NHS Grampian Assurance Board minutes: 4 December 2025

Attendees and apologies

Members

•    Stephen Gallagher, Chair
•    Donna Bell, Director NCS
•    Jack Gillespie, Deputy Director of Finance
•    Fiona Hogg, Chief People Officer 
•    Robert Kirkwood, Head of People, Governance and Appointments Unit
•    Tracy Slater, Head of Performance and Delivery

Attendees – NHS Grampian 

•    Paul Bachoo, Medical Director for Acute Services
•    June Brown, Executive Nurse Director 
•    Mark Burrell, Chair of Area Clinical Forum
•    Alison Evison, Board Chair 
•    Hugh Farrow Bishop, Medical Director
•    Geraldine Fraser, Chief Officer Acute Services
•    Steven Lindsay, Employee Director
•    Philip Shipman, Interim Director of People and Culture
•    Laura Skaife-Knight, Chief Executive, NHS Grampian
•    Alex Stephen, Director of Finance 
•    Phil Tydeman, Interim Director of Improvement

Attendees – SG/Other 

•    Irene Barkby, Professional Adviser
•    [redacted], Head of Unit
•    [redacted], Head of Unscheduled Care Policy and Performance 

Meeting Apologies

•    Professor Graham Ellis, Deputy Chief Medical Officer for Scotland 
 

Items and actions

Welcome and apologies

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

Actions/Update from Meeting Nine

The assurance board agreed the minutes and noted that the agreed actions from the previous meeting on unscheduled care and workforce would be covered in the agenda; two further actions would be brought back to meetings in January 2026 as planned; the assurance board will consider the improvement plan on 16 December 2025 after the plan has been presented to the NHS Grampian board at its meeting on 11 December 2025.  

Unscheduled Care

Geraldine Fraser gave an update on unscheduled care performance. Increased flu presentations have had an impact on occupancy and ambulance turnaround times. Current trends are 2 weeks ahead of the position at this time last year. Progress with the improvement plan includes the development of a scorecard and the emergence of learning across the pathway. Home assessment will take referrals in December/January. There was discussion around recent funding announcements from the Scottish Government and associated requests from NHS Grampian and a way forward was agreed for these discussions to be drawn to a rapid conclusion. 

The assurance board noted the significant challenge to performance levels and current pressures relating to flu, affecting both bed occupancy and staff absence. The board also noted that improvement work is being taken forward in three strands: 1 is delivery of a whole-system improvement plan, where work is ongoing and expecting the main impact to come on stream in Q4, building on momentum though Q3; 2 is work around ARI site, with a particular focus for the work on time of discharge, and noting the intent to look at modelling re flow through Aberdeen Royal Infirmary and escalation, triggers and site management; 3 is the social care funding bid to help reduced delayed transfers of care. The board noted that activity is going on in all those spaces. The board confirmed that policy colleagues will follow up on funding in the appropriate way after this meeting.

Laura Skaife-Knight advised that an appointment has been made to the site director role, with Rick Strang taking up post substantively on 05 January 2026. Rick would attend various induction activities prior to 05 January 2026 to meet members of the team at NHS Grampian and familiarise himself with the site and improvement plans. 

Hugh Farrow Bishop advised that the job description for the role of deputy medical director for unscheduled care was in advanced draft, aiming to invite expressions of interest next week with a view to interviewing before Christmas and appoint to align with Rick Strang starting in the new year. 

The assurance board noted the development of both job profiles, and is pleased to see a quick appointment to the site director role. The board look forward to meeting Rick Strang in the new year and seeing the deputy medical director job description and personal objectives in due course.

Planned Care

Paul Bachoo updated on the letter submitted to Scottish Government on 01 December 2025 and the revised trajectories within. There was discussion around the revisions and how these reconcile with previous projections, as well as questions around whether requests for mutual aid had been resolved and included in the projections, and the effect of the day surgery unit opening up. There was also discussion about repurposing £700,000 to take up opportunities for support from other health boards.

On outpatients, the assurance board noted the projected position and request to see a reconciliation of the figures as originally submitted compared to now, confirmation of offers of mutual aid, what has been taken up and what discounted, what other requests have been put out, and what would projections would look like if these come to pass. On TTG, noting the proposal in letter to revise trajectory upward, it was agreed that this may be premature given the number of moving parts. Officials will write to NHS Grampian around parameters of repurposing £700,000 following receipt of an SBAR from NHS Grampian, and then seek submission of revised trajectories for consideration.

Paul Bachoo then updated on the position of the central decontamination unit. The aim is to reopen on 19 January 2026. There are some risks associated with this, with the main one being water testing. Meanwhile, from 05 January 2026 the independent sector should be able to provide 400 trays a week.
The assurance board noted the risk around water testing, and the intent to go live from 19 January 2026 with risks being kept under active review, and NHS Grampian will keep Scottish Government well briefed and informed of any movement in dates.

Value & Sustainability

Phil Tydeman summarised the slides, noting that the position is encouraging, although clearly still work to be done; December and January are always challenging months. There is lots of board scrutiny of the numbers and there is confidence in them.
There was discussion of VAT recovery, IJB involvement with planning, progress of the improvement plan, and resource modelling, particularly in light of the Baird and ANCHOR projects
The assurance board noted that the financial position for 2025-26 is stable with confidence, that detailed planning for 2026-27 is underway, and that a deep dive on band 8 postings is planned. The assurance board also note that Laura Skaife-Knight is taking a lead role in the north-east transformation board which is being refreshed, and that Alex Stephen will share a paper on the financial impact of opening Baird & ANCHOR with the assurance board at the next meeting.

Workforce

Fiona Hogg provided a verbal update on the workforce subgroup, noted that the assurance board had been provided with the minute of the most recent subgroup meeting and an assurance note from the first meeting of the NHS Grampian working group. The subgroup has met twice so far; membership now also includes the Area Partnership Forum and Area Clinical Forum chairs, and colleagues working on the Health & Care Staffing Act. There is a need to  work at pace but also align with wider improvement work within NHS Grampian, and Phil Tydeman has joined the sub-group to support that aim.
 
The NHS Grampian working group had their first meeting on 20 November 2025, chaired by Philip Shipman, and have set out some key actions and areas of focus to progress to identify a methodology for integrated workforce planning and some areas where this can be tested. There is also the opportunity to tap into national work, especially the new workforce planning network, the sub national planning work and work which is being done by HIS, and to pilot new ways of working.

The next step is for the working group to pull together a detailed paper for the subgroup and then the assurance board that articulates what aspects of the diagnostic report can reasonably be delivered, what can't be delivered, and provide evidence for this assessment. It will also set out a detailed initial workforce planning approach and where that is going to be tested, including robust milestones and outcomes/impacts. The working group is aiming for the 27 January 2026 assurance board meeting for these reports and the subgroup will provide detailed feedback and scrutiny over their January meetings.

The assurance board reflected that using data to test the recommendations of the diagnostic report was appropriate, and that it is right to bring intelligence and the right people into this work. The assurance board are keen to establish which are the areas we intend to focus on and anticipated impact. The board also noted that while Scottish Government will continue to play a supporting role, NHS Grampian own and drive this work through their working group; a key is developing trust and confidence in the system with leadership and decision-making happening locally

 
Annual Review

Alison Evison provided an update on the ministerial annual review that took place on 01 December 2025 with Neil Gray, Cabinet Secretary for Health and Social Care. The key point raised by the cabinet secretary on the day was concern about unscheduled care performance. Questions raised by the public centred on GP and planned care waiting times, access to the Aberdeen Royal Infirmary, vaccinations and the neuro-development pathway for patients. Positive comments on increased assurance and involving people in discussions.
The assurance board noted the interest of the cabinet secretary in unscheduled care and patient flow; moving into 2026 the assurance board will keep a focus on performance but also balance this with focus on value and sustainability, and the transformation agenda.

Feedback from the joint Area Partnership Forum / Area Clinical Forum Meeting

Steven Lindsay and Mark Burrell fed back from the joint meeting of the Area Partnership Forum and Area Clinical Forum. This followed from August 2025 sessions between staff side and members of the assurance board, and reflected on staff’s concerns. There were a large number of issues and concerns being raised and the meeting helped distil which priorities to focus on in the remainder of the year. These include mental health concerns and improving experience of staff by improving staff rest/facilities. Looking to see tangible changes for staff on the ground. While initially meetings were difficult, people were being honest and challenging and meetings subsequently felt more collaborative. There was a sense of improving culture, that people are all working together.

The assurance board noted that culture and leadership is now the fourth area of focus for the NHS Grampian board, and that focus should be on closing the loop on commitments made. The assurance board reflected on what would be the appropriate time to bring that into the assurance space in the new year; the first meeting of the culture board will be on 12 December 2025, with a seminar on 11 January 2026, so bringing back to an assurance board meeting in January would be suitable.

Any Other Business

No other business was raised.

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