Later careers: Stemming the drain of expertise and skills from the profession

At a time of low morale less‐than‐full‐time (LTFT) working at a later stage of a consultant career can be of benefit to patients, the individual doctor, the hospital and the wider medical community. But it must be properly planned so everyone in the team understands and appreciates their role.

The guidance aims to:

• develop a sustainable model of working that enables a satisfactory work–life balance for doctors prior to retirement
• enable doctors working LTFT to be fully integrated and valued within the team in which they are working, to the benefit of that team and patients
• develop resources and mechanisms to support revalidation and appraisal.

Summary of recommendations

The RCP supports flexible working to retain consultants in the later stages of their career. Their continued involvement enhances quality and patient care.

Benefits of retaining senior doctors

• Make flexible or part‐time working options available to senior doctors where possible.
• Mentoring of newly appointed or trainees should be included in a senior doctor’s job plan.

Less‐than‐full‐time working

• Senior doctors and clinical leads should begin a discussion at age 55 about intentions for the next 10 years.  
• Job planning should be done as a department to make sure roles are complementary.
• The hospital and consultant should agree an annual total of programmed activities.
• Past the age of 60, a consultant should opt into on‐call only if they wish to, after discussion with the clinical lead.
• The hospital and consultant should consider job sharing.

Revalidation and appraisal

• The RCP should review its CPD requirement for senior doctors.
• Appraisal of senior doctors should be sensitive and proportionate to their working arrangements.  
• Investment in IT systems or administrative support teams should be provided to support the consultant with collection of information for appraisal.
• Mandatory training should be appropriate to the clinical role. The Responsible Officer should show judgement on requirements.

Health and long term conditions

• More research is needed into the number of doctors with long term conditions and the impact on their working lives.
• The RCP should take a lead in a positive, proactive approach to finding solutions that will help doctors who are disabled or have a long term health condition have the best chance of continuing to work.
• Departmental job planning is vital to ensuring that doctors with ill‐health or disability have work commensurate with their capacity and make a valuable contribution to their teams.  
• Issues of revalidation and ‘fitness to practice’ may need bespoke solutions when there have been extended periods of ill‐health. Retention of skilled individuals with the best health possible should be the guiding principle.
• The establishment of regional occupational health departments with experience of individuals with complex conditions should be considered.

If you have any questions or want to know more about the report, please email mwucensus@rcplondon.ac.uk.