Rise in senior doctor vacancies

Consultant vacancies have increased within NHS Scotland in the last year, prompting calls for “urgent and long-lasting action”.

The vacancy rate among consultants in September stood at 8.2 per cent, or 475 posts, an increase of a fifth compared with the same point last year, a rate described by the BMA Scotland as “deeply worrying”.

More than half of those – 250 posts – have been unfilled for six months or more.

Anaesthetics had the highest number of vacancies (44), followed by psychiatry and clinical radiology.

But the BMA Scotland warned that these figures were likely to be a significant underestimate because of the way the official NHS Education Scotland data is collated.

It believes “real-world” vacancies are much higher, by about 375 whole time equivalent posts.

This is because, unlike the official figures, the BMA figures take into account posts that are vacant but have yet to be cleared for advertisement, as well as posts that have been vacant for so long that the board has decided not to fill them. It also includes posts that are vacant but are being filled temporarily by a locum doctor.

The BMA warned that the problem with unfilled posts would be compounded by a rise in demand caused by winter pressures and the impact of rising pensions tax bills on senior doctors, which was leading many to cut their hours.

Alan Robertson, deputy chair of the BMA’s Scottish Consultants Committee, said: “The substantial long-term gaps in Scotland’s workforce are a growing and serious concern – stretching the workforce to the limit and affecting the ability of doctors to deliver the high-quality patient care they strive for. The government needs to take urgent and long-lasting action to address this deeply worrying lack of doctors.”

He added: “Previous analysis shows that a whole, large hospital could be staffed from vacancies left out of the figures, which demonstrates how far from reality today’s figures are likely to be. We need to be realistic about how many vacancies there are, and the BMA stands ready to help that process.”

He called upon the Scottish Government to publish its delayed integrated workforce plan for the NHS, which was originally due out last year.

“In that, we need to see serious steps in Scotland to make working as a doctor an appealing career choice and show doctors they are valued. That means focused efforts on recruitment and retention, improved work-life balance and concrete steps to improve the culture in the NHS; tackling bullying and reducing the narrow focus on targets and the high pressure, blame-focused environment they create.

“I appeal to Scottish ministers to take this matter seriously and to address it urgently before it’s too late.”

The data also confirmed that nursing and midwifery vacancies stood at six per cent, up from 4.8 per cent in September 2018 and 4.5 per cent in September 2017, with 3,826 posts unfilled.

Last week, the RCN Scotland revealed that nurses felt under enormous pressure at work and were too busy to provide the level of care they wanted to. The findings came from a survey of nearly 2,000 Scottish nurses.

Norman Provan, associate director of the RCN Scotland, said: “Quite simply, Scotland needs more nursing staff. The findings from our survey published last week highlight the impact that workload and workforce pressures are having on patient care and staff wellbeing – 60 per cent of our members who responded said they were too busy to provide the level of care they would like.”

Earlier this year, the Scottish Parliament passed the Health and Care (Staffing) (Scotland) Act, placing a duty on NHS and social care providers to ensure that there are suitably qualified and competent staff working in the right numbers at all times. The RCN is pressing the Scottish Government to ensure that boards have enough funding and an adequate supply of staff to meet their duties under the Act.

by Rebecca McQuillan

Society & Welfare

Nurses report they have 'never felt pressure like this'

Mr Provan added: “This feedback should be seen as an early warning. The serious consequences of staff shortages are clear and the current vacancy level is further evidence of the need to legislate to ensure staffing for safe and effective care. The decision to increase the number of nursing staff and improve patient care is one of political choice.”

The health secretary Jeane Freeman pointed to Scotland having the highest ever number of consultants and a “record high” workforce.

She said: “The workforce of Scotland’s NHS has increased to a new record high level, having increased by 11.3 per cent to over 14,300 whole time equivalent staff under this government. Our NHS is built on the dedication and hard work of healthcare staff and we thank them for their incredible efforts.

“The NHS in Scotland has substantially more staff per head than the health service in England, and today’s figures show we also have a record high number of consultants.

“We recently passed our new safe staffing legislation to help plan and recruit our workforce to meet the changing health and care needs of the people of Scotland long into the future. We’ll also soon publish our new integrated workforce plan, building on the three plans for primary care, acute care, and social care that we’ve already delivered.

“We want to ensure our NHS has the right staff in the right place long into the future, which is why we’re increasing training places for medical students and for nursing students.”