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27 July 2017, 07:06
The Scottish Government needs to urgently improve workforce planning for the NHS if the health service is to have sufficient staff to meet future demands, public spending watchdogs have warned.
Audit Scotland said that despite increasing numbers of staff - the NHS employed the equivalent of 139,431 full-time workers at the end of March 2017 - there are still "major issues to be addressed''.
Opposition politicians and organisations representing doctors and nurses have repeatedly highlighted pressures many health workers can face.
Audit Scotland has now warned there may not be enough staff to meet future demand.
Its report said: "Processes for determining training numbers risk not training enough doctors, nurses and midwives with the right skills for the future.
"Medical recruitment numbers are based on replacing current numbers rather than looking at the impact of changing demand.''
Tory health spokesman Miles Briggs branded the research "deeply concerning''.
Labour's Anas Sarwar added: "This is an absolutely damning report from Audit Scotland.
"It reinforces our warnings that the SNP has presided over a workforce crisis in our NHS, leaving staff over-worked, under-valued and under-resourced.''
Spending on NHS staff amounted to £6.5 billion in 2016-17, accounting for 57% of day-to-day running costs.
In the period between 2011-12 and 2016-17, the cost of bringing in agency staff increased by 107%, going from £82.8 million to £171.4 million.
Audit Scotland said: "There are urgent workforce challenges facing the NHS caused by factors including an ageing population, an ageing workforce and recruitment difficulties.''
One in three staff in NHS Scotland are aged 50 or above, the report said, adding "upcoming retirements may increase vacancy levels in parts of the NHS where the age profile of the staff is older''.
Audit Scotland said: "The Scottish Government has not fully considered the risk that retirement from the NHS in coming years may lead to increased vacancies.
"Certain consultant specialties and certain areas in Scotland are relying on an ageing consultant workforce who may retire in the next five years.
"Similarly, over a third of the nursing and midwifery workforce is over 50 and the number of newly-qualified nurses in Scotland available to enter the workforce to replace them fell by 15% between 2013-14 and 2014-15, and a further 7% in the following year.''
While the number of staff in the NHS is at a record high, the watchdog said the Scottish Government and health boards "have not planned their NHS workforce effectively for the long-term''.
Major reforms are taking place to allow more people to be cared for at home or in their local community but Audit Scotland said funding for this "does not clearly identify associated workforce costs''.
The report continued: "The Scottish Government expects demand for health and social care to rise but it has not yet adequately projected how this will impact on the skills and workforce numbers needed to meet this demand.
"It has not looked at long-term scenarios for future patient demand when considering recruitment decisions and future workforce costs.''
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.''