Doctors in Scotland are increasingly concerned that patient safety is being compromised and feel unable to influence change in their workplace, a new report has revealed.

The General Medical Council (GMC) is warning understaffing, growing workloads, competition for posts, and lack of senior support for development are adversely impacting the career hopes of doctors and the safety of patients.

BMA Scotland has reported NHS doctors are facing an unemployment crisis despite understaffing, doctors have now told the GMC that inadequate staffing is the primary barrier to good patient care.

The new workplace experiences report shows 73% of Scotland’s doctors feel inadequate staffing is negatively affecting patient care, with nearly half (46%) saying they have witnessed risks to patient safety at work – higher than the UK average of 40%.

Despite more doctors in Scotland saying they feel part of a supportive team compared to their UK counterparts, they are less likely to report feeling that they could influence change in their workplace.

More than two thirds of doctors in Scotland say delays in providing care, treatment, investigations or screenings present a barrier to good patient care.

Meanwhile, half of doctors in Scotland say they found it difficult to manage patient expectations at least once a week – again higher than the UK average.

On average 39% of doctors said they could progress their career as they wanted, with those in radiology, psychiatry, anaesthetics, paediatrics and intensive care more likely to feel able to progress as they want.

In Scotland, 37% of doctors reported feeling they could progress their career in a way they wanted.

The GMC report also shows around a third (30%) of doctors in Scotland were considering leaving the profession – slightly fewer than the UK average (34%).

Work-life balance and wellbeing are the reasons most frequently given for considering a career change, with doctors at high risk of burnout most like to have taken hard steps to leave.

While fewer doctors in Scotland reported taking hard steps to leave the profession than the rest of the UK, they were on par with the UK average at 44% considering reducing their contracted hours.

Around 1 in 5 Scottish doctors reported considering moving to practise abroad, slightly less than the UK-average of 27%.

Charlie Massey, Chief Executive of the GMC, said a concerted, whole-system effort is required to modernise healthcare and “drive real change” that meets the needs of patients and staff:

“Doctors need to be satisfied, supported, and see a hopeful future for themselves, or we may risk losing their talent and expertise altogether.

“Efforts need to go further than previously, so I’m pleased to see these priorities reflected in the ambitions of the 10-year Health Plan for NHS England, as well as in equivalent strategies across Northern Ireland, Scotland, and Wales.

“Improving the experiences of doctors and their environments correlates with enhanced patient care. It is encouraging to see marginal improvements in wellbeing, but this progress must be nurtured.”

The workforce report follows the GMC’s trainee survey, which found many resident doctors are hesitant to ask for help and over half of Scotland’s doctors in training are at moderate-to-high risk of burnout.

Doctors across Scotland are now being invited over the next few months to shape medical workforce reforms.

The Scottish government has announced it will run a series of focus groups to better understand pressures facing the profession and how best to respond to the challenges they face.

A Scottish government said the government is committed to listening to health and care workforce as it brings forward reforms:

“The Scottish government is extremely grateful to all NHS doctors for the valuable work they undertake, day in and day out.

“Patient safety is paramount and we will ensure any concerns raised by the GMC are fully considered and addressed.

“We want doctors to feel their voices are heard – our Future Medical Workforce project will collect direct feedback from physicians in the coming months to help shape future reforms in training and recruitment and ensure being a doctor is a sustainable and fulfilling career path.”

Read more: Scottish doctors happier but still at risk of burnout; Racism in NHS Scotland still rampant; Scotland to work with UK on Physician Associate reform; Corridor care ‘the norm’ in struggling hospitals; NHS waits pushing more patients private; Scotland’s ‘invisible’ patients and carers; NHS Chair: “I'm sorry”; Current metrics fail to capture NHS activity; Ten-year low in Scots healthy life expectancy; First Minister unveils NHS renewal plans

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