NHS workforce displacement into private aesthetics sector information: FOI release

Information requested

Information relating to the movement of NHS-employed prescribing clinicians into the private aesthetics (cosmetic medicine) sector and any associated impact on NHS Scotland workforce capacity.

1. Any data held by your organisation regarding NHS-employed prescribing clinicians (including but not limited to medical practitioners, dentists, nurse independent prescribers, pharmacist prescribers and allied health professional prescribers) who have left NHS Scotland employment within the last five financial years.

2. Any recorded destination-of-leaver data indicating movement into:

a. Private healthcare practice
b. Independent clinical practice
c. Cosmetic or aesthetic medicine services
d. Non-surgical cosmetic treatment providers
e. Self-employment in healthcare provision

3. Any internal workforce impact assessments, modelling, workforce planning assumptions, risk registers or reports produced since 2018 that reference:

a. Workforce loss to the private healthcare sector
b. Workforce loss to the cosmetic or aesthetic medicine sector
c. Reduced NHS clinical capacity linked to private sector migration
d. Prescribers reducing NHS contracted hours in order to undertake private aesthetic practice

4. Any estimates held regarding:

a. Full-time equivalent (FTE) clinical capacity lost due to prescribers undertaking private practice
b. Waiting list impact associated with workforce attrition to private practice
c. Training investment loss associated with prescribers leaving NHS Scotland employment

5. Any correspondence, briefing papers, or policy discussions held since 2018 relating to:

a. The migration of NHS clinicians into the cosmetic/aesthetic medicine sector
b. The impact of dual practice (NHS and private aesthetics work)
c. Retention risks linked to private sector injectable or cosmetic treatment markets

6. Any plans, current or proposed, to:

a. Monitor workforce migration into cosmetic or aesthetic medicine
b. Record private sector destination data more accurately
c. Mitigate workforce displacement related to private aesthetic practice

Response

While our aim is to provide information whenever possible, in this instance the Scottish Government does not have some of the information you have requested. The reasons why we don't have the information are explained below.

With respect to Question 1, while our aim is to provide information whenever possible, in this instance the Scottish Government does not have the information you have requested. The Scottish Government does not hold information which identifies whether individual staff members within the leavers dataset were prescribing clinicians. TURAS (the NHS Education for Scotland Data Intelligence website) does not contain a field indicating prescribing status, and job titles do not reliably distinguish prescribers from non‑prescribers. Therefore, under Section 17(1) of the Freedom of Information (Scotland) Act 2002, we must advise that this information is not held.

However, TURAS does hold data on leavers by professional staff group (e.g., medical, dental, nursing & midwifery, pharmacy, AHPs) for the last five financial years. These staff groups include individuals who may hold prescribing qualifications, but we cannot identify prescribers within them. This information is published on the TURAS Data Intelligence website and can be accessed at the following link: NHS Scotland workforce | Turas Data Intelligence

With respect to Question 2, The Scottish Government does not hold reason for leaving data or destination of leaver data. TURAS does not capture information on a leaver’s subsequent employment, including whether they moved into private healthcare, independent practice, cosmetic/aesthetic medicine, non-surgical cosmetic services, or self-employment. Therefore, under Section 17(1) of FOISA, we must advise that the specific information requested is not held.

With respect to Question 3, the Scottish Government does not hold any internal workforce impact assessments, modelling, workforce planning assumptions, risk registers, or reports that reference workforce loss to the private healthcare sector, loss to the cosmetic or aesthetic medicine sector, reduced NHS clinical capacity linked to private sector migration, or prescribers reducing NHS contracted hours to undertake private aesthetic practice. For the purposes of this response, we have interpreted “private healthcare” to mean stand‑alone private healthcare providers, and not private agencies supplying staff to work within the NHS.

However, one internal communication was identified that contains a brief reference to a potential workforce capacity risk associated with NHS clinicians undertaking additional work in the private healthcare sector. This relates specifically to Question 3(a). The relevant extract will be included in Annex A. This communication has been redacted where necessary, and an exemption under section 38(1)(b) of FOISA applies, as the redacted information consists of personal data that would identify an individual and cannot be disclosed under data protection legislation.

While the Scottish Government does not hold the internal assessments you refer to, NHS Health Boards publish their own workforce plans, which may include discussion of local workforce challenges, including movement of staff to private practice. As these documents are produced and held by individual Boards, the Scottish Government cannot confirm whether they contain the specific information you are seeking. Therefore, under Section 17(1) of the Freedom of Information (Scotland) Act 2002, we must advise that the remaining information requested is not held.

With respect to Question 4, The Scottish Government does not hold estimates relating to:

1. Full‑time equivalent (FTE) clinical capacity loss associated with prescribers undertaking private practice;
2. Any waiting list impact linked to workforce attrition to private aesthetic work
3. Training investment loss arising from prescribers leaving NHS Scotland employment.

Accordingly, in terms of Section 17(1) of the Freedom of Information (Scotland) Act 2002 (FOISA), I must advise that this information is not held.

With respect to Question 5, The Scottish Government holds some information relevant to this part of your request. Extracts of the information identified are provided in Annex B. These extracts have been redacted where necessary, and an exemption under section 38(1)(b) of FOISA has been applied. This exemption applies because certain content constitutes personal data which would identify an individual, and disclosure would therefore be unlawful under data protection legislation.

This exemption is not subject to the 'public interest test', so we are not required to consider if the public interest in disclosing the information outweighs the public interest in applying the exemption. No other correspondence, briefing papers, or policy discussions relating to these topics are held. Accordingly, under section 17(1) of FOISA, we must advise that the remaining information you have requested is not held.

With respect to Question 6, The Scottish Government does not hold any specific plans to monitor workforce migration into the cosmetic or aesthetic sector, nor any plans to record private‑sector destination data in a more detailed or systematic way. More broadly, NHS Boards are responsible for ensuring they have sufficient staff in place to deliver safe and effective services based on local need, and workforce planning continues to be managed at Board level. While the Scottish Government does not hold the specific monitoring plans you have requested, you may wish to contact NES directly to enquire whether they hold any relevant information. Accordingly, in terms of section 17(1) of FOISA, we must advise that the specific information requested regarding monitoring plans is not held.

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at https://www.gov.scot/foi-responses.

FOI 202600507150 - Information released - Annex A and Annex B

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