Which Shift Pattern Should Your Healthcare Business Use?How to ensure round the clock care without harming your employees

With the COVID-19 pandemic straining the healthcare industry more than ever, the increased needs of your customers, service users, or patients will put added pressure on your workforce.

To ensure workers are focused, well rested and motivated, while still maintaining 24/7 coverage for your business, choosing the correct shift pattern is pivotal in managing workload and avoiding burnout in a high stress industry.

But in a world where more is demanded from a healthcare business than ever before, what shift pattern is the right one to use?

Common shift patterns in the healthcare industry

2-3 consecutive 12 hour shifts

One of the most common shift patterns in healthcare is the 12 hour working shift taken back to back in consecutive days, with the incentive for the worker being a shorter working week and two to five days off. Usually, this is split into day and night shifts, with workers rotating every few weeks between the two.

1st, 2nd and 3rd shifts

Another common shift pattern is the shorter 8 hour day, with three shifts covering the full 24/7 period.

For example, your 1st shift could be between 8am and 4pm, 2nd shift between 4pm and 12am, and 3rd shift between 11pm and 9am, ensuring there is sufficient overlap between shifts so there is no drop in coverage. Typically, the night shift would be longer as demand on the staff would be reduced.

Split shifts

This shift pattern would split a worker’s day in to two or more working periods, giving staff time to rest during quiet periods. For example, a worker may start at 7am and work through to 1pm, then break and resume the rest of their shift at 4pm working until 10pm.

Split shifts should generally be avoided wherever possible, due to the added strain and disruption caused to worker’s home and social life. If unavoidable due to higher demand or absence of other workers, ensure catering and rest facilities are available to allow staff to get sufficient rest and replenishment.

Variable shifts

A common alternative to the classic shift patterns are more variable shifts, in which a worker may cover the entire 24 hour period in the week. For example, an individual may work 7pm to 7am Monday, 11am to 11pm Wednesday, and 3pm to 3am on Friday.

The advantages to this would be allowing the worker to get to grips with the job at all hours of the day and night, reducing complacency and increasing staff engagement with the role.

It would, however, create a far more complex working schedule for your business, to ensure coverage at all hours while still giving sufficient rest between shifts for your workers.

Considerations for optimal performance


A 2016 report noted that between 30-70% of nurses sleep less than six hours before their shift, while a 2018 study in America ranked healthcare support occupations second in the industry for sleep deprivation, with 45% of all workers reporting a lack of sleep.

In the UK, meanwhile, the outbreak of COVID-19 has seen rates of sleep loss among health and social care workers double to 36%.

Whatever the demands of your healthcare business, with demands on workers being greater than ever before, minimising a drop in performance by giving enough time off to rest is essential.

Shift length and timings

Long shifts have been shown to impact on the stress levels and overall well being of workers, with nurses reporting almost three times as many errors on a 12 hour shift compared to those on a 8 hour shift. Shifts that are longer than 12 hours are strongly discouraged due to risks of deteriorated alertness and performance.

Similarly, transitioning from an early to a late shift can result in long periods of wakefulness in workers, with the same repercussions.

The Health and Safety Executive advises against morning shifts starting before 7am, and suggests forward rotating shifts (i.e. from the earliest shift in the rotation one week one through to the latest in week three, as opposed to late to early) to avoid disrupting the internal body clock.

Stress and wellbeing

Managing the stress levels of your workforce is essential in reducing work errors, absence rates, and presenteeism. A long working day or week with insufficient time off, and regularly working antisocial hours, would contribute to an increase in stress and general ill health.

While demand is greater due to the COVID-19 pandemic, evidence suggests long shift work could impact the immune system and lead to an increase in absence and costs in managing workload.

This should be a key consideration when choosing the shift pattern for your workforce, as often the most popular shifts can prove to be the most demanding.

Remaining flexible

It is important to remain flexible in creating shift patterns for your workforce that meet your businesses’ needs, while minimising impact on staff performance and wellbeing.

Some workers may prefer one shift pattern over another, depending on their own circumstances, home life and needs, and where possible try to work with them in creating something beneficial to both.

It is also important to regularly check in with workers via surveys or meetings, and remain flexible in adjusting a shift pattern in the future should individual’s circumstances or health require it.

Start scheduling your staff online.

No credit card required, nothing to download, no mailing lists and no surprises.