NHS Grampian notification: letter to Health, Social Care and Sport Committee

To: Clare Haughey MSP, Convenor, Health, Social Care and Sports Committee

From: Neil Gray MSP, Cabinet Secretary for Health and Social Care    

12 May 2025 

Dear Clare

NHS Grampian: escalation to stage 4 of the NHS Scotland Support and Intervention Framework 

NHS Grampian have been facing significant financial and operational pressures for several months, leading to the Health Board’s escalation to Stage 3 of the NHS Scotland Support and Intervention Framework for financial management in January 2025. Stage 3 is the first formal stage of escalation and, as such, NHS Grampian has been receiving tailored support, however there remain concerns about the Board’s financial position, plans, leadership and governance; and any associated impact this may have on the delivery of local services. 

I am writing to you to advise that following careful consideration, the Government has decided that NHS Grampian’s escalation status be raised to Stage 4 for finance, leadership and governance. Stage 4 is the highest stage on the Framework which can be reached without the exercise of Ministerial powers of direction (e.g. replacing the board/leadership). Further, formal escalation is felt necessary (along with the additional support and scrutiny this provides) to help mitigate the significant risks to both the local board and wider, overall NHS Scotland financial positions. 

The key focus of this further escalation will be to arrest the rate of expenditure in NHS Grampian and help mitigate immediate concerns about financial and associated operational pressures, and to stabilise the system. 

One of the key, initial elements of this package of enhanced support and scrutiny will be a whole system diagnostic, to be carried out by an external consultancy and is expected to conclude in June. That will help to inform the tailored support package that follows and will provide a robust basis for the wider, transformation work required over the longer term in NHS Grampian; in support of the local leadership under the new Chief Executive, with the interviews for that post taking place in early June.  

With the agreement of Parliament, a Ministerial statement will be provided at the appropriate point to keep members updated on this matter.

I hope this is helpful.

Yours sincerely

Neil Gray MSP