierarchies, gendered norms about caring, racism, disability discrimination, ‘ideal worker’ culture that values overwork, flexibility stigma) that contribute to flexible working inequalities. Conclusions Further research and multi-level policy action is needed to address flexible working inequalities to promote health. Research could usefully focus on intersectional inequality, including systemic societal processes (i.e. stigma, racism, discrimination) shaping flexible working in practice. Policy action could include: evaluating the implementation of existing flexible working legislation in relation to inequality; national-regional-local action to support inclusive business models in which the bargaining positions of employees around flexibility are more equalised (e.g. cooperatives); evaluation and strengthening of Fair Work Charters; and funding and showcasing of flexible working pilots focused on addressing unequal flexible working access.