CSP members in Scotland warn of staffing crisis impacting patient care

Almost 600 physiotherapists working in acute, community and primary care teams across Scotland filled out the latest CSP survey. It revealed alarming levels of staffing shortages in physiotherapy services, with an overwhelming majority of members (98 per cent) reporting concern that current staffing levels are insufficient to meet the needs of patients.

Workforce crisis

The survey highlights the dire situation many physiotherapy teams are facing. Some areas are reportedly operating with fewer than a quarter of the staff needed to provide safe and effective care.

One physiotherapist shared: 'For my team, the professional judgement tool states we should have 15 registered staff. Most days I have just three or four.' Others spoke of the increasing pressure they are under as they manage growing lists of patients with fewer resources, leading to patients being confined to bed longer than necessary and suffering a loss of independence.

Many physiotherapists also reported that, due to the lack of experienced staff, new graduates are being thrust into complex rehabilitation roles, struggling to cope with high caseloads and severe staff shortages. One respondent noted:

We have lost many skilled and excellent therapists due to poor job satisfaction and stress

Patient care at risk

Physiotherapists across the country are seeing firsthand the devastating effects of these shortages on patient care. Respondents highlighted how longer waiting times are worsening patient outcomes, with some teams having to delay treatment by more than two years for routine rehabilitation, leaving patients at greater risk of falls, emergency hospital admissions, and further complications.

The survey also revealed that staffing shortages are contributing to worsening health outcomes for patients. Physiotherapists reported a noticeable increase in disability, pain, and mental health issues among patients, with 60 per cent of respondents observing more pain and disability, and 56 per cent noting increased anxiety and depression in those waiting for care.

Over three-quarters (77 per cent) reported that patients are waiting longer than clinical guidelines recommend for treatment. This prolonged understaffing has led to what many describe as ‘crisis interventions’ rather than the comprehensive rehabilitation care patients need.

Staff are also reporting safety concerns related to their patients. Reduced on-call staff numbers have caused gaps in services like respiratory care, putting patients at risk. Meanwhile, therapists are grappling with difficult decisions on whether to rush through sessions and risk leaving patients uninformed or to take more time, which results in longer waiting times for others.

Staff and services at breaking point

The staffing crisis has put enormous strain on NHS services, with a growing backlog of patients and inadequate rehabilitation facilities. Nearly all respondents (83 per cent) report they are dealing with daily crises rather than having the time to improve or innovate services. Over half reported that cuts to funding, recruitment freezes, and the elimination of vital posts have further exacerbated the situation.

Nearly half of the respondents (49 per cent) also said they have considered leaving their roles due to the overwhelming stress, and many report experiencing mental and physical health issues themselves as a direct result of their working conditions. Even a graduate just nine months into her role said she wasn’t sure ‘how much longer’ she could go on under ‘such stressful working conditions.’

A call for urgent action

The CSP’s call for action is clear: the Scottish Government must urgently address this crisis and increase training places and initiate a planned expansion of the NHS physiotherapy workforce in Scotland.

Sara Conroy, CSP's professional adviser for Scotland, said: 'This crisis has been building for years, and despite our repeated warnings, the lack of concerted action from the government has allowed the situation to worsen. Over the past decade, the number of undergraduate physiotherapy training places in Scotland has remained stagnant, while demand for places is growing. In contrast, England has doubled the number of training places during the same period.

We are appalled by the declining and often desperate context in which physiotherapists are trying to provide healthcare. 

'It’s taking a huge emotional toll on our members, who went into the profession to help people yet are consistently unable to do so because they are being failed by the system. We will continue to lobby the government on this issue and seek meetings with them to secure the decisive action we need from them to prevent the situation from deteriorating even further.'

How you can help

The CSP is urging members in Scotland to write a letter to their MSPs to make them understand the severe impact of an understaffed physiotherapy workforce in their constituency, and pressure the Scottish government to act.