Recently, I attended the NHS Improvement alumni conference aimed at the Trusts who were participants in the initial waves of the NHS Improvement Recruitment and Retention Collaborative. It was great to see figures presented at the conference showing that overall nursing turnover rates have fallen from 12.5% to 11.9% since the start of the programme, and although there are some regional differences, nationally, we have not seen this turnover rate since 2014. It was also great to hear peers share case studies on how they had made progress in both recruiting and retaining staff.
When I consider the age profile of nurses and midwives in my own trust, I recognise that we have an opportunity to recruit these valued people back into roles that are attractive to them and support the ongoing delivery of care, in turn supporting our nursing and midwifery teams.
There were two phrases that consistently came up throughout the day as high impact areas for Trusts to look at: flexible working, which is an area that I wrote about recently in BJN (Foster, 2019), and organisational approaches to retirement.
During the alumni event, Mark Radford, Deputy Chief Nurse at NHS Improvement, quoted a troubling statistic: last year the NHS recruited more nurses from Portugal than it retained through ‘retire and return’ posts. The Nursing and Midwifery Council (NMC) (2018) reported that of the 3496 respondents to a survey of nurses and midwives who had left the NMC register, 52% gave ‘I have retired’ in their top three reasons. Furthermore, the NMC reported that the two largest age groups on the NMC register are people aged 41-50 and 51-60, and that together these two age groups account for 56% of the total register.
Watson et al (2003) found that stakeholders in the nursing workforce, including senior nurse managers, human resources professionals, and trade union reps admitted to a poor translation of policies relating to retire and return. During the round table discussions at the alumni event, there were many examples of situations where confusion surrounding options for staff who would like to retire and return and myths around the application of policies to support staff to return to nursing following retirement had led to missed opportunities to retain staff.
Watson et al (2003) also explored the factors that influence older nurses' employment decisions and found that there were a number of both positive and negative considerations. Negative factors included the pace of the modern NHS and technological change, in addition to feelings of stress and burnout. Positive reasons included the opportunity for flexible hours, and the ability to continue to earn a salary if well advised on pension matters.
One of the peers cited as having made improvements in how they approach the process of retire and return was Southend University Hospital NHS Foundation Trust. NHS Improvement (2019) has shared the Southend approach online. The Flexible Retirement & Retire and Return: A Guide for Staff and Managers guidelines (Southend University Hospital NHS Foundation Trust, 2018) are intended to answer some of the questions staff and managers may have regarding retirement. The Trust highlights that it aims to make the retirement process for those who wish to retire as easy and as problem free as possible. The aims of ‘retire and return’ are to:
In the guidance, Southend has identified a number of options available to staff to stay on in employment within the Trust, or return following retirement (which would allow them access to their NHS pension), together with details of the benefits or considerations involved in each case:
Also detailed are offers of pre-retirement support meetings on a one-to-one basis, pre-retirement seminars and follow up independent financial advice, which is provided free to staff. Individuals have access to a health check and occupational health services.
To conclude, it is clear that we need a number of approaches to continue to improve the turnover of nursing staff in the UK, and learning from examples such as Southend we can devote specific attention to retaining nurses and midwives who will be considering retirement options, and in turn the NHS will retain this valued group of staff.