NHS Grampian Assurance Board minutes: 16 December 2025

Attendees and apologies

• Stephen Gallagher, Chair, Scottish Government 
• Donna Bell, Director, NCS, Scottish Government
• Jack Gillespie, Deputy Director of Finance, Scottish Government
• Robert Kirkwood, Head of People, Governance and Appointments Unit, Scottish Government
• Professor Graham Ellis, Deputy Chief Medical Officer for Scotland, Scottish Government

• Alison Evison, Board Chair, NHS Grampian

• Laura Skaife-Knight, Chief Executive, NHS Grampian
• Paul Bachoo, Medical Director for Acute Services, NHS Grampian
• June Brown, Executive Nurse Director, NHS Grampian
• Hugh Farrow Bishop, Medical Director, NHS Grampian
• Geraldine Fraser, Chief Officer Acute Services, NHS Grampian
• Leigh Jolly, Chief Officer, Aberdeenshire Health and Social Care Partnership, NHS Grampian
• Alex Stephen, Director of Finance, NHS Grampian
• Phil Tydeman, Interim Director of Improvement, NHS Grampian
• Scottish Government policy team

Apologies

Items and actions

Welcome and apologies

The chair welcomed members and attendees to the eleventh meeting of the assurance board, noted apologies and outlined the agenda.

Actions/Update from meeting ten

The assurance board (AB) agreed the minutes and noted that there were two outstanding actions from the previous meeting included in today’s agenda: further discussion on the improvement plan will be covered in item 6, and the planned care team to resubmit their trajectories, reconciling original figures with revised and accounting for mutual aid will be covered in item 4.

Unscheduled care

Geraldine Fraser provided an update on the current performance. This remains challenging due to an increase in presentations due to flu cases. She described the virtual control centre that has been put in place and noted that this can be transformed to an in-person centre if required.

There was a discussion on hybrid working and the importance of visible on the ground leadership and the AB were informed that site managers will be on site and there will be senior management presence over the festive period. There was also discussion on the need for all roles to have a sense of ownership in performance and decision making and any decisions or changes implemented as a result of the control centre introduction.

Geraldine Fraser also provided an update on the processes in place for improving consistency of discharge planning and practice recognising the size of the opportunity here and summarised the meeting that had taken place with senior colleagues on this subject attended by the CEO, Medical Director, Acute Medical Director and Chief Officer for Acute Service, and said that more relevant data was being produced by ward, as well as better forward planning. This includes a strengthened focus on weekend discharge profiles and considering discharge without medication, as one example, where pharmacy challenges were the cause of delay.  

Laura Skaife-Knight advised her intention to ensure greater visibility of leadership in quarter four and committed to updating the AB in due course on progress, recognising the importance of more on the ground leadership in responding to the challenge the organisation faces.

Donna Bell requested that the AB continue to receive updates as the control centre evolves and concrete examples of any changes implemented. It was agreed this was helpful to provide feedback to ministers on performance variations.

The AB noted that operational performance was not where NHS Grampian wanted it to be, however seasonal flu pressures were noted to be having an impact. A control centre was in place; there were discussions in place about ensuring senior managers provide more visible and on the ground leadership. It was also noted that the site director will take up post on 5 January 2026.

Action - USC operational performance will remain high on the AB agenda.

Geraldine Fraser provided an update on the unscheduled care programme. Seven of the indicators are on track, four are ahead and four are behind. Recruitment for advanced nurse practitioners is progressing.

Leigh Jolly updated on the firebreak for Aberdeenshire Health and Social Care Partnership. 17 patients have been identified and suitable care places located.

In summary the AB noted the status of the programme and the immediate progress on the transfer of care for patients from Aberdeenshire.

Planned care

Paul Bachoo provided an update on the central decontamination unit issues. New machines will be arriving in January and February 2025 that will provide a total of five new machines across two sites.

NHS Grampian have conducted an exercise to look at the number of reported surgical site infections and there has been no elevation reported in the review timeframe. NHS Grampian are also conducting track and trace processes with patients where there could be a risk of contamination from equipment used in cases of known blood borne viruses (BBV).

It was agreed that should there be any cases where a BBV has been contracted as a result of the faulty equipment the Scottish Government (Office of Chief Operating Officer) would be notified of the numbers (not details).

Paul also provided an update on the redirection of funding to further improve the 52-week performance. A discussion took place, stressing the need for the repurposing to give the biggest impact. Planned care and patient travel was highlighted as a need.

The AB noted the progress on the impending new machines and the work being done with the help of Public Health Scotland to identity any patient safety impacts.

Action: Kathryn Connor agreed to write to Laura Skaife-Knight in response to her letter to Tracy Slater and Christine McLaughlin re: confirmation of redirection of funding.

Value and sustainability/finance

Alex Stephen provided an update on the finance position at Month 8. Forecast completed on November 2025 (Month 8) results maintain an expected deficit of £47.1m although NHS Grampian still anticipated to deliver a maximum overspend of £45 million for 2025/26. Identifying savings continues, with a focus on recurring savings.

A discussion took place on IJB spend and it was reported that Moray IJB had reported a deterioration in their savings delivery and overall position. It was agreed that a discussion would take place offline on the next steps of the AB on this deterioration and how further assurance would be obtained.

Phil Tydeman spoke on the Value and Sustainability programme and reported that good progress was being made on the prioritised list of schemes and indicative savings by the end of December 2025 as we plan for 2026/27. Quarter 4 will focus on additional savings to close the anticipated gap.

Alex Stephen provided an update on the Baird & ANCHOR paper and assured that processes were in place to monitor costs as best they can on the new buildings.

In summary, the AB noted the positive emerging Month 8 position, the emerging trend around Moray IJB’s finance, the extensive engagement between IJBs and NHS Grampian and the assurance given on the Baird and ANCHOR revenue assumptions, noting that the Full Business Case costs remained robust and were factored into future financial planning.

Action: The chair and Laura Skaife-Knight to discuss the situation with Moray IJB position and agree next steps in relation to the AB role.

Improvement plan

Phil Tydeman talked on his paper regarding the process to agree the improvement plan. The public board meeting held on 11 December 2025 approved four governance boards:

 

• Planned Care
• Unscheduled Care
• Value and Sustainability
• Culture, Leadership and Governance

 

All boards will feed to the executive team monthly. Each recommendation will have a detailed plan and only the NHS board will be able to close a recommendation.

 

Alison Evison confirmed the NHS board were content with the planned governance structures and welcomed the addition of the culture programme board.

 

A discussion took place on the reporting of these governance boards to the AB and it was agreed that information would be shared on a monthly basis in paper form, with deep dives conducted on a quarterly basis on any aspects that require further assurance.

 

It was noted a report on the culture programme board, including visibility of the Terms of Reference, would be presented in January 2026.

Engagement in Sub-national Planning and Delivery Arrangements

Laura Skaife-Knight provided a verbal update on her and wider Board-level engagement in national planning and the new arrangements. Laura will lead on unscheduled care for the East region. She described the importance of the need to have remote, rural and Island as a priority and said she was pleased that this had been recognised by Scottish Government.

 

An executive-to-executive meeting with NHS Highland is planned later in quarter 4, to explore the strategic relationship between both boards, which was welcomed.

 

Laura confirmed that effective communication with staff (including via Area Clinical Forum and Grampian Area Partnership Forum updates) and patients and the community, as well as Local Authority CEOs, was in place and regular updates provided.

 

Alison Evison endorsed Laura’s comments and described the intention for ongoing public messaging building on the paper update Laura brought to the 11 December 2025 public Board meeting on this important matter.

​​​​​​​MP/MSP meeting update

Alison Evison provided an update from the most recent MP/MSP meeting. The topics discussed were national planning, the section 22 report and the priority performance areas. Consistency across areas was mentioned and staff engagement was a concern. The impact of flu and the impact of vaccinations and ‘Near Me’ were included in the questions as well as women’s health and mental health in general.

​​​​​​​​​​​​​​​​​​​​​Reflections on Assurance Board

 

The chair led on an end of the year reflection of the assurance board, and the range of topics covered. Others shared their own reflections.

 

A discussion took place on the length and the continued need for subgroups. It was agreed that the workforce subgroup would continue until there was a firm proposition and clear definite developments and evidence of sustained progress in place. The unscheduled care group will also continue to allow discussion on the progress of the sustainability plan. It was also agreed that going forward subgroups would exist whilst they continue to add value, when that ceases, they can be mainstreamed.

Any Other Business

No other business was raised.

The chair thanked colleagues for their contributions to the eleventh assurance board meeting and closed the meeting.

 

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