NHS Grampian Assurance Board minutes: 17 November 2025

Attendees and apologies

Members

•    Stephen Gallagher, Chair, Scottish Government
•    Donna Bell, Director NCS, Scottish Government
•    Professor Graham Ellis, Deputy Chief Medical Officer for Scotland,  Scottish Government
•    Jack Gillespie, Deputy Director of Finance, Scottish Government
•    Fiona Hogg, Chief People Officer, Scottish Government
•    Tracy Slater, Head of Performance and Delivery, Scottish Government

NHS Grampian

•    June Barnard (on behalf of June Brown)
•    Hugh Bishop, Medical Director
•    Alison Evison, Board Chair 
•    Geraldine Fraser, Chief Officer Acute Services
•    Deb O’Shea, Chief Finance Officer, Moray IJB
•    Judith Proctor, Chief Officer, Moray IJB
•    Laura Skaife-Knight, Chief Executive, NHS Grampian
•    Alex Stephen, Director of Finance 
•    Phil Tydeman, Interim Director of Improvement
•    Alan Wilson, Director of Infrastructure, Sustainability & Support Services

Attendees/SG other

•    Irene Barkby, Professional Adviser
•    [redacted], Head of Unit
•    [redacted] Senior Financial Improvement Manager
•    Alan Morrison, Deputy Director Health Infrastructure & Sustainability
 

Apologies

•    June Brown, Executive Nurse Director 
•    Robert Kirkwood, Head of People, Governance and Appointments Unit
 

 

Items and actions

Welcome and Apologies

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

Actions/Update from Meeting Eight

The board agreed the minutes and noted that any outstanding actions from the previous meeting would be covered in the agenda.

Finance

Q2 review: Alex Stephen provided an update on the Q2 performance review meeting, referring to the shared slides. The board were content to note the Q2 position and that the review has been undertaken, and noted that a system-wide financial planning session with local authorities, integration joint boards and NHS Grampian has taken place since the last meeting.

Month 7 update: Alex Stephen provided information on the month 7 position, based on information collated that morning. The data indicated that the board remained on target to meets its agreed financial and savings plans for 2025-26. The board noted the emerging M7 position and noted that this provides further indicative assurance of the organisation’s stabilisation. The chair advised NHSG finance colleagues to stay in close contact with SG finance colleagues over the coming months.

System planning meeting: Laura Skaife-Knight provided an update on the 7 November 2025 system financial planning session, referring to the summary paper previously circulated to board members which sets out the agenda covered and actions and follow-ups agreed. It was generally considered to be a positive and productive session, strengthening relationships and establishing a shared understanding of the strategic context of each organisation and the financial challenges that each face, and agreeing a common purpose and shared outcomes. Action to be taken forward by the group includes the visibility of savings schemes across all organisations, capturing shared system risks, and standing back up the north-east transformation group and ‘once for Grampian’ opportunities. 
The board encouraged partners to remain in close contact, and noted the intent to re-engage with the NE transformation group. The board also noted that this reflects increased ‘horizontal integration’, with local partners, but advised a focus on ‘vertical integration’ also with national planning partners and processes.

Moray IJB finance: Judith Proctor provided an update on Moray IJB finance, referring to the shared slides. The board noted the progress made in investigating underlying reasons for the overspend at month six, although reflected that a breakdown of associated costs and overspends in these areas would be helpful to assure that efforts to address were proportionate. The board also noted the point about additional resource to scope remedies and medium-term planning. The chair invited the presenters to come back to a future board meeting (in January 2026) with additional detail, including how the work is manifesting and, if they are able to turn around the deficit by year-end, identification of learning to share with partners. 
Action: Judith Proctor and Deb O’Shea to be invited to a January 2026 meeting of the assurance board to give a further update.

Baird & ANCHOR
Alan Wilson gave an update on the construction and completion of the Baird and ANCHOR facilities, referencing the shared paper. The board noted the position of the projects, and recognise that specifications have changed over time and the impact of this on timescales and costs. The board noted the project has been working closely with NHS Assure, would welcome further assurance around financial drivers underpinning these facilities, and advised that there should be a lessons learnt exercise relating to this project, which the NHS Grampian board have committed to doing. The board note and commend induction plans, and will seek a further update/s as these projects come to conclusion in 2026. 

Planned care

Laura Skaife-Knight advised that the planned care external peer review report had been received and that some actions are already being taken forward. The paper will need to go through local governance processes, having only been received the week before, but consideration being given to triangulation, reporting processes and the role of the executive team and health board in performance and risk. The aim is to have plans in place in January 2026 after discussion at the executive team and planned care programme board, and will report back to the assurance board. The assurance board noted the receipt of the review, that NHSG board will be giving active consideration to the recommendations, and welcome an update in due course.

Action:  Laura Skaife-Knight to provide an update on plans at a January meeting of the assurance board.

Phil Tydeman gave an update on the day case surgical unit, urology and central decontamination unit: 

Day case surgical unit: The unit opened on 10 November 2025, initially for one day, with an additional day-per-week of opening being added – the unit will operate for five days per week within three weeks’ time. Question was asked about whether the operation of the unit had been considered when plotting trajectories – this will be explored and confirmed. 
The board noted that the unit opened doors on a phased basis, and that detail would be provided on functionality of the day room, and how these play into trajectories. The board asked to explore whether the unit could operate for more than 5 days per week. 

Urology: There is a long-standing capacity issue. Independent sector support and mutual aid from other health boards is being sought, with the aim of reducing the 52-week waiting list to zero. In-year funding slippage has been identified. The board notes the scoping exercise with independent sector contractors, and that a review of mutual aid and slippage expenditure will be carried out over the course of the week, with decisions to be made next week.

Central decontamination unit: The board noted that planned care trajectories will be revised and resubmitted to Scottish Government by the end of November 2025 which will include the central decontamination unit impact, urology impact and mutual aid impact.

Laura Skaife-Knight fed back from the board seminar session of 13 November 2025, and advised that four programme boards will oversee the plan – planned care, unscheduled care, value and sustainability, and a new culture programme board. Final plans will be taken to the next meeting of the NHS Grampian board on 11 December 2025. The assurance board noted the work done, including through the strategy day, and will provide further comments and feedback ahead of the next assurance board meeting.
Action:  Assurance board to provide feedback on the improvement plans before 4 December 2025.

Workforce

Fiona Hogg provided a verbal update on the workforce subgroup: NHS Grampian are setting up their own workforce working group; next meeting of the assurance board subgroup will be on 27 November 2025; it is recognised that this is key bit of activity with links to national/sub-national planning, but there is a clear need to begin work in Grampian and link in to wider efforts in time and as needed; membership of the subgroup will expand to include the right people from NHSG and SG, and include input from other boards that are doing this well; will also include the lead for the Health & Care Staffing Act from NHSG; terms of reference for the subgroup will be part of the agenda for the next meeting. 

The board noted the update and look forward to a further update at the 4 December 2025 meeting. 

Action: Fiona Hogg to provide a further update at the 4 December 2025 meeting.

Unscheduled care performance

Geraldine Fraser provided an update on the last subgroup meeting and plans for making immediate improvements. Discussion focused on bringing plans together quickly; reflecting anticipated outcomes; ensuring clear messaging around ambulance stacking and ability to respond in the community, including the impact of measures on improving this; ensuring the medium- and long-term plans are not adversely affected by what is implemented now; announced additional funding for social care should provide additionality and not detract from plans
The board noted that the emphasis should be on improving flow rather than creating holding spaces, and recognised potential for repurposing some aspects of the plan. The subgroup are scheduled to meet again next week, but there is value in maintaining momentum throughout this week. The board welcome an update at their next meeting.

Action: Donna Bell/Geraldine Fraser to provide a further update at the 4 December 2025 meeting.

Any other business

Alison Evison updated on preparations for the NHS Grampian annual review meeting ahead of 1 December 2025, and reflected on the response to the publication of Audit Scotland’s section 22 report into NHS Grampian. The board noted these updates.

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