This site is intended for health professionals only

New guidance to encourage older doctors to ‘stay well in the NHS’

New guidance to encourage older doctors to ‘stay well in the NHS’

NHS England has published guidance to help retain doctors in the late stage of their careers, including flexible working, financial advice on pensions and mentoring.

The guidance, published at the beginning of this month, gives ten recommendations for employers to consider when supporting doctors in late career ‘to stay and stay well in the NHS’.

Around 30% of the NHS workforce are aged 50 and over, with NHS Digital figures showing that almost 38% of fully qualified, full-time equivalent GPs were aged 50 or over as of April this year.  

The commissioner said that while the new guidance is primarily aimed at those working in secondary care settings, it can be adapted by other staff groups including doctors in primary care.

It said that ‘it is important to have retirement conversations early enough to help older doctors to plan and consider their options around retirement’ and that ‘employers should not make assumptions about how doctors’ preferences change with age’.

According to the guidance, retirement conversations could be ‘standalone conversations’ or could be included as part of appraisals and yearly reviews of job plans but should ‘ideally happen before a staff member has begun to consider or started preparing to leave, and the opportunity to retain them may already have been lost’.

It also recommended that employers should promote and support various options for flexible working, including less than full-time working, reduced or no on-call/out-of-hours responsibilities, job sharing, annualised hours contract and remote working.

Doctors in late career stages should also be signposted to financial advice and be provided access to information to help raise awareness of pensions taxation and the options that exist for doctors worried about its impact.

Their skills could also be retained and used ‘away from the clinical setting’ as they can provide coaching, mentoring and pastoral support to NHS staff who are at the start of their careers or are newly appointed to the NHS.

Em Wilkinson-Brice, NHS England’s national director for people, said: ‘Retaining our colleagues in late stage career is important, particularly as a third of our workforce are aged 50 and over.

‘This guidance focuses on how we can best support doctors in late stage careers, however, aspects of the recommendations are also applicable to all our NHS people.’

Celia Ingham Clark, NHS England’s medical director for professional leadership and clinical effectiveness, said: ‘Older workers have a wealth of skills, experience and knowledge which can be of huge value, often with the benefit of flexibility and local insight.

‘Doctors in late stage careers also have an important role to play in education, supervision and mentoring of doctors in training and act as role models for the wider workforce.

‘We hope this resource will inspire you to help doctors in late stage careers to feel happy and fulfilled at work and supported to achieve their individual ambitions, whilst delivering the highest levels of care to patients.’

In May, NHS England announced it will run a campaign to encourage departed GPs to return to the profession, working for practices or NHS 111, by promoting ‘flexible roles where, for example, working from home is possible’.

A Pulse survey last year found that half of the existing GP workforce plans to retire at or before the age of 60.

Of more than 800 GPs surveyed across the UK, almost half (47%) said they intend to retire at or before 60, including 1 in 8 who said they intended to retire before reaching 55.



Please note, only GPs are permitted to add comments to articles

Iain Chalmers 26 June, 2023 6:47 pm

I like a good laugh, & this is hilarious

Dave Haddock 26 June, 2023 6:48 pm

So no attempt to identify and fix the problems that encourage people to leave early then?
Classic NHS.
ps. dumping Appraisal and Revalidation would be a start, and save a lot of money.

John Graham Munro 26 June, 2023 7:12 pm

I told you all, did I not that this type of garbage needs a new name————-I’m still working on it

Martin D 26 June, 2023 7:44 pm

As one of the “Doctors in late stage careers” there is almost nothing they could do to convince me not to retire by 60.
All my peers are the same

David Church 26 June, 2023 7:48 pm

@ Dave H : but we can’t dump appraisals now! it is an annual opportunity to persuade them to stay in post just one more year, despite their better inclinations. I know, let’s threaten to block revalidation for anyone thinking of retiring, so they have to retrain to pass and stay on another year!

SUBHASH BHATT 26 June, 2023 8:00 pm

Dave Hancock is right. Appraisal for some one who has worked for several decade ,
feed back and re validation are pointless. I want to know if any one failed Msf feed back or appraisals?
I am talking of doctors who never had any problems with their clinical work.
For older doctors lot form filling and criteria to refer or not and only do referral on proforma is prohibiting. .older generation don’t work for money.. they like to continue practicing because they love the job..

Cameron Wilson 26 June, 2023 8:14 pm

Maybe this is economic twaddle, but it is not just the NHS that lacks capacity. To lose the expertise of the 60plus age group is such a waste. The charade of quality has to be ditched. A nominal tax band for pay,perhaps 10%,which doesn’t affect other sources of income such as pension for over 60’s would encourage some perhaps many to continue. GMC,CQC would have to change their tune on the matter, after all a lot of the stress is due to capacity issues and surely having the extra experienced staff be it doctors, teachers, police, hotel staff whatever is far more beneficial than the knackered status quo of pseudo quality!
Perhaps this is wishful thinking but this country needs something far more radical than the drivel being spouted by the Politicians.

Peter Lewis 26 June, 2023 8:44 pm

This just p****s me off. So …. Let’s imagine the NHS is a FTSE100 company ….. would be the biggest bu a large margin.
So the board is told “all tour senior staff are thinking of leaving in the next 5 years “
There would much activity …. Emails , focus groups, feedback from current leavers, interviews with current staff ……
This is serious, company breaking disaster….. what can we possibly do to avoid this nightmare scenario.

No …… I’ve left 5 years early , no one had asked me why or have (other Than my ex partners & patients) even missed me.
My place after 32 years will be taken by a locum off a traing scheme.
I wish them well

Northern Trainer 26 June, 2023 8:46 pm

I’d love to see one of these mentorship sessions;
“so I’d like to offer you advice on reducing your hours but your practice will close down so we can skip that section. let’s move on to assessing you current pension using this accurate and up to date pcse information- oh, erm, what’s the next section about……?”

Stephen Savory 26 June, 2023 9:07 pm

“NHS England has published guidance to help retain doctors in the late stage of their careers, including flexible working, financial advice on pensions and mentoring.”

I’ve flexed down to 6 patient-facing sessions as a GP partner. I’ve taken financial advice: I can afford to quit as a GP partner. I could afford to quit. I’ve taken up my LMC’s mentoring offer: “Stephen: at 55 you should be happy in your work”.

‘We hope this resource will inspire you to help doctors in late stage careers to feel happy and fulfilled at work and supported to achieve their individual ambitions, whilst delivering the highest levels of care to patients.’ I aspire to all of the above whilst first and foremost ensuring my health and wellbeing, and that of my nearest and dearest. I doubt NHSE cares about anything more than my ‘retention’.

Michael Mullineux 26 June, 2023 9:08 pm

Patronising guff that encourages an overwhelming desire to call it a day sooner than previously envisaged.

Adam Crowther 26 June, 2023 9:20 pm

Surely this is political spin for the disgruntled GBP. The horse hasn’t just bolted it it has enjoyed a fulfilling life in the fields and died happily of natural causes 🤦🏼‍♂️

Some Bloke 26 June, 2023 9:57 pm

John, I am intrigued and craving to hear your thoughts.
I also think that this is a blatant case of OneOneOnkerisation of healthcare.

paul cundy 26 June, 2023 10:15 pm

Dear All,
If ever there was an example of their desperation, but hey ho, the cynic intervenes, they’ve strangled the service for 10 yrs and now they want to appear to be on our side just as they face election oblivion.
Remember how your vote counts.
Its true that Labour may have no clue but that’s preferable to a team that does (when extinction is the plan).
Paul C

Anonymous 27 June, 2023 7:26 am

Locum comfortably for the next couple of years. Retire at the age of 50. Maybe some ad hoc hours till 55 and only remotely.

Life is too short for this bs.

Nobody will give a toss.

Dr No 27 June, 2023 8:23 am

Dont bother trying to retire. It’s 10 months since I should have been paid my pension. All I get from PCSE is lies bullshit and obfuscation. It’s now in the hands of the Pensions Ombudsman and I expect they’ll be equally useless. I wonder if it’s actually a ruse to improve retention? I wonder when it comes to appraisal if I also use the excuse of having too big a backlog of work to prepare anything for another year or so.

Lise Hertel 27 June, 2023 10:11 am

Dr No ! I am exactly the same, havent got to the Ombudsman yet, but 9 months of PCSE just making stuff up and don’t start me on the pensions agency- anyone out there who plans to retire, even if its years away, find out now if you can and what to do, the BMA have been excellent helping me, but even so I have had to ask for a SAR from HMRC which was useless, sent multiple e mails to my past employers, and @m still no neaer getting MY money than before.
Also, they changed the rules,if you have designated your partner to get your pension if you die, if your partner earns more then you at time of death, they will not gte thepension, the government will.

Lise Hertel 27 June, 2023 10:13 am

PS number of typos reflect how upset I am!

PPS I wish Pulse did a ‘LIKE’ button for comments, so many people making great comments on this.

Babak Shokouhi 27 June, 2023 12:59 pm

Could the government help us make an earlier appointment for out treatments in the NHS, so we can deal with our illnesses and carry on working, being productive, and showing useful members of the public. I’ve got this cervical radiculopathy and have to take all sorts of pain killers to be able to sit down at the surgery and listen to the b***s. Am I becoming old, or already old? I can work if only I am healthy and paid enough to pay for private consultations, scans, physio and so on.

Perhaps we could have thought about the situation that we are in now, a good few years ago when we were worried about WMDs and later on the Covid pandemic and then the Russia stuff.

I cannot just work for you only if you ask me nicely and say, “please!” It’s good to know that you are thinking about my well being (of course not because you like me in any way!) 🙂

Dr No 27 June, 2023 1:34 pm

@Lise Hertel – agree! Actually I’ve been moderated loads of times on the Guardian but never here! Reckon Pulse Mag is the last bastion of political free-speech on the web. Either that or Pulse are referring me to the GMC for intemperate language. But really, what can they do to me now? I’ll enjoy even more “Free Speech” in Hallam Street if I get an invitation!

Decorum Est 27 June, 2023 3:41 pm

@Babak Shokouhi
When I was a young doc, you could ask your mates opinion about personal medical issues and oft got a reply along the lines of ‘my housemate is a reg in cardiology/etc’ and he’ll advise you (and would). It was known as ‘professional courtesy’ but that has since become akin to a ‘criminal offence’. There was a lot of healthcare provided thus and free gratis. It was a mutually supportive at the time and gave a great degree of confidence about one’s future medical needs. All that seems to have been swept away (along with 25%+ of our salary, lots of our pension and we have to jump through the hoops of Appraisal and Revalidation to even acquire the latter).

Centreground Centreground 29 June, 2023 3:20 pm

Agree with all the above but to add there is a small number of doctors who make a career from being directors, clinical leads, appraisers , PCN leads, hospital non execs and basically anything to avoid doing any actual GP patient related or clinical work and unfortunately they have the ear of the the government and the completely inept incumbents of NHSE who direct this NHS fiasco.
The power needs to be removed from this small group of pseudo GPs with an unbalanced level of influence and focussed back on grassroots GPs

Hot Felon 29 June, 2023 4:54 pm

I am ”staying well” OUT of the NHS by retiring at 57.75!
Since then I’ve had 2 cruises, (one transatlantic), a trip to Spain, and a holiday in Italy.
I do a fitness regime every day.
I pursue my hobbies.
I’m no longer cooped up in a God-awful airless box with constant interruptions, miserable weird colleagues and relentless pressure.
”Staying well” in the NHS is an OXYMORON!

Geoff Hackett 30 June, 2023 6:44 pm

There seems to be universal agreement that appraisal, revalidation and QOF has become the final straw for senior doctors. I have just sent over 100 hours taking 23 meaningless “Care shield” modules on food handling, fire safety, health and safety, safeguarding etc etc, plus fictitious long term development plans (suggested by my appraiser) after 40 years as a GP Add endless begging for 360 patient feedback forms when people are fed up of giving feedback on the Amazon delivery driver and the Sky helpdesk. Many of my colleagues have given up seeing real patients to earn a living from this nonsense. Nobody listens because too many making a living out of this pointless bureaucracy. The solution to the crisis seems to be to come up with even more.

I have done a session at the hospital for25 year but a colleague retired through illness and I was told that they thought I could see 44 patients per clinic instead of 22… response was “thanks but no thanks”.

John Evans 30 June, 2023 9:43 pm

Simple way to look after yourself.

Disinvest – as far as you can safely get away with.
Hold as little risk as you can get away with.
Be ready to get out rapidly if NHS becomes too dangerous.

Dr No 2 July, 2023 11:13 pm

@Geoff Hackett. Your comment gave me an idea. We truly can harness AI to make our lives easier. Hey Chat GPT! – Write me 5 pages of reflections on 60 hours of fictitious CPD. Then give me a list of those imaginary courses. Then create impressive looking certificates that prove attendance at those courses. Let nobody tell me AI isn’t the future of general practice.