Part-time working in psychiatry in Northern Ireland

AIMS AND METHOD

To establish the proportion of psychiatrists in Northern Irelandwho currently work part-time and the proportion of those workingfull-time who wish to work part-time. A postal questionnairewas forwarded to psychiatrists and repeated 30 months later.

RESULTS

In 2004, only 18.3% of respondents were working part-time, and26.8% in 2006. A great majority stated their intent was toalways work part-time, the most frequent reason being to achievework-life balance.

CLINICAL IMPLICATIONS

A significant number of staff working part-time will have implicationsfor the staffing of the service. Policy makers must plan forthe adequate provision of part-time working arrangements.

Introduction

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Introduction

Part-time working opportunities have been available for a significant period within the National Health Service (NHS), not leastin psychiatry. In recent years, more and more doctors are interestedin reducing their working hours. This results from a combinationof factors, including the growing salience of ‘work-lifebalance’, the increased proportion of women in the workforce,a shortages within the medical workforce and the focus on reducingexcessive hours of work.

There is a perception that increasing numbers of staff of allgrades are working part-time, while many others are reportedto be contemplating it. The British Medical Association CohortStudy (2005) of 1995 medical graduates reported that in 2004a third were currently working part-time, an increase from13% in 2001; as many as 75% of those surveyed indicated that they would like to work part-time, either now or at some pointin the future.

Psychiatry in Northern Ireland, as elsewhere, has a relativelyhigh proportion of female staff and women now contribute 40%of the Royal College of Psychiatrists’ membership amongthe British and Irish graduates (Royal College of Psychiatrists, 2006).

An increasing demand for flexible training posts is reportednationally, with a 30% increase throughout all specialties (Goldberg, 1997). In Northern Ireland there is a waiting listfor flexible training posts for specialist registrars acrossall specialties funded by the Northern Ireland Medical and DentalTraining Agency (NIMDTA).

The aim of the study was to establish the proportion of psychiatristsin Northern Ireland who currently work part-time, the proportionof those working full-time who wish to work part-time eithernow or at some point in the future, to estimate for how longmost of them intend to work part-time, and finally to ascertainreasons why part-time work is selected.

Method

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Method

In April 2004 a one-page postal questionnaire was forwardedto 180 psychiatrists in Northern Ireland identified from theRoyal College of Psychiatrists and NIMDTA databases. Thirtymonths later (in 2006) a follow-up questionnaire was forwardedto 246 members of the Royal College of Psychiatrists (excludingretired members) and 34 trainees on the NIMDTA regional seniorhouse officer training scheme.

After piloting, the structured questionnaire was forwarded alongwith a stamped addressed envelope and a covering letter explainingthe purpose of the study and assuring confidentiality and anonymityof responses. No attempt was made to contact those who didnot reply.

Results

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Results

In 2004, 126 out of 180 questionnaires were returned givinga response rate of 69%: 18.3% of respondents (n=23) were workingpart-time. In 2006 there was a response rate of 40% (n=112)with 26.8% of respondents (n=30) working part-time. Respondents’characteristics (distribution by grade and gender) and thepercentage of those working part-time within each grade arepresented in Tables 1 and 2.

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Table 1. Respondents’ characteristics

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Table 2. Part-time workers within each grade at the time of the study

Of the respondents working part-time who answered the questionabout their gender (22 out of 23 in 2004 and 24 out of 30 in2006), 4.5% in 2004 (n=1) and 12.5% in 2006 (n=3) were male.

In 2006, those working part-time worked an average 6.8 sessions(range 2-9) per week, which was a slight increase on the averagenumber of 6 sessions (range 2-9) worked as shown in the 2004study. The majority of part-time respondents in both surveyswere working within their contracted sessions (78.3% in 2004and 70% in 2006) and a high proportion stated their intent was to always work part-time (95.7% in 2004 and 86.7% in 2006).

For those working full-time, when asked if they would like theircurrent post to be part-time, 26% in 2004 (26 out of 99 whoresponded to this question) and 16.7% in 2006 (13 out of 78respondents) replied in the affirmative. In the 2006 survey,45% of full-time workers (37 out of 82 respondents) statedthey would like to work part-time at some point in the future,with a further 25.6% (21 out of 82 respondents) stating theywere as yet undecided. Those who would consider part-time workin the future would like to work an average of 6.4 sessionsfor an average duration of 9.8 years (range 2-20 and over).

What was consistent to both surveys was that none of the part-timetrainees wanted a full-time consultant post. Of the full-timetrainee respondents, 37.5% in 2004 and 48.4% in 2006 indicatedthey wanted a part-time career post, with a further 18.8% and9.7% remaining undecided. In 2006 we asked trainees to choosethe main reasons for wishing to work part-time; these are outlined in Table 3. Work-life balance was cited more frequently thanany other factor here.

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Table 3. Reasons for working part time (2006 survey)

Discussion

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Discussion

There are several important findings to emerge from this study.Part-time work continues to remain popular among psychiatristsin Northern Ireland, with an 8.5% increase in those workingpart-time within the 30-month interval between both surveys.An increasing number of men now work part-time and constituteat least 10% of part-time psychiatrists in Northern Ireland.This trend seems set to continue, with a further 27.5% of menwho currently work full-time expressing a desire to work part-timeeither in the immediate future or at some later point.

One assumption underpinning much of the drive to provide part-timework has been that this would facilitate women who wished toreduce hours while their children were young, returning tofull-time employment in later years. We found that althoughprovision of childcare is a popular reason, it is only one ofseveral factors leading individuals to choose to work part-time,with the most frequent reason selected being to achieve work-lifebalance. It can of course be assumed that for many individualsboth reasons may play equal part.

Another reason frequently selected was the opportunity to pursueother interests outside work. For men this was chosen morefrequently than childcare and as frequently as private/portfolioworking. Therefore it appears to be becoming increasingly acceptableto work part-time for a variety of reasons.

The Improving Working Lives for Doctors standard recognisesthat staff work best for the patient when they strike a healthybalance between work and other aspects of their life outsideof work (Department of Health, 2001). It seems psychiatristsare increasingly recognising this, as more and more want towork part-time. In both the 2004 and 2006 surveys those working part-time wanted to continue doing so and rarely wanted toreturn to full-time work. In general, most individuals workingpart-time manage to achieve this within their contracted sessions.However, up to 30% are working beyond their sessions, in spiteof the introduction of the new consultant contract and monitoringof junior doctors’ hours.

To avoid future workforce pressures, policy makers must planfor the adequate provision of part-time working arrangementsto prevent dissatisfaction among psychiatrists and to avoidthe potential loss of skilled clinicians.

Future workforce planning should also consider the views oftrainees in relation to part-time working - the waiting listfor flexible training posts in Northern Ireland has alreadydemonstrated the demand for such working arrangements. Whatis surprising from this study is that every part-time traineeand almost half of full-time trainees in the 2006 survey responded that they would like a part-time consultant post. Such findingsare nevertheless consistent with the existing literature -approximately 75% of female and 25% of male specialist registrarsin medical specialties are considering working part-time asconsultants (Mather, 2001). An earlier study of flexible traineesin psychiatry found that 79% wanted a part-time or job sharea consultant post (Caswell & Lowe, 2000).

Current job provision suggests that not all trainees will achievethis desired outcome and it is possible some will change theirview on this as they approach the end of their training. Astudy of 300 female psychiatrists who had been flexible trainees(Mears et al, 2004) reported that less than a half (43%) hadmoved into full-time posts, with 73% reporting they had achievedtheir first choice of working pattern.

It is undoubtedly good that many staff are being accommodatedwith part-time working arrangements, as it clearly retainsin the workforce those who would otherwise leave the service.However, in the context of an increasing number of vacant postsin Northern Ireland (as throughout the whole of the UK), asignificant number of staff working part-time will have implicationsfor the staffing of the service.

Limitations
One limitation of this study was the poorer response rate inthe second survey as compared with the first survey. However,both the original and the follow-up questionnaire had a goodsample size. It is our intention to repeat this study to monitortrends in the working hours of psychiatrists in Northern Irelandwithin the next 5 years.

References

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