Audit Scotland said one in five consultant posts are standing vacant at some health boards, while the impact of the ageing nursing workforce could leave the NHS 5,000 short in just five years’ time.
The watchdog said the Scottish Government and NHS boards have failed to plan for increasing demands on the service in the years ahead, with the current approach “confused” and split between different bodies. Political opponents say the report is a “damning” indictment of the SNP’s government’s management of the NHS after a decade in power.
NHS staffing levels are currently at a record high having risen by 11 per cent in recent years to 139,400, while spending on NHS staff amounted to £6.5 billion last year.
But Audit Scotland warns of “urgent challenges” facing the workforce amid signs that services are under “increasing stress.”
Spending on agency staff has also more than doubled to £171.4 million in the past five years to deal with the impact of shortages.
Health Secretary Shona Robison is now being warned she must come up with answers.
Auditor General Caroline Gardner said: “The Scottish Government and NHS boards recognise the challenges, but urgently need to improve their understanding of future demand, staff projections and associated costs, and set out in detail how they plan to create a workforce that can meet the long-term health needs of the population.”
The struggle to recruit senior medics is at the heart of the current problems with more than 400 consultant posts unfilled, a vacancy rate of 7.4 per cent in March across Scotland. But the worst hit areas like the Western Isles and Dumfries and Galloway have vacancy rates of 20 per cent - and consultants can take up to ten years to train. Certain consultant specialities like dermatology, urology and acute medicine have vacancy rates of 15 per cent.
There is also a stark warning that more than a third of nurses and midwives are now aged over 50, with the number of newly qualified nurses available to replace them not keeping pace. New recruits to nursing actually fell 15 per cent in 2014-15 and then a further 7 per cent in 2015-16, with projections of a 9.6 per cent vacancy rate – meaning more than 5,000 nursing posts unfilled –by 2022.
Dr Peter Bennie, chairman of the British Medical Association in Scotland, said the report showed that workforce planning has not worked.
He added: “The high level of long-term vacancies is a clear sign that the Scottish Government is not getting to grips with the crisis in the recruitment and retention of NHS staff and action is needed now to make Scotland an attractive place for doctors to train and work.”
Theresa Fyffe, director of the Royal College of Nursing Scotland said there has been an absence long-term planning to meet demand.
“The result is that Scotland has too few nursing staff in post and too few nurses being trained,” she added.
“Staff across NHS Scotland are under enormous, unrelenting pressure to meet ever growing demand.
“The significant workforce challenges set out in the report must be addressed robustly, realistically and rapidly if patients are to get the care that they need.”
Health Secretary Shona Robison said: “We’re committed to not only having the right number of staff, but also to ensure that we have the mix of skills in the right places.”
Tory health spokesman Miles Briggs said the findings are “deeply concerning”.
He added: “Time and again we have seen warnings about long term workforce planning, and these figures show the situation is only getting worse.”
Labour health spokesman Anas Sarwar said that the report is “absolutely damning.”