NHS Scotland: Targets 'placed around doctors' necks' are making recruitment crisis worse – Dr Joanna Bredski

Mental health services across Scotland are struggling. Psychiatry is a specialty that always flags high consultant vacancy rates when the quarterly workforce stats come around. It has been struggling for years, but since the Covid pandemic, demands on the service are far beyond anything we’ve seen before.

Last month the Royal College of Psychiatrists in Scotland published its State of the Nation Report: The Psychiatric Workforce in Scotland and posed the question: “How do we recruit and retain in psychiatry?” It’s a well-researched piece of work that exposes the difficulties at all levels of the workforce and makes clear recommendations about how we can fix it.

So often when staff highlight the problems facing the medical workforce, they are criticised for not offering solutions as well. Of course, there is the justified argument that it’s not our job to fix the workforce crisis, but here, in black and white, are tangible, realistic recommendations on what needs to be done. I would urge anyone with a vested interest in the future of the NHS workforce – be that employers, public or politicians – to read it and consider what the college is saying.

Indeed, many of the difficulties are shared with our specialties and many of the recommendations are transferrable too. Remarks by Dr Ihsan Kader, lead author of the report, will, I am sure, feel familiar to many: “There’s a growing trend of doctors opting to leave training and take up specialty doctor posts, take career breaks, or work abroad instead of moving directly into higher training. This results in delays in consultants coming through into the workforce. Furthermore, we are not retaining our senior doctors who choose to retire early or choose other options due to the unmanageable workload and other pressures.”

As a consultant, I find the targets placed around our necks deeply worrying. We are stretched so thin that we cannot possibly give our patients the level of care, time and help they need and deserve. Something has to give, and the authors of the State of the Nation report are absolutely right that much needs to be done, starting at undergraduate level, to improve the experience and working lives of all doctors. This must also sit alongside fair pay – yes, it does make a difference – which encourages doctors to work for the NHS in Scotland instead of going to private providers or making the move overseas.

Finally, the report highlights the need to recognise and reward medical leadership. The UK Government is clear that there’s “no health without mental health” and I believe there is no sustainable future for the health service without medical leadership. Together we can dream, support and act to protect the health service that we love.

Dr Joanna Bredski, consultant psychiatrist, deputy chair of the BMA’s Scottish Consultants Committee