Late-career nurses matter: A discrete choice experiment to elicit preferences to delay retirement

In England, disproportionate numbers of registered nurses leave the National Health Service (NHS) early as they approach retirement age. Extending the working lives of late-career nurses - those aged 55 years and over - would retain valuable experience. Research is needed to understand the job preferences of late-career NHS nurses to inform the development of tailored retention policies.

To identify the job characteristics associated with late-career NHS nurses' retirement decisions and to estimate trade-offs among these characteristics using a Discrete Choice Experiment.

A Discrete Choice Experiment is a survey technique enabling preferences to be elicited by presenting alternative job package options. Nurses then choose their preferred job package.

Following established practice, we employed both qualitative (i.e. literature review, focus groups, discussions with academic experts and stakeholders, including retention leaders) and quantitative methods to identify and select the job attributes. The Discrete Choice Experiment - included as part of a larger questionnaire - comprised eight job attributes. A 'year' characteristic was included to estimate 'willingness to delay' retirement. The Discrete Choice Experiment was administered through online surveys and distributed by the Nursing and Midwifery Council.

6888 late-career nurses responded to the Discrete Choice Experiment. We specified a Random Effect Probit regression model to estimate the preferences for delaying retirement among late-career NHS nurses. Late-career NHS nurses prefer teams with good collaboration; this ranked highest (Relative Importance: 19.6%). The number of extra years beyond nurses' intended retirement age was the second most important job characteristic (Relative Importance: 18.8%), followed by recognition (Relative Importance:13.7%) and low work pressure (Relative Importance: 13.1%). If all job characteristics were at the best levels, late-career NHS nurses would be willing to delay retirement by 2.7 years beyond their intended retirement age.

Good teamwork and collaboration, recognition and low work pressure are key for late-career NHS nurses when considering retirement. Healthcare organisations should provide a workplace culture that reflects these preferred job characteristics to retain their current workforce.

Registration on OSF: doi: 10.17605/OSF.IO/RDN9G and protocol published in BMJ Open: doi: https://doi.org/10.1136/bmjopen-2023-075066.