THE Scottish Government was under pressure last night after a report said it had not planned effectively to meet the “urgent workforce challenges” facing the NHS, and a nursing leader warned it had “failed to future proof NHS Scotland’s workforce”.

Critics rounded on Holyrood after Auditor-General Caroline Gardner said that while spending on staff in the NHS was increasing and staff numbers were at their highest ever level — the NHS employed the equivalent of 139,431 full-time workers at the end of March — there are still “major issues to be addressed”.

Her remarks came in the first of a two-part audit of NHS Scotland which warned there may not be enough staff to meet future demand.

It said: “Processes for determining training numbers risk not training enough doctors, nurses and midwives with the right skills for the future. Medical recruitment numbers are based on replacing current numbers rather than looking at the impact of changing demand.”

Between 2011-12 and 2016-17, the cost of bringing in agency staff had increased by 107 per cent, from £82.8 million to £171.4m.

“There are urgent workforce challenges facing the NHS caused by factors including an ageing population, an ageing workforce and recruitment difficulties,” said Audit Scotland. One in three staff are aged 50 or above, it said, adding: “Upcoming retirements may increase vacancy levels in parts of the NHS where the age profile of the staff is older.”

“The Scottish Government has not fully considered the risk that retirement from the NHS in coming years may lead to increased vacancies.”

The report added that patient feedback about the NHS and staff was positive, but “complaints are rising and staff continue to raise concerns about their workloads”.

Gardner said: “Thousands of people work hard in Scotland’s NHS to deliver vital public services every day, but there are signs that the health service is under stress and that staff face increasing workload pressures. The Scottish Government and NHS boards recognise the challenges, but urgently need to improve their understanding of future demand, staff projections and associated costs, and set out in detail how they plan to create a workforce that can meet the long-term health needs of the population.”

Theresa Fyffe, director of the Royal College of Nursing Scotland (RCN), said: “The RCN has warned for some time that the Scottish Government has failed to future-proof NHS Scotland’s workforce.

“Audit Scotland has hit the nail on the head - for too long plans have been restricted by what is affordable and achievable with the staff available - rather than focusing on strategic, long-term planning to meet demand.”

Dr Peter Bennie, chair of the British Medical Association (BMA) Scotland, said: “Rising vacancy levels, a lack of effective workforce planning and an ageing staff profile is putting a significant burden on the existing workforce already dealing with the stress of a rising workload which is not being adequately resourced.”

Health Secretary Shona Robison said the report acknowledged that NHS Scotland staffing levels were at a record high, and added: “We’re committed to not only having the right number of staff, but also to ensure that we have the mix of skills in the right places.

“Ensuring effective workforce planning not only has to account for changes in the nature of the demands being placed on our health and care services, but also for the challenges that are presented by external factors like the impact of Brexit on Scotland’s ability to attract and retain workers from across Europe. NHS boards are already working with partners to develop regional delivery plans setting out how they will deliver services over the next 15 to 20 years.”