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Supporting an ageing medical workforce

Ageing workforce image

The UK’s ageing population is growing with 18% of people aged 65 and over, alongside this we are seeing an ageing NHS workforce. 

The NHS is the fifth largest employer in the world, with 47% of NHS staff now aged 45 or over. Six out of 10 Consultants and SAS doctors are over the age of 45 and nearly one in every two GPs are over the age of 45.  

Many doctors are finding working in today's NHS too taxing on their work-life balance, health and wellbeing, particularly as they age, causing some to seek early retirement.

In response to these issues the BMA has created a report which explores the unique pressures facing older doctors to identify how best the NHS can support its ageing workforce.

Key points

  • Across the UK employers are realising the opportunities that an older workforce can offer
  • Early retirement in the medical workforce leads to a loss of expertise and skills in an already understaffed workforce
  • Older doctors act as role models, supervisors and appraisers
  • Older patients place unique value in being treated by an older doctor, which can strengthen the relationship between patient and doctor
  • Understanding the reasons doctors are retiring early is important so that the NHS can work out what will motivate them to stay and how they can be supported

Download the report

  • BMA recommendations

    Make it easier for an older workforce to work in the NHS so their skills and experience can be retained

    • Trusts/ Health boards and practices should support, develop and promote part-time or flexible working for staff across their medical careers.
    • Prior to advertising a post, employers should consider whether it can be filled by someone who wishes to work part-time or whether they would consider someone who wanted to work flexibly.
    • Employers should schedule 'transition to retirement discussions' with their staff to understand what support they might need to help them remain at work, should they wish to do so.
    • To ensure they are healthy, fit and able to work, senior doctors, alongside other NHS staff, should have access to a free specialist-led occupational health service.
    • Employers must support their older doctors by ensuring they are getting enough rest breaks and have appropriate facilities when staff are suffering from fatigue.

    Make it easier for older doctors to contribute their skills in other ways to the NHS

    • Employers need to consider whether it is possible to offer alternative employment opportunities allowing medical staff to focus on non-clinical duties, such as working in management, teaching research or as appraisers.
    • Many opportunities to work in local health service development or teaching require applicants to be currently engaged in clinical work. This barrier must be re-assessed so that doctors who are retired from clinical practice but who remain up to date and competent are able to take part in this work should they wish to.
    • It is currently possible for retired doctors to act as appraisers, however appraisers should have a licence to practice and ideally still be in clinical practice - this should be for no more than three years post-retirement.

    Ensure doctors are not disadvantaged financially by coming back from retirement

    • The UK Government should undertake a full review of the pensions tax relief systems, which acknowledges the impact that the current level of annual allowance has on workforce planning and pension scheme membership.
  • Age profile of the UK medical workforce


    Ageing medical infographic 03

     Ageing medical infographic 01 

    Ageing medical infographic 02

     

     

  • Case studies

    NHS Consultant

    How part-time working and support with on-call helped this consultant work longer

    “I worked as a Consultant in the NHS for 25 years. I planned to retire at the age of 60. However, due to the management team being unable to advertise for my successor in time I retired six months later than originally planned.

    "In the last decade of my NHS career I worked maximum part-time (nine sessions) and took part in different roles including teaching and chairing the department I was working in. In my final year before retirement, I became part-time and stopped being on-call. However, I continued to carry out all the other work I had been involved in. My department had appointed a long-term locum and he covered the on-call duties.

    "Once retired from the NHS, I continued to participate in my department's teaching sessions until removed from the medical register."

     


     

    GP partner

    How reductions in clinical commitments helped this GP partner continue to work 

    "I am a GP and last year I left the practice where I had been a partner for 30 years. I had always planned to retire from my practice at the age of 55 due to the fact that my job was highly pressurised, and I thought this was a reasonable aim for my own wellbeing and made my financial plans accordingly. However, when it came to it, I took the opportunity to instead, at 53, reduce my clinical commitments to the practice. This has made continuing until 59 sustainable.

    "In my later years my stamina was not the same. I began to find it harder to draw on the necessary reserves of emotional energy to give top class engagement to all my patients. On the other hand, I had also reached a level of skill and insight where I could try different consultation styles and put more truly into practice shared decision making. Without the opportunity to reduce my hours in the practice I would undoubtedly have left the practice before 59.

    "I remain on the Performers List as a GP and I would like to continue to be active locally for example, in helping service design/ commissioning and teaching medical students. Now I am nearly a year out of clinical practice I do not think I will return to the workforce, sadly many opportunities to work in local health service development or teaching require applicants to be currently engaged in clinical work."

     


     

    NHS Consultant

    How pension rules and inflexible working arrangements led this consultant to retire early

    "I am a consultant and retired from my previous trust a couple of years ago. I was struggling to work full-time and found that there were no opportunities for part-time working available, although I tried my best to find one. I retired earlier than I had planned from this trust because of pension rules. Following my retirement, I gained a part-time position at another trust where I was able to work two days a week. 

    "In addition to my two days a week I contribute to the NHS by undertaking work in my own time some of which is unpaid. Below are some examples:

    • teaching and examining medical students and teaching GP trainees;
    • writing for medical textbooks;
    • drafting research papers for universities.

    "Now that I am working two days a week I have a much better quality of life. Despite my many years of hard full-time work at my previous trust there was no support for part-time working and I was made to feel a nuisance for asking for the opportunity to stay on part-time after retirement. I was delighted to be offered this elsewhere and my new workplace have made me very welcome.

    "I would have benefited from further support from my employer in finding a part-time position at the trust I was working at. I also attended a retirement workshop and felt that they should incorporate a tailored session to women doctors as well."

     

     

  • Survey results

    Following a survey of a small sample of doctors of all grades working in different settings in the UK, we found that:

    • When considering retirement, health and wellbeing (85%) was the most important factor followed by workload (66%) and burnout (61%).
    • In actually making the decision to retire, job satisfaction (60%) and working patterns (57%) also play a significant role.
    • The most important factors that would influence a decision to work past the retirement age are the ability to work flexibly (65%), job satisfaction (57%), having time to practice the most enjoyable aspects of medicine (50%) and support with workload (44%).
    • Providing flexible working arrangements (25%) was the most important way in which employers could support older doctors who are still in the workforce.