Tackling Scottish NHS waiting lists: the role of anaesthesia

Scotland faces a critical shortage of anaesthetists – 16% below what is needed to meet patient demand – preventing an estimated 128,000 operations and procedures from taking place each year.  

It is vital this is addressed as over 630,000 people are waiting for either tests or treatment in Scotland– one in nine of the population, and most operations cannot take place without an anaesthetist.

Ahead of the May 2026 Scottish Parliament election, we have published our manifesto, Tackling Scottish NHS waiting lists: the role of anaesthesia.  In this, we urge political parties to tackle extensive NHS waiting lists through a range of measures, most importantly by funding more anaesthetic training places.

We are calling on political parties to: 

Fund more anaesthetic training posts

There is no shortage of doctors who are eager to become anaesthetists, however, at present the Scottish Government does not fund enough training places for doctors to progress in anaesthesia.

In 2025, 689 doctors applied for just 67 core anaesthetic training posts in Scotland – a ratio of over 10 applicants per place. To start fixing this, the next Scottish Government must: 

• Fund 24 additional anaesthetic training posts from 2026 onwards.
• Publish a comprehensive national medical workforce strategy, which includes anaesthetic workforce needs. 

Reform funding rules for Anaesthetists in Training (AiTs)

In Scotland, rigid funding rules for AiTs are restricting anaesthetic capacity. Currently, if an AiT decides to work part-time instead of full-time, the unused portion of their salary cannot be re-used by the hospital – for example, to take on another AiT. This differs from other nations such as England, where hospitals can reallocate funding when an AiT goes part-time, enabling them to bring in more support.

We’re calling on political parties to: 

• Reform funding rules for AiTs to allow departments to reinvest unused funds – such as when AiTs reduce their hours - into creating additional training posts.

Support the current workforce 

Across Scotland, anaesthetists are facing challenges around work-life balance, flexibility and pay, contributing to many leaving the profession early. We’re calling on political parties to: 

• Engage constructively with doctors on pay issues.
• Enable more flexible working patterns.
• Facilitate efforts for senior anaesthetists to step back from overtime and weekend work where possible.
• Improve rest and refreshment facilities. 

Unlock NHS productivity in Scotland

Anaesthetists can help unlock NHS productivity by leading numerous interventions before and after surgery, such as early screening services to assess patients’ health as soon as they join the waiting list and managing support services to help them prepare for surgery.  

These interventions are not currently widespread due to a range of barriers such as limited funding for start-up costs, poor IT systems, and a lack of incentivisation to set them up.

We’re calling on the next Scottish Government to:

• Mandate, encourage and facilitate the adoption of surgical pathway efficiencies
• Establish an ‘NHS Efficiencies Transformation Fund’ to overcome financial barriers.
• Update digital systems across NHS Scotland to be more integrated.
• Incorporate efficiency inputs and outcomes, into the inspection framework of Healthcare Improvement Scotland.

Dr Claire Shannon, President of the Royal College of Anaesthetists, said: 

“Scotland’s NHS cannot function without anaesthetists, yet we are 16% below the number needed – leaving 128,000 operations on hold each year.

“We’re calling on the next Scottish Government to tackle extensive waiting lists and reform the current system to fund more anaesthetic training places.”

Dr Daphne Varveris, Chair of the RCoA Board for Scotland, said: 

“We are delighted to launch our Scottish RCOA manifesto ahead of the Scottish elections in May. 

“We aim to highlight to all political parties the vital importance of the anaesthetic workforce and the significant role we play in reducing waiting lists. 

“By identifying practical solutions to address anaesthetic workforce shortages and to tackle inefficiencies within the surgical pathway, we hope to show how the next Scottish Government can deliver real and lasting improvements for patients.”