Extending Working Life in the NHS – Opportunities, Challenges and Prospects Work and Retirement Decision-making – The need for a broader perspective on choice architecture.

Arguably the key finding on pension investment and retirement decision making is that most UK citizens are not active planners. Rather, they are more disposed to react to options they are presented with. Although there is almost universal acceptance of the need to make financial provision for retirement, there is significant inertia and reticence over active engagement. Most people have limited knowledge or understanding of options or their implications and those are motivated to engage tend to become bewildered by the complexity and unknowable elements. People are also being asked to make their choices against a background of unprecedented (in the post WW2 period) flux and fluidity in employer and State pension arrangements. Recent rises in State pension age, the prospect of further rises, combined with high profile media reporting of pension failures, tends to interpreted as a system in crisis. Potentially corrosively, there is a risk that the associated uncertainty may feed latent procrastination and inertia, to further inhibit already weak motivations to engage in saving for tomorrow (Pettigrew, et al, 2007; Wicks and Horack, 2009); rather than strengthen motivation to plan. The UK Government’s auto-enrolment pension scheme goes some way towards addressing this, but there are questions over whether its voluntary nature and realised pension value will prove to be sufficient to be meaningful and the impact of planned rises in employee contributions on opt-out rates

Self preservation comes at a cost: Why British National Health Service Paramedics might be choosing a healthier but poorer retirement

Objectives: To explore and portray the perspectives of National Health Service Ambulance personnel related to the latest rise in the National Health Service occupational pension age.Methods: Data gathering took the form of 35 in-depth interviews. A thematic analysis was used to characterise and articulate key concepts and meanings. The analysis applied interpretive techniques, as views expressed were from personal experiences, and allowed for an in-depth analysis of shared meanings.Results: The themes reported captured the desire of many Ambulance personnel to exit their employment well in advance of their retirement age, despite satisfaction gained from patient care. This early exit is being driven by increased worry that the work demands of the job are unsustainable, especially for older workers, as clinical responsibilities increase and theirsocial support diminishes. Also, Ambulance personnel feel betrayed by their employers, because their retirement is being delayed further by another change in their pensionable age.Conclusion: There is an increased orientation for ‘living for today’ and indications of a willingness to sacrifice salary and pension income in order to protect their health in older age, which has implications for long-term financial and general wellbeing in retirement

IPR Policy Brief - Extending working life: behaviour change interventions

Despite recently announced rises in the minimum age at which the State Pension is claimable, many people continue to leave the labour market before their State Pension age (SPA).Indeed, although a significant proportion of individuals express an interest in extending their working lives, working beyond SPA represents a minority activity.To better understand what affects people’s decisions to retire, the Department for Work and Pensions (DWP) commissioned a multi-disciplinary team of researchers led by Dr Andrew Weyman to review and interpret existing UK and international research findings (for the period 2000–10), and produce theoretically informed recommendations for public policy.In particular, the study has meet DWPs requirement for an enhanced insight into the array and relative importance of social and cultural variables that influence decision-making; thereby supporting its delivery of an evidence-based approach to the design of policies that encourage extending working life (EWL)

On the minimal free resolution of the universal ring for resolutions of length two

AbstractHochster established the existence of a commutative noetherian ring C˜ and a universal resolution U of the form 0→C˜e→C˜f→C˜g→0 such that for any commutative noetherian ring S and any resolution V equal to 0→Se→Sf→Sg→0, there exists a unique ring homomorphism C˜→S with V=U⊗C˜S. In the present paper we assume that f=e+g and we find the minimal resolution of C˜⊗ZQ by free B-modules, where B is a polynomial ring over the field of rational numbers. The modules of the resolution are described in terms of Schur functors. The graded strands of the differential are described in terms of Pieri maps

One-way pendulum?:Staff retention in the NHS: determining the relative salience of recognised drivers of early exit

Purpose: Staff shortage in the UK National Health Service has a long history, but is widely predicted to become acute over the next decade. Falling enrolment rates in health professional training and restrictions to migrant labour recruitment have brought the, traditionally neglected, issue of staff retention into sharp relief. The purpose of this paper is to represent the first large scale systematic appraisal of the relative salience of recognised headline drivers of employee exodus from the NHS. Design/methodology/approach: The data were collected from an opportunity sample of 1,594 health professionals, managers and administrators employed by the NHS. Participants completed a paired ranking task (Case V method of paired comparisons, Thurston, 1927) to determine the relative importance of eight widely cited reasons for exit. The item set was derived from focus groups conducted as a component of the wider study. Findings: Findings revealed almost universal consensus regarding the primacy of shortage of resources, job demands and time pressure. Pay was ranked lower than predicted. Flexible working arrangements do not presented as a key solution, and there is no support for claims of generational differences. Research limitations/implications: Survivor population effects could constitute a source of sample bias, i.e. all participants were current NHS employees. It is possible that those who remain may be more resilient or hold different dispositions to leavers. Thus, comparisons by age and grade may not be comparing like with like. Tapping respondent beliefs about the actions of peers can embody some degree of inaccuracy and attribution bias. However, effects can be considered to operate as a source of common, rather than systematic, error across the demographics compared. The medical and dental sample was too small to give confidence in detected differences. Practical implications: Findings challenge the claim that wider availability of flexible working hours will significantly reduce exit rates. Pay, being a source of dissatisfaction, does not constitute a key push variable in itself, rather its salience reflects the effort reward-imbalance produced by rises in job demands. Social implications: Staff shortages in the NHS represent a threat to: public well-being – waiting lists and demand for care; the well-being of who continue to work in the NHS – job demands and resources; the employment prospects of staff who leave involuntarily, e.g. on grounds of incapacity and threats to health and well-being – extending to impacts on their dependents. Originality/value: Issues of staff retention within the NHS are topical and under researched. The findings provide an up to date picture of the relative influence of headline drivers of early exit from the NHS. The study draws upon a more diverse and comprehensive sample of NHS employees that any other known previous studies of early exit. Findings are of potential international relevance to other State health systems. The authors believe this to be the largest (sample) known application of the method of paired comparisons.</p

Communication Challenges Associated with the Expression of Uncertainty in the Plant Health Risk Register

Executive SummarySection 1: IntroductionThe aim of this review was to identify communication challenges associated with the expression of uncertainty in the Plant Health Risk Register (PHRR) and inform future Defra strategies for addressing these challenges.Our starting point is that the communication of uncertainty potentially relates to much more than issues of wording, numerical format and presentation. The effective communication of science and associated uncertainties, particularly for high profile / high consequence pests and diseases can require more than the application of tools and techniques that simplify and demystify complex phenomena. First we describe the PHRR itself, its history and the aspirations for it as a risk management tool (Section 2). A working definition of uncertainty and an overview of its various manifestations follow in Section 3. We consider the reasons why uncertainty should be communicated, and suggest the particular challenges of doing so within the PHRR (Section 4). This leads to a consideration of the reasons that there might be for expert risk-assessor reluctance to communicate uncertainty (Section 5) – which includes the evidence pertaining to media characterisations. Section 6 considers the way in which lay audiences might make sense of uncertainty. The next two sections move to what can be characterised as micro-level considerations, first considering evidence, largely from cognitive psychology, about the interplay between cognitive biases / recourse to heuristics and the characterisation of uncertainty that can impact on how risk is perceived and reacted to by stakeholders (Section 7) and second, broader social science insights on the accuracy of lay interpretations of alternative representations and characterisations of uncertainty (Section 8). In conclusion, in Section 9, we reflect on the main lessons to be drawn for the communication of uncertainty relating to the PHRR and, in particular, consider the implications of alternative formats for representing and characterising uncertainty in the PHRR.Section 2: Background to the Plant Health Risk RegisterDeveloping a PHRR was one of the key recommendations of the Tree Health and Plant Biosecurity Expert Task Force which reported in 2013. The PHRR aimed to provide a single repository for drawing together numerous risk assessments pertaining to individual pests and pathogens. As well as serving to prioritise risks, it was charged with ‘enabling systematic and proportionate risk management responses’, including stakeholder engagement. In response to this recommendation the PHRR was developed. The inputs to the overall UK Relative Risk Rating score ratings are subject to various forms of uncertainty. The way in which they are combined is also subject to uncertainty. How can these uncertainties best be recognised, captured and represented? Three main options are explored:1. An uncertainty range referenced to the Risk Register rating 2. An uncertainty range translated into monetised impacts3. Risk Register supplemented by an uncertainty proxy rating derived from published findings and related scientific insights.Section 3: Uncertainty: boundaries, definitions and typesIt is recognised that relevant domains of uncertainty extend beyond the technical properties of pests and diseases and options over their mitigation/control. They extend to the social world, and include uncertainty over economic impacts; stakeholder reactions to threats; and, the capacity of g/Government and its institutions to influence the behaviour of others, notably in the areas of propagation of acceptance and adoption of mitigation measures. Definitions of uncertainty and the distinction between risk and uncertainty are outlined. Most particularly the distinction is made between uncertainty in risk assessment and policy delivery are outlined. <br/