NHS Grampian Assurance Board minutes: 30th June 2026

Attendees and apologies

Members

• Stephen Gallagher, Chair, Scottish Government
• 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 
• Claire Pearce, DCN, Scottish Government

Attendees – NHS Grampian

 

• (AE) Alison Evison, Health Board Chair
• (LSK) Laura Skaife-Knight, Chief Executive
• (JB) June Brown, Executive Nurse Director
• (GF) Geraldine Fraser, Chief Officer, Acute Services
• (SF) Stephen Friar, Deputy Medical Director, Unscheduled Care
• (LJ) Leigh Jolly, Chief Officer, Aberdeenshire IJB
• (AS) Alex Stephen, Director of Finance
• (RS) Rick Strang, Site Director ARI
• (GW) Gail Woodcock, Director of Strategy, Transformation and Performance
• (MS) Melaine Saunders, Interim Director of People and Culture,
• (MD) Michael Dickson, Chief Executive, Scottish Ambulance Service
• (RJ) Ritchie Johnson, Non-Executive Director, NHS Grampian
• (DM)Drew McGowan, Interim Board Secretary
• (AP)Alasdair Pattinson, General Manager, Dr Gray’s Hospital
• (HC) Helen Chisholm, Chief Nurse, Dr Gray’s Hospital

Attendees

 

• (TS) Tracy Slater, Assurance & Improvement unit
• [redacted], Policy officer

• [redacted] Assurance & Improvement unit (notetaker)
• (JM) Jess Milne, Policy Official, Unscheduled Care

Apologies

 

• (PT) Phil Tydeman, Interim Director of Improvement

 

 

Items and actions

1: Welcome and Apologies

SG welcomed members and attendees to the twenty second meeting of the assurance board, noted apologies and outlined the agenda.

2: Actions/update from meeting

The minute from meeting 21 was signed off and no outstanding actions.

Dr Gray’s hospital visit has been arranged for 22 September.  

3: Culture Update (5 minutes)

 

MS provided an update on the latest iMatter results for NHS Grampian. It was noted that the findings had been considered by the Staff Governance Committee and would report to the NHS Grampian Public Board in August 2026.

 

The Board welcomed the increase in participation levels, with approximately 400 more staff taking part in the survey than last year. An overall response rate of 62% was reported, noting a 3% improvement in engagement compared with the previous year. Some further work was needed on ensuring staff feel more involved in decision-making and whistleblowing (including confidence when people speak up action will be taken) – and these will be areas of focus going forward.

 

The Board welcomed the positive level of participation and noted the results and planned governance arrangements for reporting and oversight and planned areas of focus. The Board noted that the survey was also feeding into the Culture Programme Board.

 

4: Unscheduled Care

 

GF provided an update on the most recent performance. SAS turnaround time has been higher than trajectory over the past few weeks, four-hour emergency access performance is just below trajectory. Delayed discharges have been above trajectory and increasing. The discussion also focused on long waits over eight and twelve hours which show a decline; it was agreed that these metrics, alongside some broader quality and safety data, including boarding, would be included in future updates to provide a more rounded picture.

 

LJ provided an update on the Unscheduled Care Delivery Board reset, which took place on 22 June. The key roles and responsibilities are set out within the Terms of Reference, providing greater clarity on accountability, challenge and oversight of both operational and strategic delivery.

 

It was noted that the revised structure comprises two groups: the Delivery Board itself and a supporting group responsible for horizon scanning and identifying emerging issues. A number of actions are progressing concurrently through the Delivery Board. It was acknowledged that performance data has not yet been presented to the Board. FH welcomed the update and highlighted the importance of ensuring the correct voices are represented within the governance structure.

 

She also emphasised the need for visible leadership and avoiding unnecessary duplication across groups and forums. FH sought clarification on the initial membership of the USC Improvement Board to understand what has changed between the original Board and the USC Delivery Board and queried the role of the Executive Team in supporting delivery. LJ confirmed that membership arrangements will be kept under review and revised as required and stated that Executive Director attendance at the Delivery Group was about ownership.

 

The Assurance Board noted the update, welcomed the establishment of the Delivery Board and its first meeting, and recognised the consistent themes emerging across the programme, particularly the focus on reducing variation and increasing standardisation across the system.

 

Frailty Services

Discussion focused on the acute frailty service, including the proposal to realigned, which would see acute frailty beds increase in capacity from 39 to 68 beds, together with the anticipated benefits for patients, including improvements to quality and safety, flow and emergency access performance. The proposals had been discussed for a second time by the Executive Team this morning and would now go to the Board for a decision on 9 July.

 

LSK outlined that helpful feedback had been received from DCMO Graham Ellis and the next steps would be to update Scottish Government delivery and performance colleagues to welcome feedback and challenge on the case. It is hoped that this discussion will take place in advance of the Board meeting on 9 July.

 

Planned Board Seminar

 

The Assurance Board received a paper outlining plans for the forthcoming Board Seminar - Unscheduled Care Deep Dive, scheduled to take place on 9 July.  It is intended to cover progress, impact and lessons learned over the past year, current priorities and trajectories for 2026/27, and test governance and assurance for the year ahead. Performance and delivery themes will also be explored, with interactive sessions aligned to the work of the new Delivery Group.

 

The event is intended primarily for NHS Grampian Board members, and it was noted that Neena Mahal will also attend.

 

The Chair commented on the purpose of the seminar, highlighting the importance of connecting key issues across the system and drawing out themes relating to patient safety, corridor care and Scottish Ambulance Service pressures.

 

The Chair also reflected on the Board’s intention to engage more effectively with partners and stakeholders, recognising the impact of decisions on other parts of the system and the importance of incorporating partnership and stakeholder perspectives into discussions.

 

The Board noted the updates.

 

SAS Update

 

MD provided an update on collaborative working between NHS Grampian and the Scottish Ambulance Service (SAS). He reflected positively on the progress made, highlighting the benefits of strengthened partnership working and the performance improvements seen at both Aberdeen Royal Infirmary and Dr Gray’s Hospital. MD noted that this reflected the work undertaken to move away from traditional models of operation towards a more integrated, system-wide approach. System partners remain actively engaged in the programme of improvement.

 

MD also highlighted work to improve stroke pathways, and advised that SAS crews are reporting increased confidence in the system, alongside a reduction in lost ambulance hours.

 

GE welcomed the progress made and the positive direction of travel. He noted that performance measures associated with quality and safety are moving in the right direction and encouraged continued focus on sustaining improvement.

 

LSK thanked MD for attending the Assurance Board. LSK reflected on the strengthening of relationships between organisations and highlighted the positive engagement taking place through the regular Monday SAS meetings. It was noted that leadership has become more distributed, creating opportunities for others across the system to contribute and feel empowered to lead improvement activity.

 

The Chair agreed that there is now greater assurance regarding relationships across partner organisations and noted the positive evidence of collaboration provided by SAS colleagues.

 

In summarising the USC item, the Chair noted the continued improvement in four-hour emergency access performance at both Aberdeen Royal Infirmary and Dr Gray’s Hospital. The Assurance Board agreed that additional metrics relating to longer waits and quality and safety metrics (including non-standard care settings) should continue to be monitored to enable trends and patterns to be identified. The Board further noted the work underway to strengthen operational practice and reduce unwarranted variation within and across sites.

 

It was noted that JM will engage with RS to seek further support on site co-ordination arrangements, with the aim of strengthening the role and supporting delivery. The Board also noted that the first USC Delivery Board meeting had been held and that revised Terms of Reference are now in place.

 

The Assurance Board noted the update and welcomed the continued improvement in partnership working, system performance and collaborative leadership across the region.

 

5. Clinical Governance Update

 

JB provided an update on clinical governance arrangements, noting that the first Clinical Quality and Safety Improvement Board had taken place and that clinical quality and safety has been agreed as a strategic priority by the Board at its June 2026 meeting. Work is underway to align governance arrangements through a PMO model, with revised processes expected to be in place by the end of July 2026.

 

The Board received an update on the Healthcare Improvement Scotland (HIS) diagnostic review, including recent site visits to Aberdeen Royal Infirmary and Dr Gray’s Hospital. Learning from NHS Forth Valley and NHS Tayside’s improvement in the  Clinical Governance space are also being considered and visits are planned later in the week.

 

Discussion focused on the need for robust governance structures, clear lines of accountability and assurance, and a strong organisational (safety) culture. Members highlighted the importance of ensuring governance arrangements are proportionate, avoid duplication and provide effective oversight of clinical quality and safety.

 

TS sought assurance that any recommendations arising from the HIS review would be incorporated into the wider improvement programme. JB confirmed that the Improvement Board will oversee delivery and provide assurance as improvement work progresses.

 

The Chair welcomed the progress being made and encouraged greater clarity on the governance journey and future-state arrangements. It was confirmed that the Improvement Board is intended to be a temporary and transitional arrangement to support clinical governance improvement rather than a permanent business as usual structure.

 

 

The Board noted the update and welcomed progress in strengthening clinical governance and assurance arrangements.

 

6. Value and Sustainability Update

 

AS provided an update on the Value and Sustainability (V&S) Programme, noting finance plans remain on track to deliver required savings in 26/27. Work continues on the V&S structure, And a 28-week delivery plan is being developed from August 2026 to so that the 2027/27 savings programme can be developed through appropriate engagement.

 

Performance against the financial position at Months 1 and 2 was reviewed, alongside the latest Financial Monitoring Report. JG highlighted the financial implications of the Reduced Working Week and sought assurance that costs would remain within the agreed financial envelope. AS advised that current assumptions account for the reduction in hours and that the principal risk relates to regrading activity. He noted that the position will continue to be monitored closely.

 

In relation to Health and Social Care Partnership (HSCP) finances, JG noted that a detailed report is expected. AS advised that early feedback indicates HSCPs are broadly operating in line with plan.

 

The Board discussed the longer-term outlook for the V&S Programme, recognising that while delivery confidence is improving, the level of non-recurring support will reduce over time. Members discussed the need to identify further opportunities through service transformation and redesign. AS noted, that additional efficiencies could be identified, while wider transformational opportunities would require support and investment. GW highlighted that transformational savings would take longer to materialise than traditional efficiency measures.

 

The Chair reflected on a key point of the KPMG advice that achieving financial balance sustainably would require transformational change and service redesign. Discussion focused on redesigning services, future planning and the role of sub-national collaboration. It was agreed that a future Assurance Board meeting would consider how existing programmes can align to support redesign activity.

 

The Board discussed the remaining financial gap and sought assurance on whether sufficient opportunities existed to address it. AS highlighted, there was a range of smaller savings initiatives and the twelve Invest to Save proposals as potential contributors.

 

LSK welcomed the focus on system redesign and proposed a future discussion involving the three IJB Chief Officers and local authority Chief Executives to consider opportunities for transformation across the North East. Broader engagement with system partners was also encouraged.

 

RJ provided an update on the Financial Recovery Board (as Chair of this Board), noting that attendance remains strong, with representation across service areas. The Board is providing additional assurance and plans to undertake a series of deep dives into key V&S themes. Formal outputs continue to be reported publicly through the NHS Grampian Board.

 

AE reflected positively on the work of the Financial Recovery Board, noting that it provides both assurance and the opportunity to focus on key issues in greater depth. She expressed support for its continuation in the short term.

 

The Chair welcomed the work of the Financial Recovery Board and noted the value of the programme of work being taken forward.

 

7. AOB

The chair congratulated NHS Grampian colleagues on the recent announcement that Royal Aberdeen Children’s Hospital have achieved Magnet designation for care excellence with distinction. The first children’s hospital in Europe and the first hospital in Scotland.

 

Date of next meeting – 11 August 2026