College Response to the Future Medical Workforce phase 1 report

College Response to the Future Medical Workforce phase 1 report

The Scottish Government has published the Future Medical Workforce Project: phase 1 report which aims to understand the challenges and opportunities for Scotland’s medical workforce and look ahead to the next 15 to 20 years.

Dr Marion Slater, the College’s Vice President for Scotland and Northern Ireland, looks at the report in this commentary below. 

The College welcomes the publication of this report and recognises its importance in shaping Scotland’s healthcare workforce and improving care and experience over the next two decades. Doctors across Scotland continue to describe strong purpose and professional fulfilment in caring for patients alongside significant and well-recognised challenges. The report provides a valuable opportunity to address these issues in a coordinated and forward-looking way.

Communication, Collaboration and System Working

The report highlights the need to improve communication and collaboration across the system, including within organisations, across professional groups and between primary and secondary care. More effective information sharing supports better clinical decision-making, enhances engagement for clinicians and patients and improves effectiveness and efficiency. Greater visibility and spread of good practice and innovation, already evident across Scotland, would further strengthen workforce development and patient care.

Generalism and Holistic Care

The College strongly supports the report’s emphasis on generalism and the delivery of holistic, person-centred care across settings, consistent with the Shape of Training principles. Generalist skills are essential for meeting the needs of an ageing population, managing multimorbidity and reducing fragmentation across services. Strengthening generalism across training, career pathways and service design supports continuity of care, and Scotland has led the way in successfully integrating generalist and specialist training.

This integration must be supported by equitable recognition and resourcing of generalist roles across all care settings. Doctors providing generalist services often experience higher rates of burnout due to intense clinical workloads and limited support. The College remains committed to advancing training and professional development in Internal Medicine and promoting innovation that strengthens care across Scotland, with remote and rural areas representing key settings for developing and applying generalist skills.

Rural and Remote Care

The College welcomes the strong focus on remote and rural communities. Existing innovation should inform future planning, ensuring efforts are directed towards proven solutions. ‘Once for Scotland’ approaches to travel and accommodation for students and professionals undertaking rotations would reduce inequity and financial burden on individuals as well as on Rural and Island Boards. Recognition is also needed of the multiple additional roles undertaken by colleagues in these settings, with appropriate resourcing and job planned time.

SAS and LED Doctors

Recognition of the critical contribution of SAS and LED doctors is welcomed. These colleagues are central to NHS service delivery and require coordinated, equitable and structured support, including access to career support and professional development as well as improved job security. Career aspirations vary and should be supported through flexible and inclusive pathways.

Education, Training and Workforce Flexibility

Doctors play a vital role in education and training, and this contribution must be properly recognised and supported through adequate job planned time and resources. Flexibility and shared decision-making underpin not only patient care but also training placements, education and professional development. Breaking down organisational, professional and financial siloes is essential to support innovation, experience and multidisciplinary working and ensure training meets the needs of doctors as well as the patients we care for.

Workforce Planning and Transitions

Sustainable, high-quality patient care depends on robust workforce and service planning. This must integrate local and national approaches, involve patients and professionals and include clear accountability from Health Boards. Greater transparency in decision-making is required. Improved planning and communication within Boards at the end of training programmes would better recognise the investment made by resident doctors and the public, and support doctors to move into senior roles in a structured and supported way. Planning must also include sustained support for Scotland’s academic workforce.

Valuing the Workforce

The College emphasises the importance of valuing the healthcare workforce. Fundamentals such as access to safe parking, rest facilities, hot food during shifts and person-centred support taking account of individual’s personal and professional needs should be standard and no longer highlighted as systemic shortcomings. Addressing these basics is essential to retention, morale and wellbeing.

Key Recommendations

1. Strengthen communication and collaboration across primary and secondary care, professions and organisations, including improved sharing of good practice and innovation.
2. Build on proven rural and remote solutions including progressing ‘Once for Scotland’ approaches to travel and accommodation and recognising additional roles undertaken by rural clinicians.
3. Strengthen coordinated and equitable support for SAS and LED doctors with access to career development and flexible progression pathways.
4. Recognise and resource education and training roles, ensuring adequate job planned time and support for educators.
5. Improve service planning and transparency, integrating local and national approaches and supporting clearer workforce development pathways.
6. Embed multidisciplinary and flexible approaches to service, workforce and financial planning to reduce siloes and improve efficiency and effectiveness.
7. Demonstrate tangible commitment to valuing the workforce, ensuring basic working conditions and wellbeing support are consistently in place.