Edinburgh Napier University

  The NHS in Scotland (NHSS) is facing an unprecedented financial and operational challenges (Audit Scotland, 2023). Current staff are working under extreme pressure. Frustrations around workload, pay, and pensions are leading professionals to use their voice and engage in collective resistance through strike action. Senior clinicians, especially those over 50, are often in the privileged position that they can resist by exiting the organisation through early retirement or by scaling back work commitments. This paper explores the relationship between breached work expectations, work orientations, and senior doctors’ intentions to retire (ITR) or reduce work commitments.
The paper draws on data from an online survey of 1698 senior doctors across NHSS conducted in December 2022. The questionnaire was designed to explore retirement plans and included questions on work engagement, work orientation and centrality, burnout, pay and pensions, attachment to colleagues, and work-life balance as well as two open-ended questions asking doctors which generated 1535 often-lengthy responses (~300 pages). We adopted an integrative mixed method strategy analysis to holistically address the research question (Akerblad, Seppänen-Järvelä & Haapakoski, 2021). Statistical analyses including ANOVA to compare subgroups, exploratory factor analysis (EFA), and univariate analysis for selected demographic variables were completed. We undertook thematic analysis of the qualitative responses, guided by the EFA but also explored areas raised by the respondents.
The survey found that 47.65% of doctors 50 years old or over intend to retire (ITR) before normal pension age. Most intend to transition into retirement by scaling down work commitments. From the statistical analysis and free text commentary combined, it was clear that the main driver towards taking early retirement / scaling down was pension taxation issues*. Organisational disillusionment and disidentification (OiDD) was the second most important reason for premature ITR, either solely or in combination with other reasons. Both issues often combined with other important factors (such as burn out, a lack of meaning derived from their work, reduced engagement, health and family commitments) to provide a multifactorial explanation of premature withdrawal from work.
The theories of work centrality (Paullay et al., 1994) and work orientation (Wrześniewski et al., 1997) provides insight into how employees values and beliefs about work are impacted by perceived breaches in their psychological contract and how this informs their ITR. Work centrality is how important work is in an individual’s life. Work orientation refers to the meaning of work for individuals and ranges along a continuum from work being seen as just a job to provide for material purposes to work being seen as a ‘calling’ and for a higher purpose (Dobrow et al., 2023). An individual’s work orientation is dynamic and can change over time (Schabram et al., 2022). Qualitative research has suggested that challenges and changes to work that breach an individual’s expectations can lead to a loss of faith in the ‘calling’ (Cohen et al., 2019). This paper examines these relationships and seeks to contribute to research on retention planning and the antecedents and consequences of work orientations.