CONSULTANT vacancies in NHS Scotland are nearly twice as high as official statistics suggest, and a "heavy reliance" on locums is being overlooked say doctors' leaders.
Data gathered under freedom of information by trade union, BMA Scotland, estimates that there are actually 768 unfilled posts for medical and dental consultants, equivalent to 13.9% of the workforce.
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It comes after the latest ISD Scotland workforce figures indicated that the official vacancy rate for consultants had fallen by 8.7% over the past year, to a shortage of around 393 doctors or hospital dentists.
That would equate to a vacancy rate of 6.8%, the lowest since December 2016.
However, BMA Scotland said the scale of the problem was being hidden because consultant vacancies which had not been filled following a recruitment drive can be temporarily written off, while other empty posts which have not yet been cleared for advert are also excluded.
As a result, health boards can make their vacancy rate for clinicians appear lower simply by delaying or choosing not to advertise a post.
The trade union said ISD Scotland figures also fail to "fully reflect the heavy reliance on locum doctors that boards are using to cover vacant consultant posts", and expressed concern that the number of consultant posts lying empty for six months or more was up 1.7% in the past year.
Dr Simon Barker, Chair of BMA Scotland’s Consultant Committee, said: "This analysis shows that by not including certain categories of vacancy, the official statistics simply don’t provide the full picture of the scale of consultant vacancies in our NHS.
"For example, vacant posts that go unfilled are then removed from official figures. Our FOI data suggests that when these are added back in, and few would argue that these aren’t real vacancies, the actual vacancy rate is substantially higher than boards report.
"Collectively, that means there are potentially around 375 vacancies on top of those counted by official figures - the equivalent of a large hospital empty of its senior doctors."
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Overall, the NHS workforce - in Scotland and the UK as a whole - is at record levels, but campaigners argue growth has not kept pace with demand.
Dr Barker added: "Behind these figures are senior doctors who are pushed into covering the work of these vacant posts. These are professionals doing their absolute best, but under these conditions we risk burnout and stretching people beyond their limits.
"Inevitably this leads to more people leaving the profession early and the high standard of care for patients that we all strive for, not being achieved."
It comes as a report on today from the General Medical Council warned that 66% of UK doctors aged 55–64 plan to take early retirement within the next three years, as do 21% of those aged 45-54.
Among GPs, 38% said they were planning to leave the profession within three years, and 28% said they wanted to reduce their hours or go part-time.
Heavy workloads and staff and bed shortages leading to stress, as well as less time to devote to complex patients, were among medics' chief complaints.
The GMC report - which surveyed 2600 medics - said doctors admitted to bypassing clinical checklists in order to get through workload, or ordering blood tests and making referrals that were not strictly necessary simply speed up patient turnover.
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Professor Sir Terence Stephenson, chair of the GMC, said: "Doctors are telling us clearly that the strain that the system is under is having a direct effect on them, and on their plans to continue working in that system.
"We’ve heard from doctors who are referring patients on to other parts of the system because they don’t have the time to deal with their issues, understandably moving the pressure on to other parts of the service."
At the same time, the number of 'doctors in training' (DiT) across the UK - that is, medical graduates in the process of completing either their two-year foundation period or subsequent training as a specialist or GP - increased by just 1% between 2012 and 2018.
In Scotland, the number of doctors in training appeared to have fallen by 2% since 2014, to 6009, although ISD Scotland said data errors in previous years mean DiT counts could have been over-inflated.
Between 2012 and 2016, the percentage of trainee medics in the UK who took a career break after foundation training - often going overseas to work - has shot up from 30% to 54%.
Of the junior doctors who completed Foundation Year 2 in 2012, 525 - or 7% of that year's cohort - have not returned to medical training in the UK five years on.
The GMC report also highlights much faster growth in GP numbers in England - up 6.8% between 2012 and 2018 - while in Scotland the GP workforce increased by just 1% in the same period.
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