Interventions

1. CAREER PITSTOP FOR SENIOR CLINICIANS

This one-day workshop for senior clinicians has received overwhelmingly positive feedback and appreciation from delegates. It offers an opportunity to take stock and plan creatively for the next stage of a long medical career. Longer term feedback has demonstrated that these workshops empower clinicians to make positive changes which increase fulfilment and engagement, encouraging them to remain in the workplace.

These workshops for approximately twelve delegates are held off-site, and combine exploration of themes relevant to career longevity as well as peer-coaching and individual reflective exercises.

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2. Consultant Appraiser CPD Session on Career Development for Senior Clinicians

The appraisal interface is a key opportunity to hear and understand emerging themes and demonstrate organisational commitment to individual growth and development. This is particularly important for the senior medical workforce where the ‘flight risk’ is high.

This 2- hour educational session for appraisers, focuses on:

· The challenges and opportunities within the longer medical career

· Exploring the barriers to engagement and career development in later years

· Personality development in mid-life, applied to the context of medical careers

· Balancing tangible and intangible assets over a longer career

· The skills of creative career crafting within a long medical career

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3. Exit interviews with clinicians retiring from clinical practice age < 60 years

These qualitative, loosely structured, 60-minute interviews, give the opportunity for the trust to gain an understanding of the key aetiological factors informing a clinician’s early exit from the workforce. These decisions are invariably multifactorial, but there are often potentially remediable factors, knowledge of which may reduce the risk of further premature loss. Following a series of interviews, thematic analysis is undertaken, with identification of key points and suggestion of proposed interventions for presentation to the medical workforce lead / medical director.

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4. Interviews with clinicians >40years in key ‘hard to recruit to’ specialties

Specialties which are more challenging to recruit to, also often face more challenges retaining senior staff. Premature loss of senior clinicians in these areas represents a significant risk to a trust. A decision to leave the workforce early is usually multifactorial, but early identification and action on potentially remediable risk factors is a sound investment in areas where staffing could become ‘critically ischaemic’.

These qualitative, loosely structured, 60-minute interviews give the opportunity for the organisation to gain an understanding of the factors likely to inform an individual’s decision to remain or to leave the workforce early, as well as factors impacting on engagement at work. Following a series of interviews, thematic analysis is undertaken, with identification of key points and suggestions of proposed interventions for presentation to the medical workforce lead / medical director.

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Endorsements

Rebecca Jones, Nurse and leadership fellow, Late-career retention, Nottingham and Nottinghamshire In

Lois delivered a bespoke day in June 2023 for a group of experienced Nurses and Midwives undertaking a new role. The day was first class from start to finish. Lois took time to understand the needs of the group prior to the day and facilitated with ease and professionalism. She has a wealth of knowledge and experience to draw on and was entirely relatable. Lois was reliable and connected with me several times before the day to ensure I was happy with the content. 100% of the group rated the day as excellent. Comments included….

"Lois gave incredible insight into ways people’s minds work and how strategies can improve communication and compassionate interactions. The chimp model (Peters), especially enlightened me and gave deep insight into human behaviours and how to approach challenges we face."

"We discussed a range of coaching techniques and I have already gone and purchased several books to explore these more. I think coaching is the key to a developed thriving workforce. Lois was a brilliant facilitator."

Challenges of the Senior Medical Workforce

There is mounting evidence of the challenges of retaining and maintaining the senior medical workforce within the NHS.(1,2,3) Official figures show that the number of doctors taking early retirement from the NHS has more than trebled over the past 13 years.(4) Staffing has been described as the make-or-break issue for the NHS in England, and workforce shortages are already having a direct impact on patient care and staff experience (5). Arguably the senior medical workforce is one of the NHS’ most valuable assets, with the pipeline for replacements measured in decades.

Nationally, several interventions have been considered, aiming to prolong the clinical service of this valuable cohort.(2,3,6) These mainly focus on reducing hours, stepping down from on-call rotas and minimising out of hours work. There is a tendency to see these latter years as ‘winding down’, but trusts that are prepared to work creatively with their senior clinicians, can potentially not just improve retention, but also engagement, harnessing these individuals' strengths, knowledge and experience to the benefit of the organisation.

A combined approach, focusing on both individual and organisational interventions is likely to be most effective.

If you would like to explore what combination of interventions might work best for your organisation, then contact Lois directly at loisbrand@icloud.com to arrange an exploratory conversation.

References

1) The Academy of Medical Royal Colleges. The Academy of Medical Royal Colleges Later Careers Survey Results. AOMRC, 2017

2) Royal College of Physicians. Later Careers: stemming the drain of expertise and skills from the profession. RCP, 2018

3)Royal College of Obstetricians and Gynaecologists. Late Career and Retirement Report. Retaining O&G Doctors in the Workforce for Longer. RCOG, 2020

bmj.n1594

5)Closing the Gap: Key areas for action on the health and care workforce. The Kings Fund. March 2019

6)A dozen things the NHS could do tomorrow to help the medical workforce crisis. AoMRC. December 2021

Lois Brand Coaching - Career development for senior clinicians

Retention and Engagement of the Senior Medical Work Force

Interventions

1. CAREER PITSTOP FOR SENIOR CLINICIANS

2. Consultant Appraiser CPD Session on Career Development for Senior Clinicians

3. Exit interviews with clinicians retiring from clinical practice age < 60 years

4. Interviews with clinicians >40years in key ‘hard to recruit to’ specialties

Endorsements

Rebecca Jones, Nurse and leadership fellow, Late-career retention, Nottingham and Nottinghamshire In

Challenges of the Senior Medical Workforce

4)Moberley T. Doctors’ early retirement has trebled since 2008. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1594

5)Closing the Gap: Key areas for action on the health and care workforce. The Kings Fund. March 2019

6)A dozen things the NHS could do tomorrow to help the medical workforce crisis. AoMRC. December 2021

Lois Brand Coaching - Career development for senior clinicians

Retention and Engagement of the Senior Medical Work Force

Interventions

1. CAREER PITSTOP FOR SENIOR CLINICIANS

2. Consultant Appraiser CPD Session on Career Development for Senior Clinicians

3. Exit interviews with clinicians retiring from clinical practice age < 60 years

4. Interviews with clinicians >40years in key ‘hard to recruit to’ specialties

Endorsements

Rebecca Jones, Nurse and leadership fellow, Late-career retention, Nottingham and Nottinghamshire In

Challenges of the Senior Medical Workforce

4)Moberley T. Doctors’ early retirement has trebled since 2008. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1594

5)Closing the Gap: Key areas for action on the health and care workforce. The Kings Fund. March 2019

6)A dozen things the NHS could do tomorrow to help the medical workforce crisis. AoMRC. December 2021

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