Jessica O'ConnorA major Scottish Government report has set out a picture of a medical workforce under intense pressure but deeply committed to patient care, as ministers look ahead to how healthcare in Scotland could be delivered by 2045.
The Future Medical Workforce Project: phase 1 report, published this week, draws on focus groups with more than 200 doctors and survey responses from over 1,800 clinicians across Scotland.
It explored how the role of doctors may need to evolve in response to rising demand, an ageing population and ongoing NHS reform.
Doctors consistently described their work as combining technical expertise with judgement and human connection.
As one GP told researchers: “Being a doctor, it’s a science and an art.”
The report highlighted mounting pressures across the profession, including workload intensity, staffing shortages, training bottlenecks and frustration with outdated IT systems and administrative burden.
Many doctors said these issues reduce time with patients and undermine morale, particularly among early-career clinicians.
While respondents expressed pride in their work and a strong sense of purpose, they also described the strain of being seen as gatekeepers to overstretched services, often absorbing public frustration for delays and cancellations beyond their control.
Responding to the publication, Dr Nora Murray-Cavanagh, deputy chair of BMA Scotland, said: “BMA Scotland has long called for a coherent, long-term workforce plan for the NHS in Scotland to address the escalating pressures across the medical profession.
“While this report is just stage one of a longer-term piece of work, the reality is the Scottish Government has still not delivered a plan to ensure the NHS medical workforce is able to meet the needs of the population.
“Of course it is welcome that the Scottish Government have devoted time and effort to listening to what doctors are saying.
“And the report is stark and doesn’t shy away from outlining the huge challenges being faced. But without the kind of decisive action and meaningful change we have being calling for, the ability for the NHS to deliver safe, sustainable care across Scotland remains at serious risk.”
She added: “The problems that doctors articulate in the report are issues that we have been identifying for some time and indeed read like a summary of feedback from our members. Concerns were raised about the outdated and poor IT infrastructure, with calls to ‘get the basics right first’.
“Doctors spoke of feeling devalued and not listened to by management or the Scottish Government and working in a top-down, target driven culture. With doctors often being the public face of the NHS, they describe the ‘moral injury’ of being left to face the blame, distress and backlash when there are inadequate services, delays or cancellations while managers are hidden from view.
“As we have previously highlighted, this is an unacceptable and intolerable burden which is contributing to burnout and doctors leaving the profession.”
Murray-Cavanagh concluded: “While it is right that pay and terms and conditions of doctors are for other forums, we also have to acknowledge they are key issues that need addressed and improved when thinking about the future of the medical workforce.
“The document fails to look closely at the impact of the roles of PA and AAs are causing in the system, both on patient safety and on capacity for resident doctor training.
“BMA Scotland believes it is vital this is addressed – only doctors, with their full medical training can deliver what we rightly ask of doctors. There are no shortcuts or short term fixes.
“While it is positive this report sets out the issues in black and white, and it meets commitments the Scottish Government has made to investigate the challenges, we now need action. With an election approaching, and stage two of this work not starting until the new year, we are deeply concerned this whole project will ultimately turn out to be a listening exercise which won’t deliver the solutions and practical work we urgently need.”
