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One in seven consultant posts empty in some areas amid ‘worrying’ NHS vacancies



By the end of December last year, 413 consultant posts in NHS Scotland were unfilled – equivalent to 6.5 per cent.

Vacancy rates ranged from 2.6% in NHS Lothian to 14.5% in NHS Highland, which had a shortage of 48 consultants.

One in five clinical radiology and one in three urology consultant posts in Highland were unfilled.

The figures also show a 10% consultant vacancy rate for trauma and orthopaedics in both Forth Valley and Fife, while two thirds of child and adolescent psychiatry posts in Ayrshire and Arran were empty.

READ MORE: What next for Scotland’s National Care Service reform? 

Overall consultant vacancies appear to have fallen from a peak of 8.8% in June 2021, but BMA Scotland cautioned that official statistics undercount doctor shortages by excluding unfilled posts where there are no recruitment efforts ongoing.

The trade union’s own analysis, based on freedom of information requests to health boards, has previously indicated that the actual vacancy rate for consultants may be twice as high as official statistics indicate.

HeraldScotland: Medical and dental consultant vacancy rates over time and by NHS boardMedical and dental consultant vacancy rates over time and by NHS board (Image: Turas)

Dr Alan Robertson, chair of the BMA’s Scottish Consultants Committee, added that staff sickness levels across the NHS Scotland workforce as a whole were also the highest since 2013.

He added: “That again is a potentially worrying sign of the impact the ongoing workforce and workload pressures are having on everyone working in our NHS.

“It is simply unsustainable.”

The vacancy rate for allied health professionals, such as psychologists and physiotherapists, is at a record high of 8.7%, while 8.2% of nursing and midwifery roles were also unfilled – although this ranged markedly from just 0.6% in Ayrshire and Arran to 13.9% in Fife.

HeraldScotland: Nursing and midwifery vacancy rate for NHS Scotland over time, and by NHS boardNursing and midwifery vacancy rate for NHS Scotland over time, and by NHS board (Image: PHS)

Overall, NHS Scotland is missing 116 midwives and more than 5,600 nurses.

Colin Poolman, director for the Royal College of Nursing (RCN) Scotland, said: “Thousands of registered nurses are missing from teams across Scotland, impacting on the safety and quality of patient care and putting even more pressure on staff who are already working extra unpaid hours to cover gaps and going home feeling that they are unable to provide the quality of care they want.”

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The total NHS Scotland workforce has increased in size from around 132,500 at the end of 2012, to nearly 156,000 now, but recruitment and retention has not kept pace with demand.

Scottish Labour’ health spokeswoman, Jackie Baillie, said patients had been “let down by years of failed workforce planning”, adding: “We cannot allow chaos to become the new normal for our NHS.”

It came as separate figures published by Public Health Scotland (PHS) show that 6,668 people spent more than 12 hours in A&E departments in January.

This was down from 8,821 in December, but compares to 2,330 in January 2022 and 503 in January 2019.

Total A&E attendances were also lower in January, however, at 114,103 compared to 130,007 in December.

The number of elective operations carried out during January – 15,954 – was also 27% lower than for the same month in 2019.

HeraldScotland: The number of elective operations on NHS Scotland remains well below the pre-pandemic averageThe number of elective operations on NHS Scotland remains well below the pre-pandemic average (Image: PHS)

It comes amid reports that hundreds of Scots are travelling abroad, to countries such as Lithuania, to pay for private treatment instead.

The latest statistics showing the number of people who have self-funded treatment in independent sector in the UK – including data for Scotland – will be published by the Private Healthcare Information Network (PHIN) on Thursday. 

Dr John-Paul Loughrey, Vice President of the Royal College of Emergency Medicine Scotland, said it welcomed the month-on-month improvement in A&E performance but “remains extremely concerned about our patients and their safety, and for the welfare of staff who are struggling”. 

The College estimates that around 765 patients in Scotland will have suffered an avoidable death during 2022 as a result of extremely long waits in A&E, which research has shown to be closely associated with excess mortality for at least 30 days following admission to hospital. 

“This is entirely unacceptable and a marker of a system that is not functioning as it should,” said Dr Loughrey. 

“To tackle this, in Scotland we urgently need a restoration of the acute bed base, that means opening an additional 1,000 staffed acute beds where safely possible.

“There are also significant shortfalls of staff in Scotland.

“The Emergency Medicine workforce needs at least 100 more consultants, as well as senior decision makers, advanced clinical practitioners/advanced nurse practitioners/Physician Associates, junior doctors, and vital nurses.”

READ MORE: A&E delays and excess deaths – is this the new normal? 

Health Secretary Humza Yousaf said NHS staffing is at a “historically high level”, including record numbers of medical and dental consultants and allied health professionals.

HeraldScotland: The total number of people employed by NHS Scotland, from December 2012 to December 2022. Growth accelerated from mid-2019The total number of people employed by NHS Scotland, from December 2012 to December 2022. Growth accelerated from mid-2019 (Image: Turas)

He added: “We also continue to train more medical professionals.

“In the last eight years the number of available medical school places at Scottish universities will have increased by 55%, an extra 469 places, to a record high of 1,317.

“We have substantially more nurses per head of population than is the case in NHS England.

“Our latest pay offer of an average 6.5% increase for 2023/24, as part of £568m of new investment, ensures that they are the best paid in the UK.

“In fact, the UK Government would need to give NHS nurses in England a 14% pay rise to match the pay we’re offering in Scotland.”

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