Doctors’ body advises active management of older workers

BMA guidance promotes   “active age management” to optimise opportunities for older workers' health and participation.
BMA guidance promotes “active age management” to optimise opportunities for older workers' health and participation.

Timed to coincide with the UK’s older people day on 1 October, a new guide on older workers from the British Medical Association offers tips on optimising their potential while managing risk. Nic Paton reports.

Back in July, the Department for Work and Pensions published figures suggesting there are now more people aged 50 to 74 in work than ever before. There are some 9.4 million people in this age bracket in work – 3.7 million more than was the case 20 years ago. And there are now more than 1.2 million people working beyond the age of 65, it concluded.

Ageing and the workplace: key points

The guidance looks at the factors behind the ageing of the workforce; common perceptions and preconceptions; the biological effects of ageing; occupational health and safety needs; the notion of “active age” management; and a range of practice-based recommendations.

When it comes to attitudes and preconceptions, the guidance emphasises that what can be common, negative stereotypes about older workers are simply “not consistent with the cumulated research evidence”. For example, while it is generally believed health and employability declines with age, in fact only a small percentage of older people of working age decline physically and/or mentally.

While there will inevitably be individual differences in functional abilities at any given age, and the impact of getting older is minimal among those of working age, it argues that: “Diminished cognitive capacity is slight for most people in their 60s, and effects may be offset by experience and established skills.

“In most jobs, declining health has no impact on job performance; many jobs and work environments can be adjusted for emerging disabilities,” the guidance states.

In fact, chronological age is not the most important determinant of health, and getting older does not inevitably lead to illness. The biological effects of ageing can be moderated by increased physical activity, intellectual activity and other lifestyle factors.

“Although the risk of long-term conditions may increase with age, the majority of older workers enjoy good health, and most people who have long-term conditions or disability continue to work. Older workers do not take more sickness absence than younger workers,” it emphasises.

“Work demands and psychosocial factors may have a greater influence on the risk of developing work-related ill health than age.

In summary, relationships between age, health and employability appear to be weak,” it concludes.

This theme is echoed within the chapter on occupational health and safety needs for older workers.

As the guidance outlines: “There is little age-stratified evidence, but what there is suggests that in the absence of illness, workers aged 65 are at no worse detriment than those aged 50. There may be a healthy [safe] worker effect operating in some areas through self-selection.”

Attention to workplace and task design and adoption of flexible policies “are key strategies to support the retention of the older worker in work”, it argues.

“Access to high-quality occupational health support with health promotion programmes, access to physiotherapy and counselling, all promote employment longevity and staff engagement. Age-associated functional declines [and the accompanying risk of work-related injury] can be prevented, or at least delayed, by regular physical activity,” it adds.

Trumpeting the figures, employment minister Damian Hinds said: “It is clear that people over 50 are not slowing down or getting ready for retirement. I want to see businesses supporting this momentum while also reaping the benefits of the skills and expertise these older people can bring to the workplace.”

Of course, the ageing of our workforce – fuelled by a combination of changing demographics, better individual health and the UK’s woeful record when it comes to saving and retirement – is a phenomenon that has been well documented. The abolition of the default retirement age in 2011 and the gradual increase in the state pension age are other factors that play into this mix.

From an employment law perspective, age discrimination is, of course, a core element of the 2010 Equality Act. As such, it is (or should be) something most HR professionals will very much have on their radar when it comes to recruiting, retaining and managing older workers within their organisation.

Nevertheless, even though more and more employers now appreciate and accept, in principle, the need to be more inclusive and supportive when it comes to recruiting, retaining and managing valued older workers, the day-to-day reality on the ground can often be challenging.

People’s perceptions (especially those of younger managers) of ageing and older workers – their ability to cope with change, to learn and adapt in a fast-changing world – can affect how such workers are managed.

Similarly, the belief that older workers may be less capable mentally or physically to do a specific role or task, or that they have more sick leave or absence than younger colleagues, can also affect how they are perceived and treated in some workplace settings.

Guidance on care and management of older staff

To this end, the British Medical Association’s (BMA’s) occupational medicine committee has compiled a new guide, Ageing and the workplace, specifically designed to improve the care and management of our older working population.

Although primarily targeted at an occupational physician readership, the BMA’s committee chairman, Dr Paul Nicholson, is at pains to stress it also has the potential to be a useful resource for HR and health and safety professionals, as well as managers and staff representatives.

The guidance has grown out of ongoing work by the NHS Working Longer Group , which itself last year published an organisational readiness checklist designed to help NHS employers assess their organisation’s age awareness and to help plan actions.

But, as Dr Nicholson also highlights: “The ageing workforce is, of course, a challenge for all people at work, not just the NHS. So it was felt appropriate to carry out a review on this area separately, in particular some of the issues facing occupational health physicians who are asking for guidance.”

The guide was published this month to coincide with the UK’s Older People’s Day on 1 October, which is also the UN International Day of Older Persons. The guide is available as a free download from the BMA website.

“First and foremost, the message from this guidance is how important it is to ignore stereotypes, to forget what may have been past practice in terms of our expectations around when people would retire or consider taking their pension, or what they are capable of doing in older age,” explains Dr Nicholson.

“People’s abilities vary so much, irrespective of their age, let alone when you’re comparing different age groups. The fact is that we are now also seeing rising levels of obesity in younger people, meaning you cannot just assume a younger person will be fitter and more able to carry out a task or role than someone who is older.

Practice-based recommendations

Among a wide range of recommendations, the BMA’s guidance argues that occupational physicians and others who care for patients who work should:

  • help employers review relevant policies, practices and activities to provide a safe, healthy, age-sensitive and discrimination-free working environment;
  • provide training for managers and employees on occupational health and wellbeing issues specific to the older worker;
  • help managers and employees address prevailing myths and prejudices relating to older workers;
  • help employers take preventive action, principally through flexible, age-friendly policies, the design and organisation of work, and access to specialist-led occupational health services;
  • contribute to workplace risk assessment and management to mitigate the effects of staff being exposed to issues that could arise over longer working lives;
  • provide employees with suitable occupational health programmes; and
  • encourage a culture of openness about health issues at work, including those that are age related.

“There is a clear influencing role that OH professionals can play here in terms of HR and health and safety managers. This is especially true in the context of ensuring there are age-friendly policies in place, and that the organisation is aware of both the risks of age discrimination and the benefits of implementing more flexible working arrangements and the right sort of culture,” Dr Nicholson adds.

Active age management

The guidance outlines an approach to managing older workers called “active age management”, picking up on the World Health Organization’s definition of active ageing as “the process of optimising opportunities for health, participation and security in order to enhance quality of life as people age”.

To that end, employers need to take action on a number of fronts, the guidance contends: the quality and flexibility of jobs; occupational health; retirement and pension policies; and attitudes and assumptions about older workers.

While there is much that can be done at national and societal level to change preconceptions, within the workplace the guide identifies eight targets for age management:

  • Better awareness about ageing.
  • Fair attitudes towards ageing.
  • Age management as a core task and duty of both line managers and supervisors.
  • Age management included in the HR policy.
  • The promotion of work ability and productivity.
  • Lifelong learning.
  • Age-friendly workplace arrangements.
  • A safe and dignified transition into retirement.

Flexible working is one of the key areas here, it argues. “Although most employers offer flexible working to some extent, many associate this with parents of young children or white-collar workers. Many aren’t aware that part-time and flexible working can help many older workers stay in work up to state pension age and beyond.”

Within this, awareness training for managers and employees “can empower workers to speak openly about their health issues and to request support”. This could be changes as minor as improvements in workplace temperature and ventilation for menopausal women, access to cold water, ensuring access to toilets, and providing more frequent toilet or “bio-breaks”. Similarly, flexible working can help older workers of both sexes when their sleep is disturbed.

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