The College is continuing to monitor workforce issues in Scotland. This update highlights key developments, and the College approach to supporting the pathology and laboratory workforce in Scotland.  

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Scotland’s long-term workforce plan: phase 1 report 

The Scottish Government published The Future Medical Workforce Project: Phase 1 Report in December 2025, the first step in developing a long‑term workforce plan for Scotland’s health service. The report sets out the challenges facing the medical workforce over the next 15–20 years, drawing on input from more than 2,000 doctors across Scotland. It identifies sustained workload pressures, training bottlenecks, outdated infrastructure, and workforce fatigue - all of which threaten service sustainability.  

These findings echo the College’s submission to the Scottish Government in September 2025. Pathology and laboratory medicine faces critical workforce shortages, rising demand, and limited capacity for timely reporting. With moves towards prevention and increased focus on community-based care, demand will only increase. Addressing long‑standing capacity gaps, expanding training pathways for both medical and scientific staff, strengthening digital infrastructure, and ensuring sustainable workloads that support staff wellbeing and retention continue to be College advocacy priorities as the Scottish Government moves into phase 2 of its workforce planning programme. At this stage, a lack of clear action plan for workforce planning remains a concern.  

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NHS Merger 

Public Services Delivery Scotland (PSD Scotland) will replace NHS Education for Scotland (NES) and NHS National Services Scotland (NSS) from 1 April 2026. The College responded to this proposed merger in December, highlighting priorities for pathology and laboratory service planning – including robust workforce planning, training and modelling, and will continue to monitor developments and impact. 

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Specialty reports 

In 2025, the College published specialty reports on immunology and paediatric and perinatal pathology (PPP), both highlighting how high consultant vacancy rates in Scotland continue to limit service quality. These reports were submitted to the office of Professor Sir Gregor Smith, Chief Medical Officer for Scotland. 

Members in both specialties are working hard to improve service resilience. Immunology has recently seen positive progress in strengthening the trainee pipeline, with 1 trainee recently completing training and taking up a consultant post – bringing the consultant workforce to 3. For PPP, training efforts have helped build resilience, but significant staffing and service delivery challenges remain, with many services still dependent on just 1 or 2 consultants. 

The College will continue to work with service planners and commissioners to support sustainable diagnostic services. Further specialty reports are in development for forensic pathology, neuropathology, toxicology, chemical pathology, microbiology, virology and infectious disease, and cellular pathology. 

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Agenda for change – reduced working hours  

The NHS Scotland Agenda for Change staff working week reduction to 36 hours is confirmed for full implementation from 1 April 2026. Boards are responsible for redesigning services and staffing models to maintain safe care. Supporting work-life balance is important. However, for pathology services –already affected by workforce shortages, rising demand and time‑critical workflows – this change will require significant workload modelling and mitigation to avoid further pressure on laboratory teams. Members of the College Scotland Regional Council have raised concerns that backfill funding may not reach laboratories, increasing the risk of slower turnaround times and reduced capacity at a time of high workload and complex case referrals.  

The College continues to emphasise that robust, specialty‑specific workforce planning is essential to implementing service changes safely. In addition to accounting for the reduction in the working week, workforce planning should more broadly ensure that human factors are considered across all employment models. This includes ensuring vacancies are filled promptly and allowing for realistic provisions for leave. The College will continue to advocate for accurate workforce modelling and appropriate resource allocation to protect safe, sustainable diagnostic services. 

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Election priorities 

Ahead of the May Scotland election, the College has set out its key priorities for pathology services that the next Government will need to address. This identifies workforce shortages as a major issue putting the future viability of Scotland’s pathology services at risk and calls on the Scottish Government and Parliament to take action to ensure pathology services remain effective and sustainable.  

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