Ageing workforce will exacerbate NHS staffing crisis

BMJ 2002; 325 doi: (Published 14 December 2002) Cite this as: BMJ 2002;325:1382
  1. Caroline White
  1. London

The staffing crisis in the UK health service is set to deepen, unless serious attempts are made to stave off the anticipated retirement of 15% of its workforce within the next decade, finds a new report from the independent think tank, the King's Fund.

The NHS urgently needs to direct its efforts to retaining older, experienced staff, with more flexible working policies and pension arrangements, says the report, published this week.

About 150000 of the one million NHS workforce is aged 50 or older, and therefore eligible for early retirement. The Employers Forum on Age say that there are 30% fewer women and 26% fewer men aged 16 to 24 working in the NHS than in 1986.

The effect of demographics is likely to be felt most acutely among nurses, one in five of whom on the register is aged 50 or older. The Royal College of Nursing estimates that there were 22000 nurse vacancies at the end of March 2001.

The background staff shortage among doctors also gives cause for concern. About 670 consultant posts were unfilled in England in March 2001, and there were over 1200 GP vacancies in March 2000, according to Department of Health figures. About two thirds of South Asian GPs who came to the United Kingdom in the 1960s will have retired by 2007, leaving some areas with a loss of one in four of their GPs.

A national survey of 23000 GPs carried out by the BMA last autumn showed that one in four intended to retire at age 55 to 57, and 80% said they would retire at or before 60.

General disillusionment with the NHS and feeling undervalued and unable to deliver a good service without overtime were important drivers for seeking refuge in early retirement, shows the report. Occupationally acquired injuries also featured heavily.

The report calls for the adoption of policies championed by the retail and finance sectors, such as targeted recruitment, lifelong learning, paid leave for carers, flexible retirement and pension options, and mid-life career planning courses.

Human resources must become a central tenet of the performance management framework, it urges, concluding: “Staff are the lifeblood of the NHS and recruiting and retaining them must be a major priority on every board agenda.”

Alastair Henderson, policy manager for the NHS Confederation, which represents employers, said that the NHS recognised the problems and had already taken several steps to remedy the situation.

But he said: “Changes in pension arrangements are not easy to grant locally, and can take decades to do. But we are fully aware of the age issue.”

Sam Mercer, campaigns director for the Employers Forum on Age, said that the statistics were “frightening.”

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