NHS Shetland is receiving a high number of job applications from overseas which do not meet eligibility criteria and are thought to be generated using artificial intelligence (AI).
This is not said to be a local issue, with all health boards in Scotland reporting a “significant increase in non-genuine and ineligible applications” for high volume and entry level roles – mostly attributed to AI generated applications, automated bots and third party sources.
The issue was raised in NHS Shetland’s workforce report for 2025/26, which got an airing at a board meeting on Thursday.
The report said the impact of this has been increased administrative workload for recruiting managers and HR teams, extended shortlisting times, and reduced efficiency within recruitment processes.
“There is also a risk that genuine and eligible applicants may be delayed or obscured within high volumes of unsuitable submissions,” it added.
The issue has been escalated to a national level, with mitigations currently being explored.
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These include potential enhancements to eligibility screening, tighter application controls and broader safeguards aimed at filtering or preventing automated and non-genuine applications at the point of submission.
In the absence of a technical fix, the current national consensus is that health boards manage the issue “operationally and proportionately”.
This could include using clearer essential criteria and eligibility wording in adverts, early sifting against eligibility requirements and appropriate scrutiny at shortlisting and interview stages.
“Unfortunately, despite testing additional mitigations locally, including the introduction of enhanced assessment forms and killer questions requiring more specific and targeted responses, this has not resulted in a meaningful reduction in application volumes,” the report continued.
“Evidence suggests that AI-generated and automated applications are sufficiently sophisticated to bypass these additional controls, completing assessment questions without meeting underlying eligibility or suitability requirements.
“This reinforces the view that local, vacancy-level mitigations are unlikely to fully address the issue and that a system-level solution is required.
“In the interim, these measures will continue to add administrative burden for recruiting managers and HR teams without delivering the intended reduction in non-genuine application.”
Elsewhere in the report, the NHS Shetland headcount increased from 888 to 931 between April 2025 and March this year.
The total pay cost for 2025/26 was £58.251 million against a budget of £55.956 million, resulting in an overspend of nearly £2.3 million.
The cost of locum agency staff was around £2.3 million, but this represents a decrease on previous years. For example, the figure was £3.7 million in 2023/24.
Hours worked by staff from the ‘bank’, who can be called upon when there are shortages, increased by nearly 34 per cent in 2025/26 compared to the previous year. The cost of bank staff during the year amounted to around £4.6 million.
In terms of overtime and excess hours, the report says this has increased by just over 16 per cent.
It adds: “Service areas are increasingly relying on overtime and excess hours to maintain safe staffing levels during sustained clinical and workload demand.”
The report also says 105 people left NHS Shetland during the year, although only 25 per cent completed an exit questionnaire.
It added: “Reasons for leaving were varied and, in many cases, related to natural or planned workforce turnover.
“Retirement and early retirement feature prominently across several service areas.
“Other commonly cited reasons include career change, re-entering training, better career opportunities and family or personal circumstances.
“These factors suggest that much of the recorded turnover was driven by life stage or career development decisions rather than dissatisfaction with employment.”
The report also said there were “limited references” to workload pressures and mental wellbeing.
