Scottish physio staffing crisis

We know that many physiotherapy staff all over the UK feel stretched too thin – with not enough staff in their service to provide the care they know patients need. In Scotland, this situation is particularly severe. 

Nearly 600 Scottish CSP members working in acute, community and primary care teams across Scotland took the time to share their concerns through a survey. As a result, 98 per cent of members told us that current staffing levels are insufficient to meet the needs of patients. 

Crisis point

The survey highlights the dire situation many physiotherapy teams are facing. Some areas are reportedly operating with fewer than a quarter of the staff needed to provide safe and effective care. One member shared: ‘For my team, the professional judgement tool states we should have 15 registered staff. Most days I have just three or four.’

Many members also reported that, due to the lack of experienced staff, new graduates are being thrust into complex rehabilitation roles, struggling to cope with high caseloads and severe staff shortages. ‘We have lost many skilled and excellent therapists due to poor job satisfaction and stress,’ one respondent noted.

Patient care at risk 

Respondents highlighted how longer waiting times are worsening patient outcomes, with some teams having to delay treatment by more than two years for routine rehabilitation, leaving patients at greater risk of falls, emergency hospital admissions, and further complications. 

Members reported a noticeable increase in disability, pain, and mental health issues among patients, with 60 per cent of respondents observing more pain and disability, and 56 per cent noting increased anxiety and depression in those waiting for care.

Over three-quarters (77 per cent) reported that patients are waiting longer than clinical guidelines recommend for treatment. This prolonged understaffing has led to what many describe as ‘crisis interventions’ rather than the comprehensive rehabilitation care patients need. 

Staff are also reporting safety concerns related to their patients. Reduced on-call staff numbers have caused gaps in services like respiratory care, putting patients at risk. Members described grappling with difficult decisions on whether to rush through sessions and risk leaving patients uninformed or to take more time, which results in longer waiting times for others.

As one member put it: ‘We basically discharge to sink or swim. Unfortunately, this results in a high amount of the patients who could have had a successful outcome needing to be readmitted due to a fall or difficulty coping at home.’

The staffing crisis has put enormous strain on NHS services, with a growing backlog of patients and inadequate rehabilitation facilities. Nearly all respondents (83 per cent) report they are dealing with daily crises rather than having the time to improve or innovate services. Over half reported that cuts to funding, recruitment freezes, and the elimination of posts have exacerbated issues. 

Nearly half of the respondents (49 per cent) also said they have considered leaving their roles due to the overwhelming stress, and many report experiencing mental and physical health issues themselves as a direct result of their working conditions. Even a graduate just nine months into their role said they weren’t sure ‘how much longer’ they could go on under ‘such stressful working conditions.’ 

A call for urgent action 

The CSP’s call for action is clear: the Scottish Government must urgently address this crisis, increase training places and initiate a planned expansion of the NHS physiotherapy workforce in Scotland.  

Sara Conroy, CSP’s professional adviser for Scotland, said: ‘This crisis has been building for years, and despite our repeated warnings, the lack of concerted action from the government has allowed the situation to worsen. Over the past decade, the number of undergraduate physiotherapy training places in Scotland has remained stagnant, while demand for places is growing. 

In contrast, England has doubled the number of training places during the same period.

‘The context in which physiotherapy staff are trying to provide healthcare is declining and often desperate. It’s taking a huge emotional toll on our members. We will continue to lobby the government on this issue and seek meetings with them to secure the decisive action we need from them to prevent the situation from deteriorating even further.’