AI-generated job applications cause problems for NHS

NHS Shetland Islands receives a large number of job applications from overseas that do not meet eligibility criteria and appear to have been generated using artificial intelligence (AI).

This is far from a local issue, with all health boards in Scotland reporting a “significant increase in irregular and unqualified applications” for a large number of entry-level roles, largely due to AI-generated applications, automated bots and third-party sources.

The issue was raised in NHS Shetland’s 2025/26 workforce report and presented at Thursday’s board meeting.

The impact is increasing administrative workload for hiring managers and human resources teams, lengthening short-listing times and reducing the efficiency of the hiring process, according to the report.

“There is also a risk that genuine and eligible applicants may be delayed or obscured by a large volume of inappropriate submissions,” it added.

This problem has reached a national level, and mitigation measures are currently being considered.

These include potentially strengthened eligibility checks, tighter application controls, and a wide range of safeguards aimed at filtering or preventing automated and irregular applications at the point of submission.

In the absence of a technical solution, the current public consensus is that health boards will manage the issue “operationally and proportionately”.

This could include using clearer criteria and qualification language in advertising, earlier screening against qualification requirements, and appropriate vetting at the shortlisting and interview stage.

“Unfortunately, despite testing additional mitigation measures on the ground, including the introduction of enhanced assessment forms and killer questions that require more specific and targeted answers, this has not resulted in meaningful reductions in application volume,” the report continued.

“Evidence shows that AI-generated and automated applications are sophisticated enough to circumvent these additional controls and can complete assessment questions without meeting the underlying eligibility or suitability requirements.

“This supports the view that local vacancy-level mitigation measures are unlikely to fully address the problem and that system-level solutions are needed.

“For the foreseeable future, these measures will continue to increase the administrative burden on hiring managers and HR teams without achieving the intended reduction in non-regular applications.”

Elsewhere in the report, the number of NHS Shetland staff increased from 888 to 931 between April 2025 and March this year.

Total personnel costs for 2025/26 were £58,251,000 against the budgeted £55,956,000, resulting in an overspend of nearly £2.3 million.

Locum agency staff costs were approximately £2.3 million, which was down compared to the previous year. For example, the figure for 2023/24 was £3.7m.

The working hours of bank employees who are called upon during shortages increased by nearly 34% in 2025/26 compared to the previous year. Bank staff staff costs amounted to approximately £4.6m during the year.

When it comes to overtime and overtime hours, the report shows an increase of just over 16%.

It added: “Service sectors are increasingly relying on overtime and overtime to maintain safe staffing levels amid sustained clinical demand and workloads.”

The report also states that 105 people left NHS Shetland during the year, but only 25% completed an exit survey.

Furthermore, “reasons for leaving varied and were often related to natural or planned turnover.

“Retirement and early retirement are evident in several service sectors.

“Other commonly cited reasons include changing jobs, resuming training, better career opportunities, and family or personal circumstances.

“These factors suggest that much of the recorded attrition rate was driven by life stage and career development decisions rather than job dissatisfaction.”

The report also said there was “limited” mention of workload pressures and mental health.

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