NHS Grampian has been escalated to the second highest level of risk following concerns over the health board’s financial position.

The Scottish government has announced a step-up in its scrutiny of the finances and leadership of NHS Grampian, which is currently on track to overspend by almost £70m this year.

Senior civil servants will oversee the development and delivery of an improvement plan while external consultants have been brought in to help inform “a tailored package of support”.

A whole system ‘diagnostic review’ to identify challenges and savings opportunities is already underway and is expected to report in June.

Health Secretary Neil Gray said NHS Grampian has been experiencing significant financial and operational pressures for several months.

This escalation, he said, will aim to “stabilise the system” and help support the long-term delivery of care for people across the health board:

 “I am confident that, through these actions, we will soon have a clear plan to stabilise the system and set the right conditions for the necessary, longer term transformational work – with the key aim being to ensure the sustainable delivery of high-quality healthcare services for the benefit of local people.”

NHS Grampian was escalated to stage 3 of the NHS Scotland Support and Intervention Framework this January, after its financial position deteriorated from breakeven pre-pandemic to the highest overall deficit in NHS Scotland.

Board leaders were told earlier this year by the Scottish government its maximum allowed overspend would be £45m in 2025/26.

However, even with additional government funding and planned savings of £39m, the board still expects spend £68m more than its budget this year.

This remains the highest total financial overspend for any health board 2025/26.

NHS Grampian’s director of finance said in recent board papers the main factors driving overspends include a growing proportion of elderly people and patients with multiple conditions and the introduction of new technologies and medicines, adding that recruitment challenges have meant the board has had to rely on expensive agency staff.

Meanwhile, recruitment for a permanent chief executive of the board to lead improvements is underway, with interviews to take place early next month.

The Health Secretary plans to update parliament on the situation in NHS Grampian soon.

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