We are all aware of the workforce challenges facing the NHS, writes Anna Dixon, chief executive of the Centre for Ageing Better. According to recent estimates, there are currently around 100,000 vacant posts nationally, a figure that many expect to rise post-Brexit depending on the immigration rules agreed.
What is less well known is that as well as struggling to recruit, the NHS is also struggling to retain a core demographic of its workforce – those between 50 and state pension age.
In the past, large numbers of NHS workers have voluntarily retired in their early to mid-fifties. Given that more than a third of the workforce are over 50, this results in a huge loss of skills and experience. In 2017, more than a quarter of all leavers were between 50 and 65. And estimates suggest that, in England, there are about 1 million people aged between 50 and State Pension age who would like to be in work but are not.
Take the example of midwifery. In recent years, a recruitment drive has seen increased numbers of midwives joining the NHS. While this is positive, a more midwives were over 60 in 2009 than in 2018, suggesting many have left their roles. At the same time, the increase in training posts has resulted in more applications to the sector. This is great news, but the majority of these places went to people under the age of 35. Initiatives focused on new entrants must be paired with programmes that help retain workers for longer, as well as making it easier for people to return after a career break.
It is important that future recruitment campaigns actively target age-diversity, especially given the upcoming increases in nursing, midwifery and medical training posts. NHS bodies are already making progress in improving how they support the incredible people who work there, such as the work NHS Improvement/England continues to do in collaboration with NHS Employers on retention and the health and wellbeing of the workforce. And recently, the Interim NHS People Plan emphasised the need to look after our staff, retain them as well as recruit NHS employees.
The Centre for Ageing Better has developed a guide to becoming an age-friendly employer. The new workforce strategy being developed by the NHS should include the commitment for health services to become age-friendly employers and adopt our five recommendations the NHS should adopt to better support its older workers:
- Be flexible about flexible working: Many recognise that the parents of young children or those with caring responsibilities for older relatives might need greater freedom in how and when they work. However, many employees – especially older workers – are not aware that flexible working is an option for them. The long-term plan explicitly acknowledges that many leavers would stay if they had greater control over their working lives, and there is more to be done to embed flexible working practices throughout the NHS.
- Encourage career development at all ages: Ensuring that all staff are considered for training opportunities is also a key facet of being an age friendly employer. A third of UK employees over 50 feel they have had fewer training opportunities as they have grown older. It is important to recognise that career development is not just for those at the beginning of their careers. Many people would enjoy the opportunity to retrain into other roles or update their skills mid-career.
- Ensure everyone has the health support they need: Many people over 50 assume that if they have to leave work due to health problems, they won’t work again. Being alert to workers’ health is vital. Given the physical nature of many roles in the NHS, it is important that open and honest conversations about health take place, and any adjustments are made early. Making sure support is in place, as well as advocating and supporting healthy workplaces, can play a vital part in keeping experienced staff.
- Hire age positively: The NHS recruits relatively few older workers, with only 13% of joiners being over 50 in 2017. Our polling has shown that more than a quarter of jobseekers over 50 have not applied for a job because it sounded as though the job was aimed at younger people. Age-friendly recruitment practices, such as actively targeting older jobseekers, and minimising age-bias in the hiring process can mitigate this risk. Making the recruitment process more age-friendly also means showing that you value the skills your older workers have and recognise the specific challenges they face in accessing work.
- Create an age-positive culture: Leadership of an age-friendly workplace comes from the very top and needs to be matched by similar attitudes and actions in HR professionals, managers and colleagues. NHS organisations should take a critical assessment of their approach to understanding, talking about and managing age at all levels of the workplace.
The stakes for getting this right couldn’t be higher. The NHS is straining under the weight of increasing demand and staffing shortages. While it is doing well to support workers in some areas, if it can rethink their approach to supporting older workers, we might find an uptick in numbers of people choosing to stay in the NHS for longer. And that might just be enough to turn the tide of the growing workforce crisis.
Anna Dixon is chief executive of the Centre for Ageing Better. Follow her on Twitter at @DrAnnaDixon
NHS Employers has a range of resources available, including: