Age profiling nurses reduces the risk of skill and knowledge gaps

6 June, 2010

The nursing workforce is in the midst of a historic period of review and change. An ageing demographic, combined with a period of redesign in some services, will for all employers mean putting their equality and diversity policies centre stage to ensure they have the right workforce to deliver effective patient care.

One in five nurses on the UK’s professional register is aged 50 years or older. Over the next few years, the profession could lose many of its most experienced practitioners through retirement. In addition, as more and more nurses reach their middle years they are likely to have different requirements and attitudes to nursing work. Therefore, if employers are to continue to get the best from their workforce they will need to ensure their policies on age are equitable.

As well as the social and economic drivers of change, legislative measures are playing their own part too. In 2009 the government published its strategy to address the demographic changes and opportunities of an ageing society. Building a Strategy for All Ages outlines its vision for a future where people are not defined by age; this is supported by the Equality Bill which, in April of this year, became an act of Parliament, outlawing unjustified discrimination on the basis of age when providing goods and services.

‘Employers who understand the demographics of their workforce and address the associated risks can avoid loss in productivity as well as costly recruitment drives’

Over the last 18 months while the private sector has, in many areas, contracted in size due to the economy, the public sector has found itself in an attractive position, able to draw from a deeper pool of recruits. The tide is now changing and the public sector is faced with those same financial pressures but this is no reason to abandon the diversity work that has happened so far.

The NHS still needs to attract, employ and develop the best staff to meet the needs of a changing population and yet the nursing profession is expected to lose, through retirement, many of its most experienced practitioners over the next few years; in addition to this, there will be fewer school leavers entering the labour market.

In this increasingly competitive market for talent, staff retention becomes ever more vital; recruiting staff is a costly exercise for employers in terms of the time it takes to recruit and the organisational knowledge that departs when experienced and skilled staff leave.

Employers who understand the demographics of their own workforce and address the associated risks can make informed decisions and avoid any resulting loss in productivity as well as the expense of costly recruitment drives.

The need and desire to provide more community based care to more people alongside the need to cut waste from the system has led to employers looking to bring together several teams, develop new roles or develop new models of service delivery to support changes in the delivery of healthcare. The change in any service delivery model needs to be sustainable and employers need to ensure that they have taken into consideration how to maintain any of the developments that are introduced. To do this they will need demographic data.

Age profiling can help an organisation to make informed, evidence based decisions around its workforce and therefore also around its models of service delivery. To get started and to establish a baseline data set, employers need to know how many people are employed by age group or age band.

Alongside age data, employers also need to consider the working patterns, practices and the skills profile of their teams. Without this baseline data it will be very difficult to plan employment or service changes that are sustainable. NHS Employers has developed a range of tools and guidance for employers on how to do this systematically and how to undertake effective analysis. See the box for details on how to download these materials and other useful information.

Using the local age profile data collected employers can also see their own organisation’s potential retirement projection. In order to reduce the risk of expensive skill and knowledge gaps it is imperative that managers of services are fully aware of the flexibilities and options that can be used within the NHS Pension Scheme if needed. Retaining skilled staff - even if on a reduced hours basis or in a different role - can be critical to not only ensuring the continuation of services but also maintaining the motivation of other team members.

While we are still in the early days of a new government we already know that there is a commitment to protecting NHS budgets as well as phasing out the default retirement age. Still despite this the challenges facing employers should not be underestimated. By placing the management of diversity at the centre of the business planning process, real sustainable changes can be delivered while enhancing the quality of care for patients, reducing employer costs and establishing a strong reputation for the organisation.

Readers' comments (12)

Anonymous | 6-Jun-2010 12:11 pm
i suspect that the nhs, like almost every government funded organisation, will go for the cheapest short-term option, as always...
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Martin Gray | 7-Jun-2010 9:09 am
I am retiring from nursing on 1st August, mainly due to disability I admit, at the age of 55 (just). However, I have become so disillusioned with the way the profession has changed so dramatically since Project 2000, I am glad to be 'hanging up my uniform'.

After reading so many of the comments from us old school nurses on different topics on the NT website I strongly suspect I am not alone in my feelings; many more would now retire early if they were able to and for the same reasons as myself. So many arguments over degree/non degree entry, poor standards of patient care with a myriad of excuses in justification, the constant pressure of having to achieve ever higher academic qualifications to enable nurses to do more of the junior doctor role, and the general attitude of management and newly qualified nurses and students towards their elder, more experienced peers.

To achieve the correct skill mix to deliver proper nursing care, as opposed to filling in care plans and the like, will be to have more HCAs rather than nurses. That way both the Government and the DoH can achieve their goals whilst cutting down on nurse salaries. I truly believed that any new government would address the imbalance between the number of managers to front line nurses, and sniggered at the fear of nurses losing their jobs. Now I am saddened and disgusted at what is happening, despite the promises of Cameron and Clegg, to see that I was so wrong in my belief.

Perhaps a solution would be to employ the older nurses, that still hold the same care values of basic nursing care over modern teaching, to be clinical tutors once again. The clinical tutors were responsible for teaching practical nursing on the wards, and it is since their role was removed altogether that basic nursing care has reached such a low delivery of patient care.

In order to move forward perhaps we need to reflect, honestly and criticaly, to what nursing once used to be. In that way many of the failings can be identified, and rectified, and the profession can regain the standing it once had in society.
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Angela Grayson | 7-Jun-2010 9:28 am
I am about to start Nurse training at the age of 49. There are several people on my course who are in their forties. I think there is a 'new' generation of older nurses coming along. I am hoping sincerely that my life experience-I worked in Psychiatry for 12 years in a non-nursing capacity-combined with training, will mean that I will not be retired early (that gives me only a few years!!) but utilised as an equally valuable member of staff, regardless of my age. I am being told that the retirement age will be going up over the next few years. I hope newly-trained 'oldies' like me won't be wasting our time in trying to enter the Nursing profession.
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Martin Gray | 8-Jun-2010 10:44 am
I take my hat off to you Angela, you are undertaking a huge commitment, and one that may, unfortunatley, not be rewarded as well as you may expect.

When it comes to nurse training I'm not convinced that the age of a student is relevent as they all receive the same training, which is where things appear to go wrong.

I wish you the very best of success and hope your time and effort, plus the commitment you are placing upon yourself, are suitably rewarded.
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thestockies@hotmail.com | 8-Jun-2010 11:52 am
Martin has pretty much covered it all in his comments.
I left hospital nursing in 2000. I had been a ward manager on a medical ward for 12 or more years. In the late 90s saw a multiple increase in managers, all out to cut budgets and many without hospital experience. As a result of P2000, all student nurses, making up 50-70% of the daily workforce became college based and their replacement HCAs didn't ever materialise. Often, twice weekly on average, I would be left working with one other untrained nurse on a late shift to care for 28 pts and also expected to take admissions from A&E. When I refused to take, and I often did, I just ran up againt my managers. I regularly complained in writing, stating the various Code of Practice infringement but was ignored.
I think that CARE and COMPASSION has been gradually bred out of the health service over a number of years and my fears are that it will never return.
I read today that holding the hand of a patient can be comforting to them, and I also read that following the death of a patient in my local hospital from septicaemia, in future, any patient who has a pyrexia of over 37.5 c will have their observations recorded 4 hourly.
The irony is that these rules and ideas are being introduced by the "diploma" trained nurses who think they are breaking new ground. These nurses, following qualification in the late 90s, did not know how to set up an infusion, and many had poor clinical skills and certainly lacked compassion.
Training prior to P2000 would have seen 1st year nurses performing these tasks safely and competently. Oh, and they also CARED. In their 1st year they would have hands on experience learning about nutrition, skin/pressure care, hygene and infection control. They would have been show how to perform these tasks with compassion and empathy. Many times in those days have walked passed a student nurse, sitting holding the hand of a patient and having a quiet chat.
These days, as a patient, you are ignored by almost all you come into contact with.
The person responsible for our care crisis is Mrs. Thatcher and Ken Clarke. John Major attempted damage limitation by reducing a line of managers, but he left the managers to do this themselves and in true form, they removed all the effective, experienced ones and left the numpties in post.
I am 63 and in the last year I have applied for 4 staff nurse posts. I always get an interview, because I suspect they don't want the ageist thing thrown at them, but that's as far as it goes. I know I can show these people how to care though and introduce some humanity back into the system.

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halfanurse1987 | 10-Jun-2010 5:31 pm
As a student I have to say that I get worried by all of these comments about nursing students that dont talk to patients or know basic skills.
I was taught the basics before going out into the clinical area and always take time to talk to patients. From what I can see I have the time to do this as a student while the qualified staff members are consumed by paperwork.
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Michelle Phillips | 11-Jun-2010 11:06 am
I would like to see the statists that show what age group of staff that are actually hands on with patient care...I suspect that most experienced qualified nursing staff are not ward base or directly hands on with patients care and this may be the reflection of a group of staff at that are reaching retirement age.
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maria gough | 12-Jun-2010 0:29 am
In the years to come the government of the day will have to choose between bringing in foreign nurses to provide professional care and mentorship or making it worthwhile for the likes of me to remain in service for longer.

Since nurses can pick up their NHS pensions from age 55 - the Government will have to work hard to keep NHS trained and experienced, intuitive, hard-working, cost-effective senior nurses like me in service.

Good luck with that one David.

Maria Gough, Dip HE, Dip Couns, RGN, BSc (Hons), LLM
Senior Nurse Practitioner
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judith willis | 12-Jun-2010 1:13 am
Martin Gray...I take my hat off to you. I wish you all the best in your retirement. I echo everything you have just written.

I had to retire at 53 due to a health problem having nursed for 30 years in hospitals, in clinical, teaching and managerial positions. It did not matter what I did or how much I enjoyed my roles, I always returned to the clinical arena. I just loved direct hands on.

When I retired I wondered,what on earth will I do... No problem there, within three weeks I was in primary care as a practice nurse. That was eleven years ago and I am still doing it and loving every moment.
My training (apprenticeship) likes yours no doubt,and experience along the way equipt me with all the skills one needs.

I am now a 64 year old biddy....(who said that) but you know what...the students, both nursing and medical undergraduate and graduates flock to be with me because of my knowledge and more importantly my experience. You and I both know what we have built up over the years, these youngsters have mised out on an awful lot. Like you,I saw the writing on the wall with the suggestion of project 2000, so no surprises for us, now that it is here. I feel desperately sorry for those now entering nursing but even more so for the patients who will never receive the care that we used to give.

A long and happy retirement to you.

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tedbill5 | 15-Jun-2010 11:10 pm
Surely it is the lack of resources that means nurses cannot spend time with patients rather than their qualification. The NHS is following other public services, over laden with managers and target driven to the detriment of caring for people. The NHS is becoming a 'business' rather than a person centred service. I am a mature student on a first year post grad mental health nursing course, I have spent the past 20 years working with disadvantaged people and I certainly care and have always strived to do my utmost for their benefit. Ironically it is the mentors that I deal with who have years in the job who appear not to care from their negative attitudes and that truly is a shame because they can pass on their attitudes to others and potentially make future nurses hardened to patients and the NHS before they even begin their career.
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Steve Williams | 30-Jul-2010 7:07 am
Martin Gray – don't you dare retire. Old nurses never retire, they simply fade away...

Seriously though sirrah, you are the same age as me – probably with far more you could still offer the service – far too young to retire. Even if you have some physical probs or whatever, we'll all club together and buy you a wheelchair and a feeding cup.

Listen, it's like the armed forces, even if you absolutely cannot continue on the front-line there's still plenty of stuff where your breadth of experience could be more than usefully applied.

Yes, your “clinical tutors” idea is brilliant (I didn't realise they'd done away with them.) My various CT's were a wonderful education that opened up my thinking to problem-solving in ways that reading Sainsbury's “Key To Psychiatry” never could.

But bear with me for a second Martin... there's an even bigger picture you could be contemplating that wouldn't impinge upon your pension rights, something that the service professionals have been waiting and needing for the last two decades... A NURSE ADVOCATE.

Whoaaaaa.... stay with me for a minute and stop giggling so much....Let me explain! Give me six or seven paragraphs before dismissing the concept.

It's just a germ of an idea I've had at the moment and I admit I haven't thought it all the way through but I have a vision... These are just a few ideas I am spewing out after a few glasses

Martin, (and anyone else who's interested) seriously look around you at the current situation in the UK,

For starters:
Read the posts just on this board. There has been much muttering about the need for a nurses union run BY nurses and FOR nurses. To advocate for nurses when the government, the NMC, the RCN and the unions have thrown them to the wolves. mike, I and quite a few others have gingerly danced around this issue in the recent past but the idea is there.

Secondly:
The “Press” (a male-dominated chauvinistic institution) is against supporting “Nursing” as a (female-dominated, masochistic profession) – simply because nurses have to be much more qualified and held to an higher accountable standard than journalists do. Vagina envy or what? See the Daily Mail if you don't believe that nurses are either 'angels' or 'demons'....

Thirdly:
Doctor Who versus Mary Whitehouse. Remember her? Yes of course you do – you are the same age as me. In 1963 she started a campaign to clean up what she perceived as unnecessary violence and sex on Television, the stage and the Daily Mail. (http://en.wikipedia.org/wiki/Mary_Whitehouse)

Just one woman (working from her front room) and her (albeit) bigoted views made that campaign work and it is still running until this day.

I make no comment about whether her tenet was right or wrong... I do admire that she had the brass balls to run it from her little Essex cottage and the fact that it became a National force.

Fourthly
Is it beyond the bounds of conception that Nurses (new, current and retired) could, for the first time, coagulate themselves into a body that not only expertly repudiates media fiction but also challenges the nonsense that is dished up to us here (on The Nursing Times) but also in the national press.

Martin Gray, you have a mission. Set up a website. Call it... well I don't know.... “Gray Aliens In The NHS...” or “HELLO I'M NOT GRAY... seriously I'm not!”

LISTEN.... you have to do this. Nurses need a nurse-advocate from the shop-floor and there's no one more erudite and lucid than you.

mike et al. will help you (as will I) WE NEED an organisation (not a union) that will fight for our rights not to be viewed as Doctors Handmaidens/whores, male wannabes....

Think about it Martin.

Seriously.

You have the chance to start something that most of us will never get the chance to do. mike can't do it – he's too young. I can't do it – I am here in Canada. Lot's of people can't do it because they simply haven't got your kudos, flamboyance and longevity.

Don't misunderstand me. It's not a union or a professional body – but a nurses pressure-group to instantly repudiate every “anti-nursing” bit of misinformation that comes out of the government or the press... just like Mary vehemently waxed-away after every Tom Baker episode concluded!

Still want to retire into lonely submission? I thought not!!! :)

New bit...

“Patient Advocation” has been a good and justly cause for the last two decades... but now it is the 21st Century and we need to assimilate the concept of “Nurses Advocation” into our common vocabulary.

We, as a service – just like the armed forces – need an organisation that will understand the stresses we face and duly defend us when we are at our weakest and most vulnerable.

The organisation and the managers that have placed us in that situation are the culpable villains and they need to be appropriately punished and dismissed.

We need plenty of these old-farts like Martin – and some new “old-farts” like mike to kick-off a new concept of nursing... Nursing For Nurses... Not a union – a public pressure group like Mary Whitehouse organised.

Martin can start it, he doesn't need to be afraid. The contributions will come in from far and wide. He doesn't even need to be worried about setting it up – there's loads of nurses that will give him help. He doesn't even need to worry that he might end up as the figurehead of this movement – remember Tolstoy, Lenin and Stalin?

Listen up flocks.... I don't care how old you are, how many degrees you have gotten, how many hands you hold or brows you lovingly stroke whether you are an RMN, SGN, RMNH, RN, HscB, BHC, Dip Soc or Dippy Sock with tumble drier.... the basic fact is that you are all getting deeply rogered up the rectum...

(Assumes Victor Meldrew persona) Holy Christmas night... When will you silly girls not realise that you are simply being shafted because your public persona is one of Angels?

Actually I am NOT an angel. I hate it when I am called a “professional” because it means I am being shafted. I am a medical health service provider, a qualified RN that deserves the same recognition on the pay-scale as an MD, surgeon, HCA, PSW, RPN, porter, dietician et al.

Yup, guess what categories got a 16% raise in Ontario - and guess which “profession” got a mere 1% increase?

Am I bitter? No not in the slightest. To be bitter would mean that you have at least two connecting synapses in your frontal cortex – no chance there then... I'm just a nurse...

OF COURSE I AM FUCKING BITTER!!!! THE NHS RUINED MY BLOODY LIFE!

Oh yeah, that's what I originally meant to say...

So toodle-pip for now
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fidawn | 5-Aug-2010 10:07 am
at 60years old, i discussed part time with my manager. later that week the acting agency(pulse) senior nurse approached me after clinic and talked about part time , said she would sort somthing out for me.after leaving she shouted up the corridore in clinic "you will hand your notice in next week".i was so shocked after 31years at this nhs trust an acting agency manager should behave in this way .i lost all my confidence. have not worked since,two and a half years on i am still awaiting a thank you from the trust .i am now trying to find part time as a care assistant hope i will be lucky .i hope other nurses are not treated the way i was .is this how all nhs trusts treat there staff?
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