Pressures on doctors ‘causing cracks’, report warns

Doctors fear “pressures are causing cracks to professional cohesion”, a report has warned.

The Future Medical Workforce report follows six months of extensive engagement between the Scottish Government and the medical profession, with 2,000 doctors participating in a national survey and 40 focus groups.

The report explores views on how Scotland’s medical workforce might need to evolve over the next 15 to 20 years.

It concluded: “Doctors across the NHS have told us about the pressures they face on a regular basis and the commitment with which they approach the delivery of high-quality care to their patients.

“They have described the challenges which erode their sense of enjoyment and feeling valued, from a lack of access to rest areas, hot food and car parking to more significant barriers such as growing workloads, lack of time, resource constraints and pay.

“This is fuelling a rising sense of disempowerment and a perception of diminishing respect for the profession.

“Within the profession it appears that these pressures are causing cracks to professional cohesion, as we heard of tensions across the primary secondary care interface as each group of clinicians navigate their role in managing patient risk.”

Health Secretary Neil Gray said it is “vital” to plan now to ensure the workforce is in place for the future.

He said: “Our doctors are the backbone of our NHS and it’s vital that we plan now to ensure we have the right workforce in place to meet Scotland’s healthcare needs in the decades ahead.

“I have been clear of the need to listen closely to doctors at every career stage, and I am grateful for their honesty and insight, which is invaluable in shaping our next steps.”

The report said doctors also have concerns over training “bottlenecks”.

It highlighted the need for better integrated local and national planning to ensure the training pipeline meets the population and service need.

The report also said it is important to consider what the role of the doctor will be in the future and ultimately what role people are being trained for.

Mr Gray continued: “Scotland’s population is changing. People are living longer and many of the cases we see in hospitals are now more complex.

“The decisions we make today will shape our future medical workforce and we are committed to empowering our doctors with positive working environments, manageable workloads and the resources they need to continue providing excellent care.

“We have invested a record £21.7 billion in our NHS this year and reached a historic deal with GPs by investing £531 million over the next three years.

“The next phase of this project will turn these insights into action, working in partnership with the profession to deliver meaningful change that supports the medical workforce and improves care for patients across Scotland.”

Phase two of the project begins in January 2026 and the work will focus on supporting clinical teams, improving workforce planning and redesigning training pathways.

The proposed work has been guided by Scotland’s National Workforce Strategy for Health and Social Care to explore the themes of planning, attraction and training, and recruitment and nurture.

Professor Andrew Elder, chairman of the Academy of Medical Royal Colleges and Faculties in Scotland (Scottish Academy), said: “Whilst multi-professional working is key to delivering high-quality care, we welcome the clear focus on the role of the doctor, and the report accurately and honestly reflects both the hopes and detailed concerns of doctors and underlines the central contribution they must continue to make to patient care.

“We are committed to working together with the Scottish Government to ensure that the key recommendations of this work are taken forward in a fluent and effective manner.”