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Our Research:

Workforce and Organisation of Care

Theme Leader: Dr Diane Skåtun

The Workforce and Organisation can have severe implications for workforce planning
of Care theme aims to further and service provision. Our research on ‘Medical
our understanding of individual training pathways’ seeks to better understand the
and organisational behaviour movement of medical trainees at a critical point in
within the healthcare sector. The their training pathway where choices are made in
health service faces continuing terms of progressing to speciality training. This project
pressures on recruiting and undertaken by Diane Skåtun and Attakrit Leckcivilize
Diane Skåtun
retaining its workforce. With focuses on the transition of medical trainees through
Theme Leader
increasing demands on the health the training pathway in terms of a time dimension,
service, it is important that the role of the healthcare taking into consideration the outside opportunities
workforce, as a crucial resource within the healthcare that trainees may have. It also considers the movement
system, is better understood. The theme examines the of trainees to specific specialities.
role of financial and non-financial incentives on both
2019 saw the continuation of research on the project
individuals and the organisational structure in which
‘What keeps doctors practising? A discrete choice
they operate. The theme’s research spans all aspects of
experiment to determine which factors influence doctors’
the health workforce life-cycle; from training decisions
retirement decisions and the relative importance of
at the start of a career through to career-end retirement
each influencing factor’. This project is funded by
decisions.
the University of Aberdeen Development Trust
A new project began in 2019 that considers the and continues HERU’s collaboration with Professor
behaviour of individuals undertaking medical training. Jen Cleland of the Centre for Healthcare Education
Medical training is a long-term investment for both Research and Innovation (CHERI) at the University of
trainees and the government. Changes in behaviour Aberdeen and Terry Porteous (CHERI and HERU) along
in terms of the flow through the training pathway with Diane Skåtun, Zoé Ejebu and Mandy Ryan.

Doctors’ retirement decisions: should I stay or should I go?
HERU investigators: Diane Skåtun, Zoé Ejebu, Terry Porteous and Mandy Ryan

While retirement is a natural stage in a career, early retirement results in an immediate
loss of experienced clinicians. This can impact directly on patients through a loss of
clinical capacity but also have indirect impact in terms of reduced support and access
to an accumulated knowledge-base for remaining colleagues. Recent research has
shown that a significant proportion of doctors approaching the end of their career,
plan to retire within the next few years. Given these issues, the aims of this study are: to
explore the factors that doctors consider as they plan when to retire; to determine the
relative importance of those factors; and to establish whether and how doctors might
trade-off between them. A better understanding of these issues will inform future
interventions that may encourage older doctors to remain for longer in the workforce.
Qualitative, semi-structured face-to-face interviews have been undertaken to explore the factors that doctors consider
when deciding whether to retire or stay in the workplace. Key ‘stay‘ and go’ factors that might prompt a doctor to retire
or stay in the workforce were identified as relating to financial concerns, perceived lack of support from management
and workload intensity. This data helped develop a quantitative survey instrument (Discrete Choice Experiment)
to target doctors aged over 50 years, registered with the General Medical Council in Scotland and either practicing
or recently retired in both the primary and secondary care sectors. Survey distribution was facilitated by the British
Medical Association. The data will be analysed and reported in 2020.

10 HERU ANNUAL REPORT 2019