NHS ‘stretched to its limit’ as vacancies rise for both consultants and nurses

Doctors’ leaders voiced their concerns after the latest workforce statistics were published.

The NHS is being “stretched to its very limit”, doctors have claimed as new figures showed hospitals have vacancies for more than 450 consultants.

Vacancies have increased by 39% over the last five years – and by 7.1% in the last year – with the NHS trying to fill the whole time equivalent (WTE) of 452.3 consultant positions.

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The figures, from the end of March 2019, also showed 245 WTE consultant posts have been vacant for six months or more.

While this is down by 3.5% from March 2018, the number of long-term vacancies has increased from 79.2 in March 2014 – a rise of 209%.

452.3 - The number of whole time equivalent consultant vacancies in NHS Scotland at the end of March 2019. ISD Scotland.

Doctors’ leaders at the British Medical Association (BMA) said the “substantial long-term gaps in Scotland’s consultant workforce are a serious concern – not just for the NHS, but equally for everyone who relies on it for the care they need”.

The latest NHS workforce statistics also showed more nursing and midwifery positions not being filled.

At the end of March this year, the NHS had vacancies for 3,143.7 WTE staff in this area – 11.7% more than in March 2018 and 92% higher than five years ago.

Meanwhile, the number of positions that have been vacant for three months or more has gone from 352.2 WTE in March 2014 to 853.1 in March 2018, before rising again to 901.8 this year.

Overall, the WTE staff number in the NHS grew by 0.6% over the year to the end of Match 2019, with the equivalent of 140,881.2 full-time workers employed by Scotland’s health service.

While it is the seventh year in a row staffing has grown, three health boards – NHS Tayside, NHS Ayrshire and Arran and NHS Greater Glasgow and Clyde – saw their number of workers fall. In NHS Tayside, where the drop was greatest, there were 223.1 WTE fewer staff than at the end of March 2018.

"We simply don’t have enough doctors" - Simon Barker, BMA Scotland

Across Scotland, spending on agency nurses and midwives increased by 10.9% to £26.2 million in 2018-19.

Simon Barker, chair of BMA Scotland’s consultant committee, claimed the published statistics were “still hiding the real scale of vacancies among the consultant workforce”.

He added that complex tax rules meant doctors fear they could lose out financially by working more, saying “doctors are changing their working habits as a result and either not taking on extra work, or cutting down the work they do”.

He stated: “All this tells the story of a workforce stretched to its very limit. We simply don’t have enough doctors.

“Yet, perversely, those doctors in post, who are going above and beyond what is expected of them to cover gaps in the workforce, are then getting punished financially for trying to help keep the NHS working. Action simply has to be taken.”

Professor Derek Bell, of the Royal College of Physicians of Edinburgh, said: “Recruitment and retention of staff is one of the biggest challenges facing our NHS.

“These posts must be filled – particularly those which have been vacant for six months or more.”

However, Health Secretary Jeane Freeman stressed there was a “new record high number of NHS staff, with seven consecutive years of growth”.

She added: “There has been a 7.4% increase in qualified nurses and midwives under this government, and over this parliament, we’re creating 2,600 extra nurse and midwifery training places. We’ve also seen the number of consultant staff in post grow by 50%.”

Liberal Democrat health spokesman Alex Cole-Hamilton insisted that “persistent vacancies across the NHS are making life difficult for hardworking NHS staff and jeopardising patient care”.

He said: “The SNP government has made a hash of NHS staffing and are still delaying and delaying their workforce plans.

“As a result, doctors and nurses are being forced to pick up the slack in under-resourced teams and the taxpayer is having to cover huge bills for agency staff to paper over the SNP’s mistakes.”