“It does, ultimately, become like rats from a sinking ship,” she said, “Your colleague goes under, more stress and workload transfers to you and others on the team. It shouldn’t be how it is but people do want to try their best so what happens is you burn out and go under so the vacancies do absolutely need to be filled.”
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Her comments come as new workforce data released earlier this week and obtained by BMA Scotland through Freedom of Information requests suggests the number of unfilled consultant posts across Scotland is far higher than official statistics indicate.
The figures show there are 1,165 whole-time equivalent (WTE) consultant vacancies across Scottish health boards, representing a vacancy rate of 16.8%.
However, statistics published by NHS Education for Scotland (NES) for the equivalent period in September 2025 recorded 447 WTE consultant vacancies, a rate of 6.7%.
The BMA says the discrepancy arises from how vacancies are counted.
“Their numbers undercount the vacancies and it’s the way that the data is collected,” Dr Bredski explained, “NHS Education for Scotland just counts jobs that are cleared to be advertised but haven’t been recruited into yet whereas when we do our Freedom of Information requests, we ask for that but also ask for posts that have been sitting vacant for so long that nobody is bothering to try and recruit into them any more and we collect data about posts that are partially covered by locums including locums who don’t actually have full consultant qualification.”
Joanna Bredski, chair of BMA Scotland’s Consultant Committee. (Image: BMA)
Asked if they want the Scottish Government to prioritise their figures when assessing the workforce crisis, Dr Bredski said: “Yes, that’s fair to say and if you don’t look at the accurate information about the current workforce, you can’t properly inform your workforce plan.”
The Scottish Government is currently developing the next phase of its medical workforce plan, following the publication of the first stage of the Future Medical Workforce report.
Dr Bredski said the initial report had been encouraging but warned that the crucial test would be whether the next phase delivered practical solutions.
“The first phase of the future medical work force report of the Scottish Government workforce plan was really brave and really honest.
“It did talk about the problems that did exist in the NHS for staff and patients as a consequence but the next phase is actually planning to improve the situation through, hopefully, proper workforce planning and you need to do that on the basis of the evidence.”
However, she said it remained unclear how quickly the next stage would progress.
“I honestly think it remains to be seen. I’m encouraged by the first phase report…I do not know what the next is going to look like.”
The next phase of the work is due to begin, but Dr Bredski said there was uncertainty about the timetable.
“The election will get in the way of a lot of things. There was a stakeholder meeting in the last couple of weeks…but I do not know a timescale. It’s work is intended to be done at pace.”
She warned that rapid action was essential given the growing strain on staff across the NHS.
“It’s absolutely crucial. On the ground, it just gets more and more difficult and you don’t have to look very far to see the rates of burnout amongst consultants and other healthcare workers are experiencing. There’s sickness absences amongst healthcare staff which is at the highest it’s ever been. The pressures have never been higher. Moral injury is everywhere and vacancies just compound that.
“We need to have the right number of consultants, the right number of other healthcare professionals and we need to be going to our jobs able to do our best but not burn out.”
The shortages are particularly acute in rural areas and in certain medical specialties.
“There’s consultant vacancies across Scotland but they are worse in the rural boards and they are worse in certain specialities. I’m a psychiatrist and consultant vacancies in psychiatry are particularly high so it does hit some specialties more than others and some places more than others but it does hit us all.”
BMA Scotland’s data indicates that the largest numbers of vacancies are in some of Scotland’s biggest health boards, including Lanarkshire (180), Lothian (144), Dumfries and Galloway (119) and Greater Glasgow and Clyde (101).
Vacancy rates are particularly severe in rural and island health boards, including the Western Isles (76%), Shetland (64%), Dumfries and Galloway (57%) and Orkney (44%).
Overall consultant vacancies have risen since the last time the BMA collated the figures, when 1,003 WTE posts were unfilled in 2025, representing a 14.4% vacancy rate.
Nearly one in four posts for specialty, associate specialist and specialist (SAS) doctors are also vacant, with a vacancy rate of 22%.
Dr Bredski said the staffing crisis was contributing directly to long waiting lists for treatment and leaving doctors struggling to provide the level of care they want to deliver.
“To get on top of waiting lists, you need to have enough staff to see the patients. We are sitting with really lengthy waiting lists. Yes, some of them have come down but from extraordinarily to still pretty extraordinarily long.
“Not only is that a big problem for patients waiting for appropriate care and treatment, it is very difficult for the staff on the ground all day every day. We are having to apologise for delays in care and treatment that are not caused by us as individuals. We are unable to give the care and treatment to our patients that we really want to give.”
She said many clinicians now felt they were being asked to operate in conditions that did not feel safe.
“Doctors and other healthcare workers are being required to do work which is impossible. It does not feel like good and safe practice and what that feels like to the individual is a sense of being unsafe and moral injury.
“It almost feels like we are being asked to accept working in these appalling conditions. It’s not inevitable and it’s not necessary. You don’t need to go very far to see countries with health systems that are better resourced and where senior doctors are paid better and health outcomes are better.”
Dr Bredski called on ministers to act urgently to address the staffing crisis.
“Pull on every available lever to get these vacancies filled now and do the workforce planning at pace at a really high quality so that we have help right now when we need it and so that we have really good plans for the future so our services are sustainable and our staffing is sustainable.”
She also urged political parties to prioritise the NHS ahead of the forthcoming election.
“Health is just about always amongst the top three priorities for voters and rightly and people are in the main proud and supportive that we have the NHS that we have in this country.
“There may be for some people acceptance of the way things are because austerity has affected us all but I simply do not believe that is true. I think it’s possible to have a vastly better health service and people living longer and having fewer rates of cancer and other preventable conditions if we invest at the right level and in the right ways. We should aspire to do that.”
A Scottish Government spokesperson said: “The latest data shows that NHS Scotland long waits have fallen for eight consecutive months, with substantial year-on-year increases in activity. These demonstrate real and sustained progress in reducing waiting times for patients across Scotland, ensuring thousands more people receive the care they need.”
“Our workforce in NHS Scotland is our most important and highly valued asset and has now grown for 14 consecutive years. The number of Medical and Dental Consultants has increased by 23% over the last decade.
“NHS workforce statistics, including vacancies, are produced by NHS Education Scotland and quality assured following the official statistics code of practice. NHS Boards are clear that all advertised vacancies within the NHS are reflected within official figures.”