Spending on staff in Scotland's NHS is increasing and overall staff numbers are at their highest level ever but there are urgent workforce challenges, according to a report issued by Audit Scotland.
In the first part of a two-stage audit on workforce planning in the NHS in Scotland, Audit Scotland focuses on clinical staff in hospitals and other secondary care settings. It reports that the Scottish Government has not yet adequately estimated what impact increasing and changing demand for NHS services could have on the workforce or skills required to meet this need.
As well as determining the right mix of skills needed to meet future demand, the NHS faces recruitment challenges in the current workforce. Vacancies for some consultant and nursing positions remain high and difficult to fill. Increasing retirements could escalate vacancy levels in parts of the NHS where there are higher proportions of older staff, such as the general nursing workforce.
Caroline Gardner, auditor general for Scotland, said: "Thousands of people work hard in Scotland's NHS to deliver vital public services every day, but there are signs that the health service is under stress and that staff face increasing workload pressures.
"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."
Overall, patient feedback about the NHS and its staff is positive. However, complaints are rising and staff continue to raise concerns about their workloads. NHS boards are spending more on agency cover to help meet workload requirements, and 13 of the 14 territorial boards overspent against their 2015/16 pay budgets.
The report says responsibility for NHS workforce planning across national, regional and local levels is confused, and there is a risk of more fragmentation as integration authorities develop their own arrangements and new specialist centres are established.
