A struggling NHS board has been told by private management consultants to consider replacing up to 40% of its human resources, finance and procurement staff with AI to save money.

The proposal is one of 27 cost-cutting recommendations made to NHS Grampian by KPMG, as part of the private consulting firm’s review of the health board.

The Scottish government contracted KPMG to step in after escalating NHS Grampian to stage 4 of government oversight arrangements, amidst growing concerns around its finances, leadership and governance.

NHS Grampian is currently on track to overspend by almost £50m in 2025-26 – the worst financially performing board in Scotland.

According to the board’s recovery plan, it needs to find at least another £4.2m of savings – on top of the £60.4m already identified – to meet government expectations by the end of the financial year.

Published today, KPMG’s report says ‘leveraging technology to support or replace much of the administrative work performed by staff across bands 1-4’ could save the board up to £15.6m by 2030.

NHS boards in Scotland cannot make staff redundant, so KPMG suggests recruitment to these posts be paused to support a 30-40% reduction over the next five years.

Other cash saving proposals made in the report include converting long-serving agency staff to permanent or fixed term contracts and reforming procurement practice.

The review estimates if NHS Grampian adopted the full list of savings proposals it could claw back an additional £26.7m this year.

In response to the findings, NHS Grampian has committed to carefully consider all savings proposals.

However, these additional savings will still fall short of delivering financial balance to the board in the short-term.

Health Secretary Neil Gray MSP has announced the government will make an additional £5.9m available to NHS Grampian this year to help drive immediate improvements in A&E and unscheduled care performance.

He welcomed the KPMG report as an important part of NHS Grampian’s recovery process:

“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.”

The KPMG review also looked at leadership and governance arrangements and ways to optimise services.

The savings and improvement programme will be led by NHS Grampian Chief Executive Laura Skaife-Knight, with the oversight of a government assurance board.

Ms Skaife-Knight, who joined the board last month, said she is confident NHS Grampian’s financial and savings plans will be achieved this year:

“All savings schemes will continue to be carefully considered to ensure patient experience, clinical care and staff wellbeing is maintained or improved.

“We are committed to working collaboratively with our local, regional and national partners, and to working as a whole system so that ideas for improvement are designed and developed together for the benefit of the local communities we serve, and to openness and transparency as an organisation, all of which are critical to taking our organisation forward.”

Read more: Health board escalated over deepening financial risk; Struggling health board appoints new leader; 

 

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