Psychiatry Recruitment and Retention Working Group: final report

Evidence of challenges in the attraction and retention of psychiatrists in NHS Scotland

The Group explored the known and well documented issues facing the recruitment and retention of psychiatrists in Scotland, some of these challenges are not unique to Scotland but point to wider issues in the rest of the UK and globally. The Group shared their own valuable expertise and experience of the reality working in NHS Scotland as a psychiatrist and offered solutions to the challenges presented.

Workforce Data

The most recent official mental health workforce statistics, published quarterly by NES (at 31 March 2025), show that across NHS Health Boards in Scotland:

• The Whole Time Equivalent (WTE) of psychiatry consultants across all specialities in post was 541.7 WTE, this is an increase of 20% (90.2 WTE) in the last decade, and an increase of 0.5% (2.6 WTE) since the previous quarter.
• The current vacancy numbers (69.5 WTE) mark a 35.7% decrease since 31st March 2024 (-38.6 WTE decrease). The current vacancy rate of 11.5% is low compared to recent figures.
• 46.5% (69.5 WTE) vacancies were vacant for less than 6 months, while 53.5% of the vacancies were vacant for 6 months or more.
• The combined staff in post and vacancies indicate that the psychiatry workforce has grown slightly since last quarter. However, it has the slowest growth rate among the mental health professions and has plateaued.

The official data published by NES also showed that:

• The total psychiatry workforce i.e. consultants, Doctors in Training (DiTs), Specialist and Associate Specialist Doctors (SAS) and other has increased from 1109.1 in September 2014 to 1260.3 in September 2024. An increase of 13.6%.
• In the last quarter the number of consultants measured in headcount has increased from 647 to 649.

Source: Official Statistics on the workforce of NHS Scotland

Group members reported that official psychiatry workforce statistics do not fully reflect the true state of vacancy rates across NHS Scotland Health Boards. In the ‘Workforce Census Report: 2023’ published by RCPsychiS in March 2024 and ‘State of the Nation Report’, published in October 2023 reported:

For Consultants that “a BMA report from 2021 suggested that the consultant vacancy rate in Scotland was more than double the official government figures.”

The ‘State of the Nation’ report made recommendations for the Scottish Government and NES to ensure the consistent data collection and recording of workforce data and ensure it can be broken down by speciality and region to enable more accurate workforce planning. The Group were made aware by lead NES colleagues that the data currently reported is available at specialty, local and regional level: NHS Scotland Workforce Data

RCPSYCHIS also undertake their own biennial workforce census providing an evidence base for understanding issues such as the prevalence of locum doctors and the effect this is having on the NHS workforce in psychiatry.

The Audit Scotland Adult Mental Health report (2023) highlights that “pressure on staff is increasing because of high vacancy and turnover rates and difficulties in filling vacancies” going on to say that the “vacancies for general psychiatry consultants are the highest of medical and dental consultant roles in Scotland”.

Therefore, the Group would like to see an improvement in workforce data, in particular in relation to the way that vacancies are reported.

VOX Lived Experience Report – Psychiatrists in Scotland

Voices of Experience (VoX) Scotland published a report in December 2024 which captured the views of individuals who have experienced psychiatric care in Scotland within the last five years. The report shared the findings of a survey which ran over a seven-week period and captured the experiences of 469 people. The report made a series of recommendations in relation to psychiatry in Scotland. VoX representatives presented at a Group meeting in January 2025 where members welcomed their findings. The full list of recommendations is being considered by the Scottish Government.

For the purposes of this report, the recommendations that relate to the recruitment and retention of psychiatrists are summarised below:

• Improve care by gradually reducing the reliance on locums, especially those who do not hold the right qualifications or training, whilst increasing permanent posts in psychiatry.
• Implement a standardised system of psychiatrist job titles/roles which reflect their training and level of qualification achieved.
• Address pay and conditions received by permanent staff to ensure posts remain attractive and discourages psychiatrists moving to locum posts.
• Introduce a cap on locum spend.
• Ensure sustainable recruitment and retention of psychiatrists which takes into account challenges in rural areas.
• Ensure money saved from reducing locum use is reinvested in permanent psychiatric workforce and mental health services.

The VoX report linked challenges in the workforce to the published Scottish Government mental health core standards. These Standards support in improving the quality and safety of mental health services.