Future Medical Workforce Project: phase 1 report
The future medical workforce phase 1 report follows an extensive exploratory process to understand the challenges and opportunities for Scotland’s medical workforce as we look ahead to the next 15 to 20 years.
Strategic context
Demand for medical services
We know that demand for medical services will be higher in 2045 than it is now. We have an ageing population and persistent health inequalities and recognise we will be facing an increased burden of disease.
The Scottish Government published the Population Health Framework (2025–2035) in June 2025 which sets out a national vision for improving physical and mental health and wellbeing across Scotland. The Framework marks a cultural shift from treating illness to preventing it, promoting a whole-system approach to improving population health. Its overarching aim is to improve life expectancy and narrow the life expectancy gap between Scotland’s most deprived 20% of areas and the national average by 2035.
- Scotland’s population was estimated to be 5,546,900 in June 2024. By mid-2047 Scotland’s population is projected to continue increasing, by 6.2% to 5.8m[1].
- In 2024 20.5% of the population is aged 65 and over, up from 16.2% two decades ago, while the proportion of children aged 0–15 has declined to 16.2%[2].
- From 2021 to 2023, Healthy life expectancy had fallen to 59.6 years for men and 60 years for women[3].
- The annual disease burden is forecast to increase 21% between 2019 and 2043 based on demographic factors alone[4].
- Cardiovascular diseases, cancers, and neurological disease account for 68% of the total increase in forecasted disease burden by 2043[5].
While the burden of disease alone does not directly determine the need for relational increase in medical services or workforce, it is helpful to consider when planning for the numbers of doctors required by 2045. Future increase in service demand is generally expected to drive higher workforce requirements, but there are key considerations around whether these additional roles will be filled by medical professions, other healthcare professions or a combination of both. As the roles of the different professions continue to evolve, multidisciplinary teams remain crucial in service delivery, with some areas shifting from consultant-delivered to consultant-led models of care.
NHS Renewal and Reform
By 2045, Scotland’s NHS is expected to look very different. The kind of treatments and care patients receive, as well as the ways they access them, will have evolved. This transformation will also influence the kind of doctors needed, where they will work, and what jobs they will do.
The Scottish Government’s Health and Social Care Service Renewal Framework (SRF), published in June 2025, sets out a high-level guide for change to ensure the sustainability, efficiency, quality, and accessibility of health and social care services in Scotland to support the vision of a ‘Scotland where people live longer, healthier, and more fulfilling lives’. It sets out key actions relating to transformation, system integration and innovation over the next five years to achieve the year 10 objective of a renewed health and social care system. The forthcoming (2026) Primary and Community Health Route Map will set out further the future delivery approach to the SRF, with particular reference to our ambition to shift the balance of care.
As part of considering what our medical workforce needs to look like in the future, we have explored the evidence that exists on the known views of the public and patients, the potential of innovation & technology[6] and the opportunities and challenges facing services as they seek to redesign in line with the SRF. (Further details can be found in Annex A).
In summary, we know that the Scottish public strongly supports the NHS and its founding principles of free, tax-funded healthcare but perceives that the system does not always currently meet their needs and requires improvement. The public strongly supports a shift toward community-focused, preventative care to reduce pressure on secondary services and A&E, alongside greater involvement in managing personal health. Key enablers include access to primary care, improved understanding of service structures, and enhanced digital access. Technology offers opportunities for early detection and self-management through genomic surveillance, big data, wearables, and AI, but integration into clinical practice and workforce capacity remain challenging.
Moving from illness-focused to prevention-focused care will require organisational, service, and social innovation, strengthened primary care, and initiatives targeting lifestyle factors such as obesity and healthy eating, alcohol consumption and smoking.
Holistic, person-centred care is highly valued by the public and patients but requires continuity of care, interoperable digital records, and innovations that empower patients through shared decision-making and self-management tools. Population planning should use demographic and epidemiological data to target need while avoiding inequities, especially in rural and deprived areas. Digital technologies and AI offer significant potential for improving access, efficiency, and precision medicine, but concerns persist around data security, digital exclusion, and ethical governance. AI and digital technology cannot replace clinicians’ ability to care but can support them to provide this care more effectively and with more time to do so.
Successful adoption will depend on modern infrastructure, workforce upskilling, and maintaining the human element in care.
As the NHS continues its journey of reform it is right we consider what the role of the doctor will become, and indeed some of the constraints that exist in supplying the medical workforce, to best inform NHS renewal and service design.