Agile Working Request and Decision Form
Part 1: To be completed by employee making a request
Before completing or submitting this formal request, please read the Agile Working Policy and
Guidance.
You do not need to use this formal procedure if you are requesting ad-hoc agile working, for example
occasional home working or one-off changes to hours of work in response to personal circumstances.
You should only use this procedure if you are requesting a new and consistent change to your hours,
days, weeks or place(s) of work, whether on a temporary or a permanent basis.
Please note: Completed forms should be emailed to Agile-Working-Requests@open.ac.uk
Your personal details
Name of employee:
Staff number:
Name of line manager:
Team/department:
Unit:
Type and duration of change
Are you requesting a permanent or a temporary change (tick one box)?
Permanent change to contractual terms and conditions
If you make a request for a permanent change, a further request cannot normally be submitted within a
period of 12 months.
Temporary change
Note that all temporary changes will be subject to review no later than 6 months after introduction and
at 6-monthly intervals. A temporary change may be subject to earlier review if individual or business
needs change.
If this is a request for a permanent change, have you made a request using this procedure within the
past 12 months? If yes, please provide information.
When do you want the new arrangement to start?
Normally, the minimum period of notice should be 4 weeks and a longer notice period is preferable.
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If your request is for a temporary change, for how long do you want it to last?
A temporary change can be extended, but will not normally exceed 2 years.
Your current working arrangements
Please describe your current working pattern (days/hours/weeks/locations worked):
Your agile working options and impact
Which of the following agile working options are you requesting (tick one or more)?
Arrangement of hours
Compressed hours
Staggered hours
Part-year (term-time)
Part-year (11/12ths)
Number of hours
Reduction in hours
Job share
Location of work
Home working
Other OU centre working
Other remote working
Something else (tick this box if none of the above options apply)
Please describe the new pattern that you are requesting (days/hours/ /weeks/locations worked).
Managing the impact
Please describe the likely impact of this change on your team/department/Unit/University. Impacts may
be described in terms of challenges to be overcome and/or benefits to the business.
Please provide any suggestions you have for how the new arrangement can be made to work in your
team/department/Unit. Your request may be more likely to be successful if you can show how it can be
made to work effectively.
Your personal needs and circumstances
Does your request relate to a protected characteristic in equality law? The protected characteristics are
age, caring or dependency responsibilities, disability, gender reassignment, marriage and civil
partnership status, political opinion (Northern Ireland only), pregnancy and maternity, race, religion or
belief, sex and sexual orientation. You do not have to provide this information but if you want your
request to be considered in line with the University’s public sector equality duty or the duty to make
reasonable adjustments for disabled people, then you can give details here. Information about other
personal circumstances which do not fall under a protected characteristic, e.g. bereavement, may also
be included. The University will give due regard to requests where the reason relates to any protected
characteristic or other personal circumstance.
Any information you provide here will be treated in line with the requirements of the University’s Data
Protection Policy. It will only be used for the purpose of considering your request.
No further information or attachments are required.
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Declaration
The information included in this form is accurate and complete. I understand that if I am requesting a
permanent change to my terms and conditions of employment, and if this is accepted, I will have no
right to revert back to my previous working pattern, unless otherwise agreed with my line manager.
I understand that information I have provided may be shared with other colleagues, senior managers or
HR Partners so that my request can be considered appropriately. Information about personal
circumstances that I disclose will not be shared with others in my team without my explicit further
consent.
Name:
Date this request sent to line manager:
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Part 2: To be completed by line manager to acknowledge receipt
Normally an acknowledgement should be sent to the employee within 2 weeks of receipt of the request.
The form below can be completed and a copy sent to the individual employee, or the information can be
sent in an email.
I confirm that I have received your agile working request on:
(date).
I will be arranging a meeting with you to discuss your request, ideally within 3 weeks of this date.
Name:
Date:
Part 3: To be completed by line manager to notify employee of decision
This decision notice must be completed after a decision has been made, normally within 4 weeks of
receipt of the request. Decisions should be made in line with the agreed delegated authority levels in
your unit. Before making a decision, please read the Agile Working Policy and Guidance. If you are
unable to accommodate the request, you need to consult with others and you need to document the
statutory business reason for the refusal following the guidance provided.
Management decision
Having considered your request for agile working carefully, I can confirm that (tick box 1, 2 or 3 below
and complete the information in that section):
1.
The team/department/Unit/University is able to accommodate your request.
Your new working arrangements are as follows:
These arrangements will commence on:
(date).
If this is a temporary change, the following frequency of review has been agreed (the first review
must take place no later than 6 months, and subsequent reviews at least at 6 monthly intervals):
Review date:
Further comments:
The following expectations have been discussed in relation to these new arrangements:
OR
2.
The team/department/Unit/University is unable to accommodate your request fully,
but is able to accommodate alternative arrangements which we have discussed and you
have agreed are acceptable to you.
Your new working arrangements are as follows:
These arrangements will commence on:
(date).
If this is a temporary change, the following frequency of review has been agreed (the first review
must take place no later than 6 months, and subsequent reviews at least at 6 monthly intervals):
Review date:
Further comments:
The following expectations have been discussed in relation to these new arrangements:
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OR
3.
The team/department/Unit/University is unable to accommodate your request for the
following business reason(s) (normally only one business reason for refusal is required):
The burden of any additional costs is unacceptable to the organisation
An inability to reorganise work among existing staff
An inability to recruit additional staff
The change will have a detrimental impact on quality
The change will have a detrimental effect on the ability to meet customer demand
The change will have a detrimental impact on performance
There is insufficient work during the periods the employee proposes to work
There is a planned structural change and the request is incompatible with that change
N.B. Before completing the next section, please review the guidance document for details of
how to objectively justify any of the above reasons for refusal.
The specific details of how this business reason(s) applies in this circumstance are as follows:
The most senior person consulted before this decision was made is:
If your request has been refused and you are unhappy with the decision, you are entitled to appeal,
providing that at least one of the following grounds for appeal is met:
i.
You can provide additional information which was not available to management at the time the
original decision was made. This might include information about how the proposed
arrangements can be made to work or information about changes to customer expectations that
the manager was not fully aware of. The additional information must be more than minor or
trivial in order for it to warrant sufficient grounds for an appeal.
ii.
You can claim that the application was not handled in line with any aspect of the policy. This
might include, for example, a claim of insufficient documentation of the business reason for
refusal, or insufficient consideration given to a protected characteristic in equality law where this
has been declared.
If you requested a permanent contractual change and you have been offered a temporary change
subject to review, an appeal will not be allowed, providing the change to hours and pattern and location
are the same as those that you requested. It is not unreasonable for your manager to want to first trial
an arrangement to ensure it does not have any detrimental effect or unexpected consequences.
Towards the end of the first 6 month review period your manager will consider the feasibility of making
the arrangement permanent if you still want this. If your manager decides that a permanent change is
still not feasible, then an appeal will be allowed, providing one of the two grounds for appeal is met.
Your appeal should normally be made within 7 days of you receiving notification of the decision and
should state the ground(s) for appeal. You will be asked to attend an appeal meeting, which should
normally take place within 3 weeks of notification of the initial decision. The appeal will be heard by
someone independent of the original decision and who is an equivalent or higher grade to the most
senior person consulted on the original decision.
Name:
Date:
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Unit Staffing Team Use Only
Action
Check that Line Manager has approved/declined the Agile Working Request
Tick
If there has been a change of 5 hours or more a Change of Circumstances Form should be generated and
processed as normal
Amend PIMS to reflect all changes in hours and working patterns (adding comments in hours worked notes
box where necessary)
Email completed forms to the Agile-Working-Requests mailbox so that the HR Admin team can update
Resourcelink where applicable, and the impact of the Agile Working Policy can be monitored
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