The NHS faces a consultant recruitment and retention crisis, with vacancy rates at 8.2% nationwide in July 2025, and some trusts reporting vacancies above 30%. This shortage is driving significant operational and safety concerns.

Filling consultant posts takes a long time: among 116 recruiters, 29% reported vacancies lasting over a year, 26% for 7–12 months, 41% for 3–6 months, and only 3% within 3 months, with 80% of applicants deemed unsuitable by some recruiters.

Workload pressures and rota gaps are affecting patient care and safety, with recruiters noting a very significant impact on patient safety, corroborated by Royal College of Physicians data on high workloads and loss of control among consultants.

Demand is strongest in psychiatry (25%), followed by surgery (11%), paediatrics (7%), and radiology (5%), highlighting specialty-specific pressures.

The consultant workforce is aging, with 41% nearing retirement and about half of those over 50 still working; about a third of the over-50 group plans early retirement, worsening the shortage.

From 2022 to 2025, nearly 33,000 consultant roles were advertised in England and Wales, indicating capacity to staff large hospitals but not translating into quickly filled positions, with most vacancies concentrated in Greater London and the South East.

Financial and operational costs are mounting, with NHS spending at least £674 million on locum consultant fees for 2024–2025, while shortages threaten patient safety and timely care due to rota gaps.

Possible remedies include clearly valued job plans, more compelling recruitment adverts to reach passive candidates, strong employer reputation, flexible working arrangements (such as childcare support and remote options), and leveraging personal networks, while many solutions focus on building home-grown consultants through reforming training and removing bottlenecks.

Contributing factors include a shrinking pool of active job seekers, a large share of applicants lacking specialist registration or GMC credentials, and fierce competition from locum agencies.