The NHS is reaching a crisis point in consultant recruitment as 1 in 3 consultant posts lie vacant in some parts of the UK and recruiting managers regularly wait over 12 months to secure a candidate, leading to increased locum costs, finds a new report published by BMJ Careers today.
Data obtained under the Freedom of Information Act reveal that these shortages are costing the health service upwards of £674m on locum consultants and are negatively affecting staff morale and patient care. Relying on expensive agency staff also risks derailing work to cut waiting lists.
One resident doctor at a north London trust said: "It's a complete nightmare – the doctors who are left working have to work at 150%, patients have to wait longer to be seen, and by the end of the shift doctors are running on fumes."
Phil Johnson, Director of BMJ Careers, says: "The word 'crisis' can be overused, but at a time when activity is increasing, the new Labour government is pledging to "eliminate" agency spending and slash international recruitment at the same time, it is time to acknowledge a tipping point has been reached."
Analysis by BMJ Careers found that nearly 33,000 consultant jobs were listed on the NHS Jobs website between 2022 and 2025 in England and Wales - enough to staff more than 66 large hospitals. Over a third of those vacancies were in Greater London and the South East and a quarter were for psychiatry positions. Other in-demand specialties were surgery, paediatrics and radiology.
BMA consultants committee co-chairs Dr Shanu Datta and Dr Helen Neary said these data counter the government's narrative that the NHS has more doctors than ever. "Simply put - we do not have enough consultants to meet the needs of patients or run services to the standard they should be."
Today's report also sheds new light on how consultants feel about job-seeking. A BMJ Careers survey of 107 consultants, carried out earlier this year to inform the report, found very few (4%) are actively looking for work, but a substantial minority (47%) were open to changing jobs, despite not 'actively looking.'
Of those who are open to looking for work or actively looking, a substantial minority said they feel increasingly disillusioned with NHS working conditions and were interested in relocating outside the UK.
BMJ Careers also surveyed 116 recruiting managers about the challenges they face when recruiting consultants. Half said their need to recruit consultants will increase in the coming year but only 5% expect their budget to increase, while 61% said consultant vacancies were having a significant negative impact on waiting times and 54% on quality of care.
Meanwhile, over a quarter (27%) said they regularly or always have to source candidates from overseas to fill difficult consultant vacancies, and many spoke of measures put in place by their employer to control staffing costs.
The long term solution to the recruitment crisis is to restructure specialist training to create more homegrown consultants in shortage areas and remove bottlenecks, says the report. In the meantime, it outlines how recruiters can attract consultants, such as offering enhanced job plans and more flexible working to help them grow their career.
"To keep consultants working in the NHS, they must be valued, both financially and professionally," add Dr Datta and Dr Neary. "Pay is part of this but providing more time to innovate and improve services for patients is also key."
A spokesperson for NHS England told BMJ Careers: "While agency spend is at a record low with trusts on track to save £1 billion over two years, we want to go further still." They added: " .. we are working with the government on a 10 Year Health Workforce Plan which will detail the numbers of staff we need now and in the future."
A Scottish Government spokesperson said: "Since 2006, the number of consultants has increased by 71% and now stands at over 6,200 Whole Time Equivalents." They added: "We work directly with health boards to reduce the use of medical agency staff, encouraging alternative staffing options, as well as ensuring any locum use represents best value."
A spokesperson for the Welsh Government commented: "The NHS in Wales now has more doctors than at any point in its history." They added: "Spend on agency and locum medical and dental staff fell by approximately £16 million between 2023-24 and 2024-25, and we anticipate further reduction this year."
