BMA Scotland says the government must act now for the sake of patients after nearly one in five doctors told a General Medical Council (GMC) survey that they were taking steps to leave the NHS – with many feeling unable to cope with their workload.

In response, the Scottish government says it is working towards actions that will address the workforce concerns raised and avoid staff burnout across the NHS.

The latest report from the medical workforce regulator has found that Scottish doctors are more content with work but still at risk of burnout.

Around one in three doctors in Scotland reported they had felt unable to cope with their workload and 69% said they worked over their rostered hours at least once a week.

BMA Scotland says this report is a warning that the ongoing medical workforce crisis will worsen if action is not taken to retain doctors at all levels.

Simon Barker Deputy Chair of BMA Scotland said:

“We have long warned of a medical workforce crisis in Scotland, driven by shortages of doctors and an inability to keep up with demand.

“These figures, from the GMC suggest that this is likely to get worse – with 17% of doctors taking hard steps to leave the medical profession.

“To be clear – these aren’t doctors who are just thinking about it – they are actually doing something about leaving our NHS.”

Almost one in five doctors across the UK have reported taking ‘hard steps’ towards leaving medicine, from applying for clinical jobs abroad, contacting a recruiter, applying for training or other roles outside medicine, to applying for retirement or pension.

This is the highest level since the GMC began surveying this.

Retaining staff amid rising demands

The GMC also revealed despite Scotland’s doctors reporting more positive experiences, 14% were ‘high risk of burnout’ and almost half were likely to reduce their contracted hours.

The regulator warned that if this trend continues unaddressed, the ‘already stretched’ health services could see capacity further reduced, placing patients at risk.

Although Scotland’s Health Secretary and First Minister have promised to stand against attempts to privatisation of the NHS, the BMA says two-tier healthcare is rapidly developing and Scotland is ‘sleepwalking’ into a private healthcare system.

While, concerning patterns are seen across all groups, nearly half (48%) of GPs are struggling and consistently have worse experiences than others since the report began in 2019.

This follows a Scottish GP Committee warning that despite Scotland going further on contract reforms, much more is needed to recruit and retain GPs amid “constructive talks” on doctors’ pay.

BMA Scotland’s Mr Barker added:

“With waiting lists growing, and prospects for this winter already looking bleak, losing doctors will only exacerbate these challenges, and mean that performance and ultimately patients suffer.

“We simply, as we have said repeatedly, must do more to retain doctors at all stages of their career.”

Scotland’s Cabinet Secretary for Health and Social Care Neil Gray launched a national conversation for the workforce and public to inform NHS reform, saying “significant transformation” is urgently needed.

Mr Gray recently told healthandcare.scot that he is seeking urgent clarification from Westminster on what pay offers in England could mean for Scotland’s funding.

BMA Scotland’s Mr Barker said more action is needed to make NHS Scotland on work-life balance:

“Of course, competitive pay is one crucial part of that – and with new pay offers across the UK, Scotland’s doctors are at risk from emerging from this year as the worst paid in the UK.

“We now need pay offers across the profession that properly address this competitive disadvantage for Scotland’s NHS.

“Alongside that, we need much more action on work-life balance, support in the job and simply making Scotland’s NHS a better, less pressured place to work.

“Otherwise, these forecasts will bear out, we will lose more doctors, and things will get worse for patients.”

Listening to staff

The GMC highlights the need for doctors and other healthcare professionals are ‘properly valued’, and employers to create more supportive, inclusive environments.

A Scottish government spokesperson told healthandcare.scot:

“We are working with healthcare leaders and listening to staff to understand where the current pressures are, and what further actions can be taken to mitigate their impact on staff and avoid burnout.

“We will ensure concerns raised by the GMC over workload pressures are fully considered and addressed.”

The GMC says not being part of a supportive team, feeling dissatisfied with day-to-day work, struggling with workload or to provide sufficient care were key to doctors taking steps to leave.

Disabled doctors continue to report worse experiences and are more likely to consider retiring early than those living without a disability.

A government spokesperson said staff wellbeing is “paramount” and the Scottish government which is investing in support including listening and confidential mental health services, access to psychological therapies and self-care resources:

“We are grateful to all NHS doctors for the work they undertake – they are the bedrock of Scotland’s services.

“It is crucial staff feel able to raise concerns and that issues will be treated with the utmost seriousness and thoroughly investigated.”

Read more: Scottish doctors happier but still at risk of burnout; Scheme for GPs to help lost patients extended; A ‘dispiriting picture': human rights in prisons; ‘Bleak picture': health leaders react to NHS review; NHS reform letter to boards

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