Career Pitstops for Senior Clinicians – a creative intervention to address senior clinician retention

There is growing concern over the shape and demographic of the UK medical workforce in the years ahead, due to the potential drain of highly experienced clinicians whose premature loss will have a significant impact on the service.¹ Although much has been written by Royal Colleges^2,3 and in the recently published ‘NHS Long Term Workforce Plan’⁴ suggesting that a more flexible approach is needed to retain senior staff, little seems to be filtering through to practical action within NHS Trusts.

At the end of 2021, after nearly twenty years as an emergency physician, I concluded that my clinical career was no longer sustainable. I loved the team and the department and had explored several options that may have made it manageable, but the flexibility was not there for me to remain and flourish. After leaving the trust, I met with the Medical Director and Director of the Medical Workforce to raise my concerns about the need for a more creative and proactive approach to the latter years of a medical career.   Following this discussion, I developed and piloted a one-day ‘Career Pitstop’ workshop for senior clinicians, with funding and support from the Thames Valley Deanery. The day aims to empower and enable doctors to take stock of their current skills, knowledge, and strengths. Recognising and normalising the inevitable challenges that arise for clinicians who have been in post for many years and providing a psychologically safe space to explore these issues together as a group. Reflection and peer-coaching help to identify personal and professional development needs and encourage delegates to actively plan the next stage of their careers.

Feedback from delegates has been overwhelmingly positive, with limited longer-term follow-up suggesting that it has indeed empowered clinicians to make significant changes in their work plans, improving sustainability.

Here’s an example of feedback from a recent delegate:

“I made enquiries the week after the course to have a meeting with someone in the Deanery who is involved in anaesthesia and surgery in low-income countries. It is something I had always wanted to do but had not felt empowered to do because I'd not done any of this sort of thing as a trainee, and now as a 'senior' consultant, I was not confident I would be accepted. The day with you, and the other participants, gave me a boost of confidence mainly due to realising that everyone was also having doubts about their abilities and wondering what to do with the rest of their careers, and I am now well on my way to training to be useful in the low-income environment, including a trip to Uganda in November. My focus is going to be on education and training in these environments as I think this is the most sustainable way to improve healthcare there (and everywhere, in my opinion).”

The numbers to date are small, but this intervention is potentially scalable. For maximum efficacy it would be set within the broader context of institutional support for a flexible, pro-active, and forward-looking approach to senior clinician professional development, working synergistically with the established consultant appraisal process. I am grateful to the Thames Valley Deanery for recognising the importance of a proactive approach in this field and working with me to pilot this project.

By Dr Lois Brand

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
4. NHS England. The NHS Long Term Workforce Plan. 2023