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Supporting older doctors: five things you need to know about the BMA’s report

by Costanza Pearce
7 March 2019

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The BMA has said employers must do more to support older doctors, who represent a significant proportion of the NHS workforce.

Nearly half (47%) of GPs in the UK are over the age of 45 and nearly two in ten (17%) are over 55, according to the BMA’s report – supporting an ageing medical workforce – published last week (26 February).

The report outlined multiple benefits to retaining older doctors, such as their skills and experience, greater continuity of care and their suitability as ‘role models, supervisors and appraisers’.

It also said that early retirement leads to ‘loss of expertise and skills in an already understaffed workforce’.

Here are five key recommendations from the report:

1. Practices should support part-time and flexible working arrangements
Older doctors may be carers or have other demands and commitments that make full-time work difficult according to the report, which says ‘there needs to be a greater recognition of work-life balance and job flexibility’.
This flexibility must include timing of work commitments, workload and type of work because ‘doctors’ skills and abilities change with time’ and this must be recognised, the report adds.
Employers should consider whether a post can be filled by someone working part-time or flexibly before it is advertised. The BMA believe this may improve recruitment more generally, as well as the retention of older doctors.
2. Practices should increase age awareness
The BMA says 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’.
This should come as part of discussions with staff throughout their careers to ensure they feel supported in the decisions they make, the report adds.
3. Senior staff should have access to a free occupational health service
The report says: ‘A comprehensive NHS-wide occupational health service is needed to ensure that all sections of the workforce, including senior doctors, are healthy, fit and able to work.’
This follows similar recommendations made by Health Education England (HEE) in its report on NHS staff’s mental wellbeing, published last month (20 February).
Older doctors should also have sufficient rest breaks and access to appropriate facilities for when they are tired.
There should also be recognition that ‘the physiological changes of ageing may mean that some staff need to have their working practices tailored to suit their needs’, the BMA report adds.
4. Employers should enable older doctors to contribute their skills in other ways
The report says older doctors ‘have much to offer to the health service in terms of skill, expertise and knowledge’ and many have experience of working in a variety of roles ‘outside their day to day clinical work’.
It recommends offering senior doctors opportunities to focus on non-clinical duties such as working as appraisers or in management, research or teaching.
Requirements that applicants for local health service development or teaching must be currently engaged in clinical work ‘must be re-assessed’ to allow retired doctors ‘who remain up to date and competent’ to take part, according to the report.
The report adds: ‘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.’
5. Policy makers should ensure doctors are not disadvantaged financially by coming back from retirement
Commenting on the report’s findings, deputy chair of the BMA council Dr David Wrigley said: ‘The Government must review pensions arrangements for both working doctors, and for doctors in retirement so that they are not disadvantaged financially by deciding to return to the workplace.’
A recent study conducted by the University of Warwick revealed that 40% of GPs want to leave the job in the next five years, with work intensity and workload amongst the top reasons for leaving.
The BMA believes the growing trend of early GP retirement is ‘most likely’ also a result of changes to the pension taxation rules because indemnity costs historically made it ‘unattractive’ for GPs to return to the workforce after retirement.
However, the state-backed indemnity scheme announced in October 2017 means ‘indemnity costs should vastly reduce for GPs who retire and return, helping the recruitment and retention issues faced in general practice’ from April 2019, according to the report.