Policy statement

10/11/25

10 November 2025

National survey of consultant physicians shows doctors are under growing pressure across the NHS

Doctors working together

Consultant physicians are seeing widespread rota gaps and vacancies

A majority of consultants (59%) report vacancies at their own grade, and two-thirds (66%) experience gaps in acute duty resident doctor rotas, whether daily (12%), weekly (32%), monthly (15%) or less frequently (7%). Only 2% said they never see rota gaps. Based on 1415 respondents*.

Most consultants say rota gaps are harming patient care

83% of respondents believe consultant-level gaps are negatively affecting patient care. The most common consequences are reduced access to out-of-hours inpatient care (39%) and longer hospital stays (28%). Based on 926 respondents*.

Almost half of consultants’ enjoyment of work has declined

When asked about their job enjoyment over the past year, just 15% reported an increase (13% increased; 2% greatly increased). In contrast, 45% said it had fallen (33% decreased; 12% greatly decreased), while 40% saw no change. Based on 1362 respondents*.

Better IT and lighter workloads would boost wellbeing

Consultants identified their top three priorities for improving workplace wellbeing as well-functioning IT equipment (43%), reduced clinical workload (32%) and fewer administrative tasks (32%). Staff vacancies (31%) and more administrative support (27%) also featured prominently. Based on 1398 respondents*.

Enjoyment trends vary by specialty and region

Increased enjoyment was most marked in endocrinology and diabetes medicine (17%) and respiratory medicine (15%) but fell most steeply in acute medicine (56%) and rheumatology (46%). London North West (27%) and the West Midlands (20%) saw the biggest rises, whereas the East of England (53%) and Kent, Surrey and Sussex (52%) experienced the largest drops. Based on 1362 respondents*.

Nearly a third of consultants have brought forward their retirement

30% of respondents say they have accelerated their retirement plans. Among all respondents, 6% intend to retire and return in some capacity, 4% to retire fully, 9% to work less than full time, 3% to take a career break or sabbatical, and 3% to work abroad over the next year. Based on 1356 respondents*.

Those returning after retirement plan diverse roles

Of the 136 consultants* planning to retire and then come back, 51% expect to do outpatient work, 27% teaching, 26% educational supervision and 24% quality improvement projects. Clinical roles include specialty inpatient care (25%), specialty on-call (13%) and internal medicine (10%); only 7% plan to rejoin the unselected medical take.

Consultants remain confident in delivering inpatient care

59% felt confident or very confident managing general medical inpatients, with another 20% moderately confident. 20% cover the acute unselected take, 51% work on the wards after that take and 29% do both. Based on 1070 respondents*. 

Specialty work dominates inpatient time for most consultants

When asked how they divide their inpatient hours between specialty care and general medicine, over half (53%) spend 81–100% of their time on specialty work while 11% devote 81-100% to general medicine. A small minority (12%) devote 0-20% to specialty care, while 56% spend 0–20% on general medicine. Based on 1037 respondents*.

Same day emergency care and virtual wards are growing areas

26% of consultants practise in SDEC settings, and half of them run hot clinics exclusively for specialty patients. Another 22% run hot clinics outside SDEC. Virtual wards or Hospital at Home models are used by 10% of consultants: among those, 22% work in that setting daily, 40% weekly and the rest more sporadically. Caseloads range from under five patients (20%) to more than 20 (27%). Based on 1411 respondents*.

Delayed discharges affect most hospitals

68% of consultants reported problems with delayed discharges in the month before they responded to the survey, underscoring systemic pressures beyond the ward. Based on 1403 respondents*.

Survey dataset

Of 2,211 people who accessed the survey, 173 respondents who were not UK consultant physicians were excluded, leaving 2,038 valid respondents.

Of the 2038 consultant responses:

  • 91% are employed by the NHS/HSC, 5% by universities, 2% private providers, remainder by hospice, charity or public sector
  • Most work in hospitals (90%), with the rest in community (3%), university (2%), hospice (2%) or clinic (2%) settings remaining (1%) stating other
  • Geographically, 82% practise in England, 11% in Scotland, 5% in Wales and 2% in Northern Ireland.

If you would like more detail about the numbers of responses to each question in the survey, please contact MedicalWorkforce.DataInsights@rcp.ac.uk