Quarterly workforce numbers show that over 3,000 more people joined the NHS in Scotland than left in the first three months of this year – taking the total number employed to over 190,000. But organisations representing both nurses and doctors say they have concerns about some of the data behind that headline, and are repeating their calls for ministers to publish long term workforce plans.

The data for the quarter to 31 March 26 published by Public Services Delivery Scotland (PSD Scotland) show annual increases of up to 3% in whole time equivalent (WTE) staff employed across every professional group.

At the same time, the number of WTE vacancies increased across medical and dental staff (2.8%), nursing and midwifery (4.2%) and, most dramatically, by 30.2% for allied health professional jobs.

Covering those vacancies came at a price. PSD Scotland says £106.6 million was spent on medical and dental agency locums while £391 million was paid to NHS ‘bank’ – non permanent – nursing and midwifery staff.

The Royal College of Nursing (RCN) says the use of agency nursing and midwifery staff has continued to decrease after the government restricted hiring from agencies to exceptional circumstances only. The agency bill dropping to £34.5 million in 2025-26.

But the RCN says the knock-on has been an 11% increase in spending on bank nursing and midwifery staff shifts which, combined with agency staff, saw spending on supplementary staffing go up by £15 million.

RCN Scotland Executive Director, Colin Poolman says workforce planning has to be prioritised by the new government, the extent of bank staff use demonstrating that current nursing workforce planning tools aren’t working:

“These figures reveal the continued scale of supplementary staffing that is required to fill gaps in the nursing workforce across Scotland.

“Bank and agency nursing and midwifery use equated to over 7,000 WTE staff last year – this is equivalent to the nursing workforce of an extra medium sized health board.”

Mr Poolman added:

“Managers will always have a need to fill gaps in the workforce and minimise the risk to patient care caused by unexpected absences or vacancies or to bolster teams at times of high workloads or increased patient need.

“Undoubtedly, NHS banks or external agencies have a role to play in supplying supplementary or temporary staff on a short-term basis. However, an overreliance on supplementary staffing is not sustainable and can affect quality of care and patient safety.

“This is why we need to see investment in workforce planning, a renewed focus on delivering safe staffing and action to secure a sustainable nursing workforce to meet current and future demand.”

Primary care

The PSD Scotland data shows that the number of GPs in Scotland, including trainees, increased by 3.1% to 5,419.

Unlike the other data in the report summary, the GP numbers are presented by headcount rather than FTE.

Chair of the Royal College of General Practitioners (RCGP) Scotland, Dr Chris Provan says the report is positive as the headcount GP numbers have grown for the second year in a row:

“It demonstrates the impact of hope returning to general practice, as we see more GPs joining the workforce than leaving it.

“The data reports the number of GPs by headcount: a flawed measure which doesn't account for the different working patterns of many GPs. By whole time equivalent, the metric that better reflects reality to patients, latest data shows Scotland has 3,657 GPs – not the 5,419 the Scottish government presents today.

"However, the Scottish government's target of 800 new GPs by 2027 is still a distant dream.”

Dr Provan added that RCGP Scotland looks forward to working with the new government to deliver its manifesto promise of a GP workforce plan and employing more GPs so that, ultimately, patients can get more time with their GPs.

 

Read more: Nursing pressures creating high risk of harm; RCGP: Future of general practice model at risk; Staff express concern over latest NHS reform plans; Doctors say walk-in GP pilot won’t work

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