Scottish budget: health and social care funding must reach the front line

The Royal College of Physicians of Edinburgh (“the College”) has welcomed the announcement of record funding for health and social care in the budget, but said that it must reach doctors on the front line. 

Doctors continue to deliver quality care outcomes despite increased demands. According to the Physician’s Census, a medical workforce report which the College publishes each year with its sister Colleges in Glasgow and London, 71% of physician consultants in Scotland said that they worked extra hours due to clinical workload.

Furthermore, 43% of consultants worked extra hours as part of the COVID-19 response and a further 18% worked extra hours due to COVID-19 recovery or “catch up” work.

The data highlights the extra pressure that doctors are under, with factors such as rota gaps, increased clinical demand and additional administrative duties contributing to burnout and low morale. It is concerning that 55% of consultants reported their morale being worse during the pandemic.

Efforts must be undertaken now to value our exhausted healthcare workforce, while reducing the burden on them. In particular, there are simply too few doctors to meet clinical demand, and so a robust staff recruitment and retention strategy is necessary.

Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh, said:

The College welcomes, as it has done in previous years, the latest funding commitment for health and social care in Scotland. We also welcome the £147.6m investment in tackling alcohol and drug related harms, a slight increase on last year.

As we have indicated in previous years, any additional funding must be used efficiently – and it must reach healthcare workers on the front line, who continue to deliver quality patient outcomes under increased clinical demand.

The College would urge the Scottish Government to use this record funding to invest in the medical workforce now, because as we highlighted in the recently published Physician’s Census, Scotland has too few doctors to meet clinical demand. Our chronic workforce shortages must now be addressed as part of a sustainable and deliverable long term plan for our NHS, taking account of changes such as the rise of part-time working, extended working, and the needs of an ageing population.

In the short term, funding must also go towards filling immediate rota gaps through innovative recruitment and retention programmes, and humane rota design; ensuring that there is enough medical equipment across all hospitals; and by providing good rest and refreshment facilities for medical staff, available 24 hours a day, 7 days a week.

The inextricable links between health and social care must be supported and enhanced in an integrated way, and there is a real need to provide funding to support carer recruitment and training in the formal care sector, as well as support for informal and unpaid carers.


The Physician’s Census Report, including data toolkit, can be downloaded here: