There are currently an estimated 40,000 nursing vacancies across the country (NHS 2019) and if these trends continue the NHS in England could reach a shortfall of 108,000 full time equivalent nurses by 2028/29 (Health Foundation et al 2019). In addition to these significant nursing workforce shortages, the workforce is aging. In 2017 48.9% of Registered Nurses in the UK were aged 45 years or above (RCN 2017). A range of recruitment and retention strategies are in place to help alleviate nursing shortages and a key area of focus is the recruitment and retention of Registered Nurses in the early part of their career. Whilst this is welcomed the lack of policy attention on retaining the older workforce is, in my view, a missed opportunity.
Closing the Gap (Health Foundation et al 2019) cited the ‘all-or-nothing’ choice in relation to shift patterns and a general lack of flexibility in working arrangements as important factors in why experienced nurses choose to leave the workforce. The NHS Pension scheme was also acknowledged as a barrier to the retention of experienced nurses. Recent political intervention targeted issues with doctor’s pensions, however there has been no such appetite to review the pension policies affecting older nurses, many of whom would choose to work longer if circumstances enabled this.
In Ontario there is a well-established, centrally supported Late Career Nurse Initiative (Doran et al 2015), aimed at nurses 55 years and above, which supports organisations to utilise the skills and experience of this workforce in different ways. Through this initiative nurses are supported to work 80% of their time in their usual clinical area whilst during the other 20% they are involved in specific local projects for example mentoring, audits or quality improvement programmes. Funding is provided for 16 weeks per nurse, but organisations can continue to support thereafter.
More targeted work could be undertaken with experienced nurses in the UK to establish what types of work options would be of interest. This could result in more bespoke mid to late career opportunities enabling these Registered Nurses to continue to work in the profession, whilst achieving a more sustainable work-life balance. As approximately 50% of the Registered Nursing workforce in the UK is aged 45 years and above the potential for change is significant.
Doran, D, Jeffs, L, Rizk, P, Laaported, R, Chilcotea, M and Baiy, Q (2015) Evaluating the late career nurse initiative: a cross-sectional survey of senior nurses in Ontario. Journal of Nursing Management 23, 859-867. Retrieved from https://onlinelibrary.wiley.com/doi/epdf/10.1111/jonm.12227
Health Foundation, King’s Fund & Nuffield Trust (2019) Closing the Gap. Key Areas for Action on the Health and Care Workforce Retrieved from https://www.nuffieldtrust.org.uk/files/2019-03/heaj6708-workforce-full-report-web.pdf
NHS (2019) Interim NHS People Plan. Retrieved from https://www.longtermplan.nhs.uk/wp-content/uploads/2019/05/Interim-NHS-People-Plan_June2019.pdf
Royal College of Nursing (2019) The UK Nursing Labour Market Review 2018. London: RCN.
Dr Pauline Milne MBE PhD MN BN RN
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