Retirement fears for doctors borne out in report

In addition, less than 30% of this cohort intend to work beyond retirement age. With Scotland already facing challenges to train, recruit and retain doctors in some specialties, the findings suggest that the NHS will face significant future workforce planning issues.

Researchers at Dundee’s School of Business were commissioned by NHS employers in Scotland, the BMA (Scotland) Consultants Committee, and the Academy of Medical Royal Colleges and Faculties in Scotland to produce the largest and most comprehensive survey of doctors’ retirement intentions compiled to date.

‘Senior Hospital Doctors’ Intentions to Retire in NHS Scotland’ drew on almost 1700 responses to a questionnaire created by the researchers. The views of doctors under 50 were also sought and compared with the 50+ cohort for signs of age differences.

The headline finding is that doctors in the 55+ cohort group intend to retire at age 58, which is two years before their normal pension age. For the 50-54 cohort and <50 cohort this figure is 60, which is well below their normal pension age of 65-68. Most doctors intend to transition into retirement by scaling down work commitments. Only 22% of the total sample did not intend to scale down as they approach retirement.

The pension taxation regime, something that the recent UK budget sought to change, was the main reason given by doctors for their intention to retire before normal pension age and/or scale down work commitments.

Disillusionment and dissatisfaction with the ways in which NHS values were being enacted by the system and their employers were the second most common reason given for intention to retire prematurely. Such disillusionment and dissatisfaction adversely affected doctors’ engagement with the job and sense of purpose.

“Even allowing for the recent pension taxation reforms possibly removing a major source of grievance, the level of doctors’ disillusionment with the system and their employers is sufficiently strong to severely challenge their sense of optimism over a better future for the NHS,” said Graeme Martin, Professor of Management at the University and lead author of the report.

“The NHS needs to address the causes of these issues and provide evidence that an exciting near future is a distinct possibility. In the report we discuss how boards can do so.

“Our research provides solid evidence for the recent pension taxation changes. However, these do not deal with other key grievances, such as a strong sense of disillusionment with their organisational and NHS leaders, declining engagement with work and its sense of moral purpose.  There is also evidence of burnout among doctors, particularly in some specialties.

“In combination with our earlier research, this work shows the nature and extent of dissatisfaction among doctors over how they are treated in the NHS. If anything, the findings are more worrying because they show how organisational disillusionment has resulted in doctors feeling their work lacks the meaning it once held for them.”

In addition to changes in the pension taxation rules, the doctors who contributed to the survey wanted to see more help with work restructuring and flexible working. Better designed and consistently implemented retire and return programmes also featured prominently. 

They also wanted workload issues, succession planning and staffing issues to be addressed, along with ‘honest messaging’ by the NHS as to what could be realistically delivered by senior leaders within the current financial envelope.  Finally, doctors said they wanted to feel valued, have a greater voice in how they are managed, and help with later career planning. 

The researchers also noted significant differences among doctors in how they responded to many of the survey questions according to key demographics, the most significant of which was age.  They also noted that there were no significant regional differences in how doctors responded, showing these findings applied across Scotland with broadly equal force. 

The authors have recommended that generational differences in values and expectations of work may be an important issue for further investigation, given the age differences. 

Professor Martin says that these factors and findings fit into a coherent narrative in which the potential withdrawal from work is a result of a severely breached ‘psychological contract’.

He said, “Doctors feel they have undergone many years of demanding training, relatively low pay compared to other professions, and long, unsociable, hours. In return, they had good grounds to expect a payoff in terms of freedom to exercise clinical judgement, high status and meaningful work accompanied by good pay, conditions and pensions. 

“Senior doctors, however, have come to feel these expectations have been breached and are responding with increased burnout, reduced meaningfulness associated with their work, and reduced levels of work engagement.

“The NHS could therefore be faced with significant problems in recruiting, engaging, and retaining newer generations of doctors, whose expectations may well be different and whose opportunities for alternative employment may be greater. Consequently, it is vital that these expectations among the 50+ and under 50 cohorts are addressed.”

Read the Senior Hospital Doctors' Intensions to Retire report