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| NHS Grampian staffing levels need to be reviewed - auditors | |
| (about 2 hours later) | |
| NHS Grampian has been subjected to an operations review | NHS Grampian has been subjected to an operations review |
| NHS Grampian's staffing levels should be reviewed amid efforts to tackle its ongoing financial difficulties, a report has said. | NHS Grampian's staffing levels should be reviewed amid efforts to tackle its ongoing financial difficulties, a report has said. |
| The health board was escalated to Stage Four of the five-stage NHS Scotland National Performance framework earlier this year, amid concerns over its financial stability, leadership and governance. | The health board was escalated to Stage Four of the five-stage NHS Scotland National Performance framework earlier this year, amid concerns over its financial stability, leadership and governance. |
| External auditors from KPMG conducted an operations review and the resulting 138-page report has now been published. | External auditors from KPMG conducted an operations review and the resulting 138-page report has now been published. |
| It recommends an independent review of staffing levels, and has also identified millions of pounds in potential savings. NHS Grampian said all options would be carefully considered. | It recommends an independent review of staffing levels, and has also identified millions of pounds in potential savings. NHS Grampian said all options would be carefully considered. |
| It came as the Scottish government announced an extra £5.9m of funding to support its recovery. | It came as the Scottish government announced an extra £5.9m of funding to support its recovery. |
| What did the review find? | What did the review find? |
| The review looked at leadership, the main causes of financial issues, and identifying cost savings. | The review looked at leadership, the main causes of financial issues, and identifying cost savings. |
| "Transformational change will be needed to address the deficit position," the report said. | "Transformational change will be needed to address the deficit position," the report said. |
| Some key findings: | Some key findings: |
| NHS Grampian has a workforce which was 13.8% larger than in 2019/20 and this does not align with a decrease in total beds and levels of activity | NHS Grampian has a workforce which was 13.8% larger than in 2019/20 and this does not align with a decrease in total beds and levels of activity |
| The health board has identified £40m of savings as part of its financial recovery plan (FRP). KPMG said it had identified other opportunities to save between about £14.8m and £26.7m - though this would take time because health boards cannot make redundancies | The health board has identified £40m of savings as part of its financial recovery plan (FRP). KPMG said it had identified other opportunities to save between about £14.8m and £26.7m - though this would take time because health boards cannot make redundancies |
| Over time the savings could increase to between £27.8m and £45.7m | Over time the savings could increase to between £27.8m and £45.7m |
| The number of outpatient appointments attended is 39.8% higher in 2024/25 compared to 2019/20 and KPMG said this issue needed further investigation as reducing the number of these non-urgent appointments could save up to £15m a year | The number of outpatient appointments attended is 39.8% higher in 2024/25 compared to 2019/20 and KPMG said this issue needed further investigation as reducing the number of these non-urgent appointments could save up to £15m a year |
| NHS Grampian bosses were under "significant pressure" and good at spotting problems but not necessarily solutions | NHS Grampian bosses were under "significant pressure" and good at spotting problems but not necessarily solutions |
| An increase in resources was not necessarily linked to an increase in performance | An increase in resources was not necessarily linked to an increase in performance |
| Despite the increase in clinical staff, usage of operating theatres has dropped 8% in the last five years, outpatient procedures have decreased by 3.8% ( despite a 39.8% rise in outpatient appointments) and elective inpatient admissions has dropped 21.8% since 2019/20 | Despite the increase in clinical staff, usage of operating theatres has dropped 8% in the last five years, outpatient procedures have decreased by 3.8% ( despite a 39.8% rise in outpatient appointments) and elective inpatient admissions has dropped 21.8% since 2019/20 |
| The board overpaid staff by a total of £140,000 in 2024/25, mostly due to late notification to the finance department to stop payments, but as of July only £30,000 had been repaid | The board overpaid staff by a total of £140,000 in 2024/25, mostly due to late notification to the finance department to stop payments, but as of July only £30,000 had been repaid |
| Other suggestions to save money include switching from paper towels to electric hand dryers and investigating installing electronic advertising boards on NHSG land | Other suggestions to save money include switching from paper towels to electric hand dryers and investigating installing electronic advertising boards on NHSG land |
| NHS Grampian said it would now focus on reducing costs, reducing planned care waiting times, and also cutting ambulance turnaround times. | NHS Grampian said it would now focus on reducing costs, reducing planned care waiting times, and also cutting ambulance turnaround times. |
| New chief executive Laura Skaife-Knight welcomed the independent assessment. | New chief executive Laura Skaife-Knight welcomed the independent assessment. |
| Laura Skaife-Knight is the new NHS Grampian chief executive | Laura Skaife-Knight is the new NHS Grampian chief executive |
| "It rightly and properly shines a spotlight on the key challenges that we face from an NHS Grampian and system perspective," she said. | "It rightly and properly shines a spotlight on the key challenges that we face from an NHS Grampian and system perspective," she said. |
| "All savings schemes will continue to be carefully considered to ensure patient experience, clinical care and staff wellbeing is maintained or improved." | "All savings schemes will continue to be carefully considered to ensure patient experience, clinical care and staff wellbeing is maintained or improved." |
| She added that the board would work with local, regional and national partners to ensure ideas for improvement were designed and developed together for the benefit of local communities. | She added that the board would work with local, regional and national partners to ensure ideas for improvement were designed and developed together for the benefit of local communities. |
| Health Secretary Neil Gray said the extra £5.9m for the current year was to "drive immediate improvements in A&E performance and unscheduled care". | Health Secretary Neil Gray said the extra £5.9m for the current year was to "drive immediate improvements in A&E performance and unscheduled care". |
| He said: "By improving the flow of patients through hospital, we can deliver real improvements for the people of Grampian." | He said: "By improving the flow of patients through hospital, we can deliver real improvements for the people of Grampian." |
| Gray added: "The KPMG report is welcome and is an important part of the process in driving improvements. | Gray added: "The KPMG report is welcome and is an important part of the process in driving improvements. |
| "It is critical that NHS Grampian prioritises action that improves capacity, makes the most impact and drives real, sustainable change. | "It is critical that NHS Grampian prioritises action that improves capacity, makes the most impact and drives real, sustainable change. |
| "I am grateful to all staff in the board for their continued efforts, and I look forward to working with the new chief executive on their improvement plans." | "I am grateful to all staff in the board for their continued efforts, and I look forward to working with the new chief executive on their improvement plans." |
| Scottish Conservative North East MSP Tess White described it as a "damning" report. | Scottish Conservative North East MSP Tess White described it as a "damning" report. |
| "Lives are being put at risk, staff are under intolerable strain, and patients are bearing the brunt of the crisis that has unfolded," she said. | "Lives are being put at risk, staff are under intolerable strain, and patients are bearing the brunt of the crisis that has unfolded," she said. |
| "The Scottish government must now take steps to put patients and staff first by ensuring urgent measures are in place to lift NHS Grampian out of this dire predicament." | "The Scottish government must now take steps to put patients and staff first by ensuring urgent measures are in place to lift NHS Grampian out of this dire predicament." |
| Decontamination issues | Decontamination issues |
| The Scottish government announced in May that it was to increase scrutiny on NHS Grampian as it moved to Stage Four. | The Scottish government announced in May that it was to increase scrutiny on NHS Grampian as it moved to Stage Four. |
| Gray said there were "continuing concerns" about NHS Grampian's financial management. | Gray said there were "continuing concerns" about NHS Grampian's financial management. |
| It had already been announced that NHS Grampian would receive a Scottish government loan of more than £67m to tackle its overspend. | It had already been announced that NHS Grampian would receive a Scottish government loan of more than £67m to tackle its overspend. |
| Health boards can move up and down the performance scale, and different levels of government support apply to each stage. | Health boards can move up and down the performance scale, and different levels of government support apply to each stage. |
| NHS Greater Glasgow and Clyde and NHS Forth Valley were both at Stage Four in recent years. | NHS Greater Glasgow and Clyde and NHS Forth Valley were both at Stage Four in recent years. |
| Earlier this month, it emerged scores of procedures were being postponed at Aberdeen's hospitals after an unknown substance - thought to be linked to a faulty piece of equipment - was found on surgical instruments. | Earlier this month, it emerged scores of procedures were being postponed at Aberdeen's hospitals after an unknown substance - thought to be linked to a faulty piece of equipment - was found on surgical instruments. |
| The central decontamination unit at Foresterhill - which sterilises and prepares the tools - was shut down last Friday. | The central decontamination unit at Foresterhill - which sterilises and prepares the tools - was shut down last Friday. |
| Ms Skaife-Knight said: "I want to apologise to the several hundreds of patients who had their dental and elective surgical procedures cancelled, recognising the impact this has had on them. | Ms Skaife-Knight said: "I want to apologise to the several hundreds of patients who had their dental and elective surgical procedures cancelled, recognising the impact this has had on them. |
| "I know from the many correspondence, and emails and letters I have already received, the impact that that has had on those patients for which I sincerely apologise." | "I know from the many correspondence, and emails and letters I have already received, the impact that that has had on those patients for which I sincerely apologise." |
| She added: "We are grateful to other health boards for offering support and I can confirm that Glasgow are supporting us in this next period as some of our staff have been redeployed and are being based there in the next few weeks so that we can get on top of this." | She added: "We are grateful to other health boards for offering support and I can confirm that Glasgow are supporting us in this next period as some of our staff have been redeployed and are being based there in the next few weeks so that we can get on top of this." |