UK State of the Nation report 2026 launched

A new report from the Royal College of Anaesthetists (RCoA) reveals up to 1.5 million operations and procedures are unable to take place each year due to a chronic shortage of anaesthetists.

The RCoA's 2026 UK State of the Nation report provides the most comprehensive picture yet of the pressures facing anaesthetic services. It highlights a UK-wide workforce shortfall of around 2,250 anaesthetists - 16% below what is needed - which is having a major impact on the NHS’s ability to provide patient services.

The report highlights how action is desperately needed to train more anaesthetists, as NHS waiting lists remain at near-record levels, with 7.1 million in England, 570,000 in Scotland, 530,000 in Wales and 440,000 in Northern Ireland and many of those are waiting for an operation.  Not only are patients facing delayed operations, 53% also reported that women in labour were sometimes delayed from getting pain relief in their hospitals due to lack of anaesthetists.  

There are currently thousands of doctors who want to train as anaesthetists but there aren’t enough funded training places for them to go to. Last year there were 6,770 applications for just 539 core anaesthetic training places.

The report also sets out steps that could be taken to retain the anaesthetists we already have.

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

“Patients are still waiting too long for surgery, and the shortage of anaesthetists is a major factor. Despite modest increases, the gap between the anaesthetists we have and those we need continues to widen.

This shortfall is delaying care for patients before, during and after surgery, placing growing pressure on our members and limiting the government’s long-term ambitions for the NHS.

We must act now. The forthcoming 10 Year Workforce Plan is a critical opportunity for the government to expand the number of training places for doctors to train as anaesthetists, retain our highly skilled workforce and deliver better care for patients.”

Jenny Westaway, Chair of PatientsVoices@RcoA, said: 

“The shortage of anaesthetists is causing real pain and distress to patients. We all know the toll it takes both physically and mentally to be waiting for a much-needed operation through our own experience or those of our loved ones. 

It’s very worrying that women in labour are facing delays in getting pain relief. The State of the Nation report provides clear steps to address this.”

Key recommendations include:  

Anaesthetic workforce shortages severely impact NHS performance

• Of clinical leaders, 88% report surgery being postponed due to a lack of anaesthetists, with 43% reporting this happening on a daily or weekly basis.
• Long waiting lists for surgery are bad for patients – 31% reported a decline in their mental health while waiting, and 36% reported a decline in physical health.

The anaesthetic workforce gap needs to be urgently addressed

• Training places need to be increased to address the workforce shortfall.
• Since 2020, the UK-wide anaesthetic workforce shortfall has been worsening by an average of 155 anaesthetists per year.  
• As of 2025, NHS hospitals across the UK had the capacity to take on around 380 extra anaesthetic training posts per year. If these posts were fully funded and filled, the workforce shortfall would finally start to close.
• UK Governments should work collaboratively with the RCoA to plan for workforce needs, as recommended by the Leng Review. This involves utilising our extensive workforce data on headcounts, shortfalls, and training capacity.

Support retention of existing staff

• More anaesthetists could be retained by tackling pay issues, pension taxation rules and supporting progression opportunities and better flexibility.  

Workforce wellbeing needs to be improved

• Better support for the wellbeing of the anaesthetic workforce also helps improve retention and reduces time off due to stress, anxiety, burnout or depression.  
• For Locally Employed Doctors and Staff and Associate Specialist doctors, NHS trusts and boards should promote better progression opportunities, and national governments should expand training places.
• Major sources of dissatisfaction are IT systems, the current pension taxation regime, hospital staff parking charges, and a lack of rest and refreshment facilities.