NHS Scotland Workforce
This is an Official Statistics Publication
This report accompanies the latest release of the Official NHS Workforce Statistics on Turas Data Intelligence. All statistics have been produced in compliance with the UK Statistics Authority’s Code of Practice for Statistics.
Revision on 19 August: The medical agency expenditure for the year ending 31 March 2025 has been published on 19 August in the NHS Scotland workforce Official Statistics. These data were not released as planned on 3 June 2025 due to concerns over quality raised during the Early Release for Quality Assurance period by an NHS Board. Data providers, NHS National Services Scotland (NSS), worked with NHS Boards to validate the data sourced from NHS Scotland’s Finance Platform. Compared with the original extract provided to NES, there were minor changes made to the expenditure for four NHS Boards.
Medical agency expenditure data for the year ending 31 March 2025 are now included in the Executive summary and Section 4.1 in this annual report and in the dashboard on Turas Data Intelligence. There are no other changes to the publication released on 3 June.
1 Executive summary
Statistics on 31 March 2025:
There were 161,333.8 Whole Time Equivalent (WTE) staff employed by NHS Scotland, a 0.1% increase from 31 March 2024.
The nursing and midwifery staff group is the largest in NHS Scotland, accounting for 67,714.6 WTE (42.0%) of the workforce. Employment in this group has increased by 0.8% over the past year.
Employment of medical and dental staff increased by 1.3% to 15,934.2 WTE from 31 March 2024.
The number of allied health professionals employed in NHS Scotland increased over the past year by 0.9% to 14,158.1 WTE.
There were 29,654 WTE administrative services staff employed, a 1.8% decrease from 31 March 2024.
The annual increase in WTE employment in NHS Scotland was a result of the outflow of 9,701.4, being less than the inflow of 11,451.3 WTE.
Vacancies in nursing and midwifery, allied health professions and medical and dental consultants have decreased over the past year. The nursing and midwifery vacancy rate has decreased by 1.1 percentage points to 3.7%. Similarly, the allied health professions and consultants vacancy rate have both decreased by 0.9 percentage points to 3.6% and 6% respectively.
The sickness absence rate for NHS Scotland has increased slightly by 0.2 percentage points to 6.4% for the year ending 31 March 2025, the highest rate recorded.
Revision: Expenditure on medical and dental agency for the year ending 31 March 2025 decreased by 16.7% to £108.0 million.
Expenditure on nursing and midwifery agency for the year ending 31 March 2025 decreased by 62.5% to £56.7 million, while expenditure on bank staff increased by 4.3% to £353.4 million over the past year.
There were 5,260 GPs (including Trainees), a rise of 2.5% from 31 March 2024.
There were 3,249 Dentists working in Primary Care dentistry, a rise of 4.2% from 31 March 2024.
2 Introduction
NHS Education for Scotland (NES) is the source for Official Statistics on the NHS Scotland Workforce. The purpose of publishing these data is to serve the public good by informing the public about social and economic matters and by assisting in the development and evaluation of public policy.
The NHS Scotland workforce has a significant role to play in the delivery of quality services that meet the needs of patients, their families, and the general public in a modern health service. Staffing also accounts for a large proportion of the NHS Scotland budget: the Scottish Health Service costs report for the year ending 31 March 2024 reports that employment accounted for 68.4% or £6.6 billion of hospital costs.
NES publishes quarterly updates on several indicators, including employment and vacancies. These data support NHS Boards and the Scottish Government with local, regional and national workforce planning. This annual report reviews these indicators for the past year.
2.1 Workforce data and information
The primary source of information on staff employed by NHS Scotland is the Scottish Workforce Information Standard System (SWISS) which brings together HR and Payroll information. In addition to this, NES collects a range of information directly from NHS Boards.
In conjunction with this report, comprehensive workforce data are available via the Turas Data Intelligence website.
A technical report is available giving background information on the NHS workforce, information on the data sources used, data quality and methodologies.
2.2 NHS Workforce across the UK
The ONS has produced an article summarising the organisations that publish Official Statistics on the healthcare workforce for the different nations within the UK, the size and makeup of the health workforce and differences in how the NHS workforce is structured in each nation. It also provides a summary of information available from the GMC and the NMC on the size of the registered workforce.
3 NHS Scotland workforce
This section reports on all staff employed directly by NHS Boards and excludes those working as independent contractors, such as General Medical Practitioners (GMPs) and General Dental Practitioners (GDPs), and staff employed on bank and agency contracts.
Throughout our reports and website this phrase is used to capture anyone who is directly paid by an NHS Board, and it broadly represents the secondary care or the community workforce in the NHS in Scotland.
There are two main exceptions; dentists working in the Public Dental Service or Hospital, and those undertaking their Dental Vocational Training, and GPs who are in training or who are working at a practice who is run by an NHS Board are included.
3.1 Employment
3.1.1 Overall Employment
On 31 March 2025, NHS Scotland employed 188,313 people. This is a 0.6% increase over the past year, and a 12.7% increase over the past 5 years. Employment measured in Whole Time Equivalent (WTE) has remained stable since 31 March 2024 at 161,333.8 WTE (Figure 1).
Footnote:
Shaded grey area from 30 June 2020 to 31 June 2022 indicates where the COVID-19 pandemic may have affected these data.
On 31 December 2018, sterile services were recategorised from support services to healthcare sciences job family (point A)
Over the past year, the number of staff employed in most job families have remained stable. The largest relative increase was in medical and dental support, with a 2.4% increase. The nursing and midwifery job family increased by 0.8% after a period of stability. Ambulance support services job family had the largest relative decrease of 3.5%, with their employment close to returning to pre-pandemic levels.
These changes in employment can be explored in more detail in the NHS Scotland workforce dashboard on the Turas Data Intelligence website.
3.1.2 Inflows and Outflows
In the year ending 31 March 2025, excluding Resident Doctors, the outflow from NHS Scotland, 9,701.4 WTE, was less than the inflow, 11,451.3 WTE.
Changes in employment reflect the difference between the number of people joining NHS Scotland, inflows, and the number of people leaving NHS Scotland, outflows. The method used to calculate turnover can be found in the technical document.
Change in WTE
The change in WTE is the sum of the difference in WTE between two time points of people that are neither outflows or inflows. The overall NHS Scotland workforce WTE has remained stable this year despite the inflow being larger than the outflow. This is due to staff who were employed at both 31 March 2024 and 31 March 2025 reducing their working hours.
The size of the change in whole time equivalent has been increasing over the past ten years, with the largest drop between 31 March 2024 and 31 March 2025. We will continue to investigate the change in WTE and report our findings once available.
The change in WTE is due to the increase in part-time working.
Detailed turnover, such as those who have moved between Boards or between job families, and the change in WTE, can be found in the Turnover tab in the NHS Scotland workforce dashboard on the Turas Data Intelligence website.
3.1.3 Demographics of the workforce
78.8% of people employed in NHS Scotland are female, although this varies between different staff job families: 49.8% of staff in ambulance support services are female compared with 89.8% of staff in nursing and midwifery (Figure 5 ).
Using data from Labour market in the regions of the UK: April 2025 11.2% of all female employees in Scotland are employed in NHS Scotland. By contrast, 2.9% of all male employees are employed in NHS Scotland.
Over the past 10 years, the nursing and midwifery age distribution has become more uniform, where previously the most common age group was 45-54. In other job families such as administrative services, personal and social care, and support services, the most common age group has shifted from 45-54 to 55-64. Over the next 10 years as these staff retire the age profile for these staff groups will level out. Outflows from retirement are likely to be larger in age distributions in which the most common age group is towards the upper end of the age distribution than in more uniform distributions.
The median age of the people employed in NHS Scotland on 31 March 2025 was 44. This has changed little over the past 10 years.
The percentage of people aged under 35 increased from 23.8% ten years ago 31 March 2015 to 26.8% on 31 March 2025 (Figure 6).
The percentage of the people employed in NHS Scotland aged over 54 increased from 19.7% ten years ago to 24.9%. The percentage of people in this age group increased for all job families (Figure 6).
3.1.4 Contracts
Part-time working
Total labour input depends on the number of people employed and mean whole time equivalent. Mean whole time equivalent in NHS Scotland varies with age and sex and between job families (Figure 7).
For most age bands, females have a lower average WTE than males. The greatest difference in average male and female WTE is between the ages of 35-44 and 60-64.
During the past year, there has been a decrease in average WTE in all job families. Personal & social care and support services experienced the smallest differences, whereas ambulance support services had the largest difference.
The Labour market in the regions of the UK: April 2025 reported that that 39.1% of females and 13.8% of males employed worked part-time. The percentage of staff in the NHS Scotland workforce working part-time is higher, with 51% of females and 22.6% of males working part time.
The number of people working part-time in NHS Scotland has increased by over a fifth (22.2%) during the last decade, and by 5.2% during the past year. At 31 March 2025, 45% of staff were working part-time compared with 43% of staff the previous year. However, since 31 March 2024, the average WTE of part-time staff has increased from 0.67 to 0.68. This suggests that despite an increase in part-time contracts, those choosing to work part-time are, on average, working more hours.
Fixed-term contracts
The increase in demand for staff caused by the COVID-19 pandemic was partly met by an increased use of fixed-term contracts.
For most job families, the proportion of fixed-term contracts have begun to decrease towards pre-pandemic levels. However, the proportion of fixed-term contracts for medical and dental has continued to increase.
Excluding Resident Doctors, fixed-term contracts accounted for 4.9% of employment measured in WTE on 31 March 2025.
The proportion of employment accounted for by fixed-term contracts varies between job families (Figure 8). In some staff groups, it is routine for contracts to be fixed-term: fixed-term contracts account for 96.4% of employment for Resident Doctors.
3.2 Sickness absence
Sickness absence in NHS Scotland can result in cancelled appointments and procedures and lead to increased expenditure on supplementary staff, such as medical locum and agency nurses. The Scottish Government set a national standard which required NHS Boards to achieve a sickness absence rate of 4.0% or less from 31 March 2009.
Sickness absence includes: normal sick leave; unpaid sick leave; industrial injury; accident involving a third party; and injury resulting from a crime of violence.
From 1 September 2022, COVID-related absences are recorded as sickness absence (with COVID-related illness reason). Before this, COVID-related absences were treated as special leave and excluded from these figures. It is not possible to exclude COVID-related absences with the current data source. More information is available in the technical document.
The sickness absence rate in NHS Scotland for the year ending 31 March 2025 was 6.4%, an increase of 0.2 percentage points from the year ending 29 February 2024 (used due to issues that arose from the change to contracted hours last year), and the highest rate during the past ten years (Figure 9). This is equivalent to 10,325.4 WTE over the year.
Footnote: Data is for year ending 31 March 2015-2025, with the exception of 29 February 2024.
Figure 10 shows the variation in sickness absence rates between NHS Boards. In the year ending 31 March 2025, sickness absence rate decreased in four boards and increased in 18 boards.
The largest decrease was in NHS Highland, which decreased by 0.5 percentage points to 6.1%. The Scottish Ambulance Service increased by 0.8 percentage points to 9.7% and remains the highest NHS Board sickness absence rate.
More detail on sickness absence data can be found in the NHS Scotland workforce dashboard on the Turas Data Intelligence website.
3.3 Vacancies
Vacancy rates help us to understand labour demand and supply in NHS Scotland. The ONS say high vacancy rates could indicate that current staff have a larger workload to cope with staff shortages.
A vacancy is defined as a post which has been cleared for advert after having been through the redeployment process (internal or external advert) and remains a vacancy until an individual starts in the post. Reported vacancies therefore include posts that are vacant due to staff leaving and the creation of new posts available due to the expansion of services.
This definition is similar to the definition used in the ONS Vacancy Survey, “How many job vacancies a business has, for which they are actively seeking recruits from outside the organisation.”
The vacancy rate is calculated by dividing the number of vacancies by the sum of the staff in post and vacancies (the establishment).
NHS Boards provide information on the number of vacancies for medical and dental consultants, nursing and midwifery and allied health professionals. These data are collected by survey.
We continue to work with suppliers to improve the way we collect vacancy data, with the aim to collect this directly from Job Train, the NHS Scotland recruitment system. Currently NHS Boards extract data from Job Train, apply local knowledge of their data to complete NES vacancy surveys according to the definition and then submit these.
Whilst investigating the use of Job Train we became aware of some minor differences in the way NHS Boards interpret the data. The largest variation between NHS Boards is in determining the start and end date of a vacancy. For this reason we do not recommend comparing vacancy data by length between NHS Boards.
We continue to review Job Train as a source of vacancy data with data suppliers and will provide an update to all stakeholders on our progress.
The number and rate of medical and dental consultant vacancies has decreased from 31 March 2024 to 31 March 2025. The number of vacancies at 31 March 2025 decreased by 13.5% to 387.2 WTE, and the vacancy rate decreased from 6.9% to 6% (Figure 11).
For both nursing and midwifery and allied health professions, the vacancy rate has decreased this year, returning to pre-pandemic levels after peaking during 2022 and 2023. During the past year the number of vacancies for allied health professions has decreased by 21.3% to 522.8 WTE and the vacancy rate decreased from 4.5% to 3.6% (Figure 11). The number of nursing and midwifery vacancies has dropped by 23.1% to 2,601.2 WTE, and the current vacancy rate has dropped to 3.7% (Figure 11). Both allied health professions and nursing and midwifery vacancies have increased by approximately a fifth over the last quarter.
The trend in the number of vacant posts for nursing and midwifery and allied health professions in NHS Scotland is similar to that of vacancies across the UK, and in particular for the human health and social care sector, reported by the UK Labour Market Vacancy Survey: vacancies fell during the early part of the pandemic in March to June 2020, and then rose to record levels before falling again.
Footnote:
Data for the shaded dates are incomplete and we therefore have not calculated a Scotland value. For March, June, and December 2020 the provision of data were disrupted due to the COVID-19 pandemic.
Nursing and midwifery staff vacancy figures are shown from the community review (March 2015) onwards.
Variation in vacancies over time are available in the NHS Scotland workforce dashboard on the Turas Data Intelligence website.
4 Bank and agency
NHS Boards use supplementary staff to temporarily fill vacant posts, cover sickness absence or various forms of leave, and provide additional temporary capacity. Bank staff are NHS employees while Agency staff are employed by private companies (Agency Workers Regulations 2010).
The Health and Care (Staffing) (Scotland) Act 2019 came into force on 1 April 2024. This Act contains several provisions about the use and reporting on bank and agency staff. During the past year, the Scottish Government have requested Health Boards reduce the use and spend of agency staff.
4.1 Revision - Medical and dental agency
The annual expenditure on medical and dental agency staff contained in this report includes those who are hired through private agencies and not locums who are directly employed by NHS Boards.
Medical and dental agency expenditure has decreased by 16.7% in the past year to £108 million (Figure 12).
Medical and dental agency expenditure decreased in 10 territorial NHS Boards in the year ending 31 March 2025 (Figure 13). The largest relative decrease was by NHS Borders with a decrease of 48.8% to £ 1.4 million.
NHS Boards that had annual increase in medical and dental agency expenditure (Figure 13) are NHS Ayrshire & Arran ( 2.9% to £ 6.1 million), NHS Western Isles ( 1.9% to £ 2.3 million) and NHS Forth Valley ( 0.4% to £ 4.8 million). Medical and dental agency expenditure in NHS Shetland remained stable at £ 1.8 million.
NHS Grampian continues to have the highest medical and dental agency expenditure (£ 18.5 million).
Footnote:
- Six boards had no medical and dental agency expenditure in the year ending 31 March 2025 or in the previous year and are not included in Figure 13: NHS National Services Scotland, Scottish Ambulance Service, NHS 24, NHS Education for Scotland, Healthcare Improvement Scotland and The State Hospital.
4.2 Nursing and midwifery bank and agency
Nursing and midwifery bank costs are calculated from NHS Scotland payroll data and are reported by board of employment. During the past year, bank data for years ending 2021-2024 were revised for NHS Lothian and NHS Borders due to their shared bank system. More information can be found in the Data quality - bank & agency notes tab in the NHS Scotland workforce dashboard on the Turas Data Intelligence website. Nursing and midwifery agency costs are collected via a nursing agency spend survey and the expenditure is reported by board.
Total nursing and midwifery bank and agency expenditure fell for the first time, to £ 410 million driven by falling agency expenditure.
Expenditure on agency staff decreased for the second year in a row by 62.5% to £56.7 million.
Expenditure on bank staff increased by 4.3% (Figure 14) to £353.4 million, however the hours worked decreased by 3.7%.
Expenditure on bank staff is driven by two factors, hours worked and the hourly rate of pay. In 2024/25, the Scottish Government agreed a 5.5% pay increase for NHS staff, including bank staff, however as the hours worked has decreased by less than this, total expenditure has risen.
Footnote: For the dates marked with an asterisk (*) data provided are incomplete and we therefore have not calculated a Scotland value.
Expenditure on nursing and midwifery bank and agency staff varies between NHS Boards (Figure 15).
For the year ending 31 March 2025, NHS Greater Glasgow & Clyde spent the most of any board on nursing and midwifery bank and agency staff. Bank staff costs increased 3.4% to £123.7 million, which is about a third of the total cost for NHS Scotland; while agency staff costs decreased 68.5% to £ 9.0 million.
Bank nursing and midwifery staff costs increased in 12 boards and decreased in seven others. The largest relative increase on bank staff was by NHS Shetland with a 47.5% increase (almost doubling) to £ 0.5 million. The largest decrease in on bank expenditure by a territorial board was by NHS Tayside, with a 10.6% decrease to £ 18.7 million.
Nursing and midwifery agency expenditure decreased in all NHS Boards except NHS Dumfries & Galloway in the year ending 31 March 2025. The largest decrease was by NHS Lothian, where agency expenditure decreased by 85.2% to £ 2.6 million. Agency expenditure by NHS Dumfries & Galloway increased by 33.5% to £ 0.7 million.
Feedback from data providers confirm the decrease in nursing and midwifery agency expenditure is a result of actions taken to reduce supplementary staffing, and no changes in data reporting and processes have occurred.
Footnote: Seven boards had no nursing and midwifery bank or agency expenditure in the year ending 31 March 2025 or in the previous year and are not included in Figure 15: NHS Education for Scotland, Healthcare Improvement Scotland, NHS 24, NHS National Services Scotland, Scottish Ambulance Service, The State Hospital and Public Health Scotland.
Users can explore the bank and agency data in the NHS Scotland workforce dashboard on the Turas Data Intelligence website.
5 Primary Care Workforce
The Primary Care workforce is primarily made up of a large number of independent contractors delivering services across Scotland.
There are some groups of staff, including GP Registrars and Vocational Dental Practitioners, who are directly employed by NHS Scotland and are also included in the NHS Scotland workforce.
We report on two staff groups from the Primary Care Workforce, General Practitioners (GPs) and General Dental Practitioners (GDPs).
5.1 General Medical Practitioners
General Medical Practitioners (GMPs), commonly known as GPs, are independent contractors who provide primary care services to patients. They are not employed by NHS Boards but are contracted to provide services under the General Medical Services (GMS) contract. The exception to this is when the practice is being directly managed and run by the local NHS Health Board.
The following sections include any GP (qualified or in training) working in primary care at the time of the census. Whole time equivalent (WTE) are collected by the General Practice Workforce survey.
5.1.1 GP numbers
On 31 March 2025 there were 5,260 GPs (including GP trainees). This was 129 more GPs than in 31 March 2024, a 2.5% increase.
GPs can be grouped into several designations:
- Performer: a GP who has entered into a contract to provide services to patients and is effectively self-employed; usually a practice partner.
- Performer salaried: A GP who is employed by the practice or NHS Board on a salaried basis.
- Performer retainee: A GP who is part of the GP Retainer Scheme in Scotland, a time limited scheme to allow qualified GPs on the Performer’s list who have caring responsibilities (usually for young children) which prevents them from committing to a more substantive post in GP.
- Performer Registrar/Specialist Trainee: A medical practitioner in a GP training program. Doctors in the first two years of their training (e.g. those in foundation programmes) are not included in the numbers provided here.
Figure 17 shows that whilst most GPs are Performers, the number of Performers has been decreasing since 2012, while number of Salaried GPs and Registrars have been increasing. Registrars are employed by NHS Education for Scotland to provide consistency of policies and management independent of where trainees are working. GP specialty training is one of the specialties receiving an uplift in the number of training places. Trainee GPs in Scotland are the main source of inflow to the Performer workforce.
5.1.2 GP Turnover
In the past year there has been an increase in the number of GPs entering the workforce, with 418 in the year ending 31 March 2025, up from 322 in the year ending 31 March 2024. There was a decrease in the number of leavers, 258 in the year ending 31 March 2025, down from 356.
More detailed information on sources of this inflow can be found in our dashboard, which shows that the increase in the number of GPs entering the workforce comes from an increase in the number of Registrars entering the Performer - Salaried workforce.
5.2 General Dental Practitioners
In Scotland dentists provide four groups: the General Dental Service (GDS), Public Dental Service (PDS), Vocational Dental Practitioners (VDPs) and hospital dentists:
- Dentists working in the GDS are independent contractors and are usually the first point of contact for NHS dental treatment. People registered with a dentist can receive the full range of NHS treatment available under GDS.
- Dentists working in the PDS provide dental care for people could not get care through the GDS (for example, for patients who are residents of long-stay care) and are directly employed by NHS Boards.
- VDPs are new or recent dental graduates undertaking a one-year programme, Dental Vocational Training. This allows them to work as an Associate or Principal in the GDS. They are employed by NHS Education for Scotland.
- Hospital dentists provide care who have either been referred for further treatment or These dentists are directly and their data are held in Scottish Workforce Information Standard System (SWISS).
VDPs, dentists working in the PDS, and in hospitals are included in the directly employed staff reported above.
In this section we report on dentists who work in the GDS or the PDS and VDPs.
The number of dentists in this report are reported as headcounts. Whole time equivalent (WTE) were collected by the Dental Workforce survey for the first time last year.
5.2.1 Dental Headcount
After a decrease in the number of dentists in the GDS/PDS services between September 2020 and September 2022, the headcount of dentists has risen slightly to 3,249
5.2.2 Dentist turnover
In the year ending 31 March 2025, excluding Vocational Dental Practitioners, the inflow (334 dentists) into the GDS and PDS workforces, was 137 greater than the outflow 197.
More detailed information on where the sources of this inflow can be found in our dashboard.
6 Appendix 1: About our data
NES publishes a wide range of data and information on Turas Data Intelligence (TDI), Scotland’s official source of information on the NHS workforce.
A Report catalogue is available to help you navigate content on TDI.
A Techincal document is available with an overview of the Data Sources, our data quality assurance processes, and our statistical methods.
A full list of these data and a timetable of future releases are available on our webpages.
Official workforce publications prior to 3 December 2019 can be accessed via the ISD Workforce publication page.
6.1 Glossary of terms and definitions
We publish an glossary of important terms to help our users understand and interpret our statistics. Many of these definitions include signposts to more detailed information or related topics elsewhere on TDI.
7 Appendix 2: Official Statistics information
As a provider, we adhere to the Code of Practice for Statistics and are regulated by the Office for Statistics Regulation. You can find more information on the Code of Practice, our protocols for Early and Pre-release Access to our publications, reports on events impacting our publications, our publication timetable, and information on how and when we receive data from our data suppliers on our website.
7.1 Early release for quality assurance and management information
Publication outputs are released to key stakeholders in NHS Boards HR and Workforce directorates ahead of their release to the public. This early release occurs two weeks before the public release of the data and is to support quality assurance. Outputs are made available to a restricted list of people via Turas Data Intelligence (TDI). This list is verified a week before Early Release goes live.
NES works with data providers at NHS Boards prior to this point to understand any data quality issues or significant changes in figures. Therefore, it is unlikely that any unknown issues would arise during the Early Release period. Since NES have been responsible for the Official Statistics publications (December 2019), there have been no issues reported via Early Release. If a data quality issue were to be made known to NES, we would work with the NHS Board to annotate this within the publication output if it were not possible to update the figures.
We also make data available to named contacts in Scottish Government for management information purposes only and under strict embargo ahead of the publication’s release.
7.2 Pre-release access to Official Statistics
Under terms of the “Pre-Release Access to Official Statistics (Scotland) Order 2008”, NES is obliged to publish information on those receiving Pre-Release Access (“Pre-Release Access” refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days.
A list of organisations and roles of individuals who receive Pre-Release Access is available on Turas Data Intelligence.