When retirement beckons, flexible working might tempt older nurses to stay

Flexible working, especially the option to do shorter hours, could help retain older nurses, many of whom want to continue but feel burnt out.

Flexible working, especially the option to do shorter hours, could help retain older nurses, many of whom want to continue but feel burnt out

Picture: Science Photo Library

Three months after retiring at 55, renal nurse Julie Emerson found she missed working and took another post. But while keen to share the skills and experience built up over almost four decades, she has handed in her notice at her most recent job after struggling with 13-hour shifts.

It was when she made a mistake during a long, tiring shift that she realised she could not continue. Ms Emerson, 57, from Corby, Northamptonshire, says: ‘I have never made such an error in my life and I can only think it was because I was so tired – and that isn’t safe.


More than 190,000 nurses and midwives on the register are aged over 51

‘I’m fit and healthy, but after a 13-hour shift, the next day my knees and back ache and my head is banging from not having enough liquid to drink. I was so fatigued.’

Ms Emerson is one of a growing number of nurses working past retirement into their late 50s, 60s and even their 70s.

Looming problem

Figures issued by the Nursing and Midwifery Council in September revealed that more than 500 nurses and midwives practising in the UK are over 70.

More than 190,000 nurses and midwives on the register are aged over 51, NMC chief executive Jackie Smith told a conference. She described the ageing workforce as a ‘problem looming’.

The usual NHS pension age is now the same as the state pension age, which means that up to 70% of current scheme members have a pension age between 65 and 68.

But while it has long been known that the nursing workforce is ageing, many nurses willing to continue working are finding that employers are not always doing enough to support them.

Challenging rotas

In a discussion on Nursing Standard's Facebook page about the increasing number of nurses working into their 70s, nurses talked about the difficulties they could foresee – or were already experiencing.

Struggles with 13-hour shifts and repeated evening and night-time working, and the lack of support from sisters, charge nurses and other staff when it came to finding a solution, were expressed.

Others stressed that they or their colleagues enjoyed working into later life. One respondent said she worked with a fantastic and capable healthcare assistant who was in her 80s.

But many others voiced concerns that their physical health would be worn down. Nursing jobs can be tough physically, and more than 45% of staff sickness absence on the NHS is due to musculoskeletal problems such as bad backs. Some nurses worried that they could jeopardise their well-being by working longer in gruelling jobs.

Flexible working

One said: ‘Can you imagine shifts in your 70s? The ageism was bad enough at 55. But if you want to and can, then it's up to the individual.’

While the media often picks up stories of nurses working into their 80s – and one US theatre nurse into her 90s – RCN national officer Nicola Lee says it is relatively unusual for nurses to work beyond the age of 65.

But nurses who can retire at 55 do often choose to retire flexibly, which allows them to continue working, or delay their retirement by stepping into to a less demanding role or reducing their hours.

‘The ageing workforce is not getting top billing, even though it is having an impact on staff shortages’

Nicola Lee

The need to retain staff is clear, with the RCN reporting a shortage of 40,000 nurses in England earlier this year.

NHS Employers Working Longer Group, which considered the issues relating to an ageing workforce, emphasised the need for flexible working, including different work patterns, to support older staff tocontinue working until a higher pension age.

Flexible working can mean varying job content, type of work, location and start and finish times. While managers can find it difficult to balance conflicting requests for flexible working while meeting the needs of the service, if they are open to discussion and negotiation with employees solutions will often come from staff, the group said.

Ms Lee says the financial and workforce pressures on the NHS appear to be making it harder for managers to consider more flexible options. ‘My feeling is that there are just so many other pressures on the health service that demographic change and the ageing workforce is not getting top billing, even though it is having an impact on staff shortages.

These pressures are also making nurses who can retire keener to do so as their work is so demanding. ‘Huge numbers of nurses, particularly in the community but not exclusively, due to retire imminently, are feeling so burnt out that they will because they can. It’s a vicious cycle, the pull of retirement to get out of that vortex.’

The ongoing shortage of nurses, increases in pension age and the ageing workforce mean flexible working is an issue employers will need to deal with, she says. ‘Employers are really going to have to grasp flexible work and flexible retirement. People are going to need to work differently in later life.’

Andrea Derrett, who works as a district nurse for three days a week near Newport in south Wales, says that while she loves the contact with patients, an increase in paperwork and a lack of flexibility from her employer mean she will hand her notice in at the end of the year.

She will do some bank nursing and seek other non-nursing work in the future after a request to reduce her hours was rejected.

‘I have been nursing for a long time, and it has changed so much,’ she says. ‘I love it and will be sad to go.’

The need for more flexible working times for nurses has been recognised by Jeremy Hunt, who announced that a new app supporting this move will be piloted by 12 trusts next year. ‘If we’re to get the best out of nurses we need to be much better at supporting them with their own caring responsibilities,’ he told the Conservative Party conference in October.

‘They need to be able to work flexibly, do extra hours at short notice, get paid more quickly when they do and make their own choices on pension contributions,’ Mr Hunt said.

What employers need to do

A ‘working longer’ survey by the RCN in 2013 of members who were either retired or aged 60 or over, said shorter hours, often supplemented by pension income, flexible working and reduced or no night shifts were the most important issues that made a return to work possible in this group.

Management support and a less physically demanding and stressful role also scored highly. Six out of ten retired respondents who had returned to work said these conditions were not available in their previous pre-retirement role or with their previous employer.

James Buchan, professor in the faculty of health and social sciences at Queen Margaret University in Edinburgh, agreed that employers were failing to take the necessary action to support older staff.

‘Flexible hours, flexible pension, flexible time off for elder care or for study can all help’

James Buchan

‘Improving staff retention has been identified as the number one priority for the NHS as it struggles to deal with nursing shortages. Yet we continue to hear that some NHS employers have not age-proofed their approach to retention,’ said Professor Buchan.

‘Flexible hours, flexible pension, flexible time off for elder care or for study can all help. Nursing has to be 24/7, but that doesn’t mean that all nurses should be expected to be available across the week, month or year.’

More options

Before she handed in her notice, Ms Emerson had a request to work ten-hour rather than 13-hour shifts turned down. She is searching for new work, preferably with shorter shifts, and wishes she had known more about flexible retirement before leaving her original post.

‘It took me an hour to drive each way so it was a 15-hour day, and driving home at midnight after a shift just did it for me. I would get eight hours into a shift and I would feel so fatigued. Trusts should offer more options to nurses when they reach 55. That has to be better than losing nurses through retirement.’

How employers can support an ageing workforce

  • Ensure appraisals are held regularly.
  • Do not use someone’s age as a reason to justify or tolerate poor performance, or to insist on different levels of performance than would otherwise be expected.
  • Take a supportive approach and consider flexible working patterns or job design if someone is finding their current role difficult.
  • Include further plans and retirement aspirations in one-to-one and appraisal discussions.


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