Third of consultant posts are lying vacant in some UK areas and costing NHS millions, investigation finds

One in three NHS consultant posts in some parts of the UK are lying vacant, with vacancies taking a year to fill, an investigation by BMJ Careers finds.

Consequently, the NHS spent more than £670m on locums in 2024-25 to fill these consultant gaps, the report found.1 The investigation also discovered that despite government efforts to reduce spending, some NHS organisations were allocating large sums for locum cover to fill ongoing consultant vacancies.

Data obtained under the Freedom of Information (FOI) Act show that across 154 NHS trusts and health boards in England, Scotland, and Wales that provided details of locum costs, a total of £674.2m was spent on covering consultants in 2024-25.

The highest spender was Betsi Cadwaladr University Health Board in north Wales (£20.3m in 2024-25), which had a consultant vacancy rate of 17%. This was followed by NHS Highland in Scotland (£19.1m), with a …