Age and Work in Health and Care

Transcription

1 Age and Work in Health and Care Lessons from a European project Institute of Actuaries, December, 2006 Philip Taylor Swinburne University

2 Content Background to the project Research team Aims and objectives Products Examples of practice What can be learned from this project?

3 A new kind of labour market but... After decades of early retirement there is a new consensus around extending working lives. 1 million people aged over state pension age are in paid employment. Majority would consider working after formal retirement, but prefer a part-time or flexible basis Employment rates going up but... 9 out of 10 older people believe that employers discriminate against them. 10% of employers do not employ persons aged over 50.

4

5 The Times, 12 May 2006, p.28

6 Research evidence on age management Funded by the European Foundation for the Improvement of Living and Working Conditions. Documenting measures in 120 organisations to improve the employment situation of older workers. Identify factors influencing success and sustainability. Review lessons and formulate guidelines for good practice in age management.

7 Research Team Eleven EU-15 countries took part: Austria Belgium Finland France Germany Greece Italy The Netherlands United Kingdom Sweden Spain

8 Products Searchable web database of case studies Consolidated analytical report Guide for good practice in age management.

9 Innovative elements of the project Revisit former initiatives from the previous European Foundation project Combating Age Barriers Case study data collected in the early and mid-1990s, allowing a longitudinal perspective Thematic focus: Life course perspective Gender Social dialogue

10 Characteristics of cases Four-fifths of case organisations operated in the private sector, one fifth in the public sector. Cases cover a broad range of industries overall. Two-thirds of cases were large Just over a fifth medium Only a few classified as small.

11 Characteristics of cases Increase over time in complexity of approach to age management. Most common measure is training and development, followed by flexible working, with incidence of both increasing. Shift in measures: health and well-being grown in importance, recruitment and redeployment fallen back. Third of measures have continued unchanged, small proportion have ended, two-fifths have continued with modifications. Previously, measures for skilled manual workers most common, followed by professional and managerial staff, but the latter now more prominent. Shift away from focusing on one age group towards greater emphasis on all age groups.

12 Influences on organisational policy Prevailing market conditions Changing business practices Public policy and support Social dialogue/collective agreements.

13 Example of practice Viennese Hospital Association Awareness, that, demographic change will require more qualified nurses, especially in geriatrics in future. Initiated a career management project. Elements: Describe and assess implicit knowledge, experience and competence Demonstrate how this competence develops and identify barriers to development Build a career model based on competence steps to allow people to develop and maintain a nursing career Five competence levels/career steps identified : Beginner; Advanced; Competent; Experienced; Expert or Master. Masters provide the majority of personnel training and devise personnel development plans.

14 Example of practice Viennese Hospital Association continued Approach tested and evaluated for its practical application and impact on work interest and motivation in three pilot wards. Results: Model supported nurses competence development. Positioning nurses as masters was highly regarded by other professions and management. Competence level of teams enhanced by master nurse s support. Work interest and motivation increased in teams of two wards, but not in the neonatal ward, due to a restructuring process at the hospital. Head nurse could now concentrate on planning and organising staff and the work with patients and other professions Time spent off the job was reduced, because more training and coaching took place on the job, or nearby, supplied by the masters or other experts and organised by the masters.

15 Example of practice Kaiserin Elisabeth Spital Vienna Implemented a shift roster with daytime shift length reduced from 12.5 to 8-10 hours. Goals were: economic: less overtime and reduced sickness costs personal: better health and work ability, retention of experienced nurses Work council refused to participate. Evaluation found that 60% of nurses viewed shorter shifts as better for health and work ability, but two thirds wanted to work longer shifts. Preference age-dependent: > 35 preferred short shifts, < 30 long shifts. Management redesigned the roster with option of one long shift in every shift group and by offering lectures about age and work to increase knowledge about age-adjusted working times. Further evaluation found a 55% preference for short shift roster. Outcomes are: Increase in work ability, work interest and life quality Better empathy for patients and their families during afternoon shifts Reduced overtime costs Sickness absence rate reduced.

16 Example of practice Les Amis - France Not-for-profit organisation providing home help and domiciliary care to mainly older people. Home helps particularly affected by the physicality of their work and in 2005 a relevant agreement was concluded between the national government, the city of Paris and the local federation of home care. Implications for Les Amis is that adjustments (medical bed, help with lifting) are made for the client which improve their well-being, with the added benefit of improving working conditions for home-helps. But when external actors have a role in implementation (in particular financing or co-financing a measure), the stability of their commitment is of importance. For Les Amis, the tripartite agreement ended in 2005 resulting in uncertainty as there were no alternative plans.

17 Example of practice Les Amis continued. This case is also an example of where public policy may disadvantage older workers. Increasing competence requirements for home-helps led in 2002 to: State Social Auxiliary Diploma (DEAVS). Requires 1000hrs of training. Validation of prior experience possible but requires constructing a portfolio and its presentation to a board of examiners. Association has encountered difficulties in using DEAVS: Lacks financial resources to provide development opportunities to the large number of its experienced home-helps. Validation of prior learning disadvantages persons with low educational attainment and those with difficulties expressing themselves in French. DEAVS requires double competency: in both care of older persons and child minding, but most home helps lack experience in both. DEAVS is split into units, which are scheduled over a 3-year period.

18 Example of practice Hinchingbrooke NHS Trust - UK National competency and career framework driving policy. However, resistance from older nurses, satisfied with their current roles and unwilling to progress to a higher level. Trust has accommodated this in its new grading structure. A valuing staff campaign where employees needs regarding health measures, flexible working, job-design etc. are addressed. Recently employed a company which offers independent advisory support to staff. Career management courses for older employees which show all possible career paths and how to progress. Awareness raising sessions regarding the then forthcoming age discrimination legislation.

19 Example of practice Goldsborough Home Care - UK Three types of age-aware initiatives: 1) Recruitment 2) Training and development and 3) Retirement arrangements Recruitment - Procedures do not discriminate on age grounds. Training and development Refresher training in recruitment methods and anti-discriminatory practices for managers; older staff mentor younger ones. Retirement - No maximum retirement age. Skill and labour shortages have driven these initiatives. Regulated recruitment and training programmes promoted by Government aim to change the public perception of the carer to promote the profession. More formal procedures have shifted public opinion, but less successful for recruitment, discouraging older applicants.

20 Benefits for older workers Employment opportunities o Job offer o Career advancement o Role enhancement o Job security Maintenance or enhancement of health and well-being o Improved health and well-being o Better work-life balance o Increased motivation o Increased job-satisfaction Learning opportunities and skills utilisation o Skill development o Changing ways of doing o Competence utilisation Relations with co-workers and managers o Feelings of appreciation and belonging o Greater trust in management o Better generational relations Retirement prospects o Better preparedness for retirement

21 Benefits for employers Securing labour supply Greater staff commitment Less stress and exhaustion among staff Reduced rates of staff turnover Decrease in sickness absence rates Reduction of early retirement resulting in reduced pension costs Result: reduced labour costs and greater productivity Maximising workforce utility Increased participation in learning and training Enhanced innovative capacity Increase in management and supervisory competence Reduced conflict and better team-working Result: increased labour productivity, company competitiveness and share value Wider benefits Better cooperation between management and trade union/works council Development of HR functions

22 Success factors for measures Six critical and highly related success factors for measures, one external, which supports the others which are internal: Public policy Management commitment and competence Industrial relations climate Flexibility and responsiveness Attention to the process of implementation Devolution of responsibility.

23 Conclusions For employers In the implementation of age management, the case studies point to the need for: sufficient planning and resources, strong, coherent and consistent messages which are agreed with trade unions and works councils if at all possible, recognising the need for the buy-in of line managers and crucially, competent evaluation. Remarkably, frequently, systematic evaluations of what were often major initiatives, involving significant commitment of resources were absent. Without a strategic vision for implementing age management as opposed to opportunistic policy making, it seems likely that taking account of the needs of older people will be vulnerable. Organisational capability varies markedly, even among a group selected because of its greater expertise in age management, suggesting a major role for employer representative groups.

24 Conclusions Employee representatives While employees may understandably be sceptical, particularly where an organisation has a long history of promoting early retirement, good age management offers unmistakable benefits for wellbeing and retirement prospects. Yet, somewhat surprisingly, workers representatives have often not played a strong role in promoting age-aware employment policies. This may be partly due to do with the lag effect of supporting workers rights to early retirement. In some cases, this lack of commitment has clearly undermined initiatives.

25 Conclusions National policy makers Have a key role in stimulating employer actions, but policy is often fragmentary and contradictory. Early retirement remains a popular tool and weaning the social actors off it must be a long-term policy goal. Goes beyond increasing the cost to organisations, to promoting attractive alternatives. Necessitates going beyond exhortations regarding the risks associated with ageing labour markets to consider the broader complexities of managing future labour supply. Policy-makers, along with trade unions need to do more to promote realistic alternatives to early retirement to older people. But clear vision of what active ageing means for individuals in their later careers is lacking.

26 Further information geingworkforce.htm htm htm