NHS Grampian should review booming staffing levels amid big deficit, report says

NHS Grampian (NHSG) should review its booming staffing levels as part of efforts to curb its £64.9 million deficit, a review has found.

The Scottish Government ordered the review by auditors KPMG after escalating the health board to stage four out of five on NHS Scotland’s National Performance Framework.

The review examined issues with the board’s finances, leadership and governance and made several recommendations to save cash.

The report found that “transformational change” will be needed to tackle NHSG’s deficit which has grown from £24.7 million in 2023/24 to £64.9 million just a year later.

KPMG said there should be an independent review into staffing levels at NHS Grampian which have grown by 13.8% – or 1,343 whole-time equivalent staff – since 2019/20.

Despite the rise, there has been a decrease in the total number of beds and level of activity in the health board.

NHSG has identified £40 million of savings through its financial recovery plan. KPMG said it found between another £14.8 million-£26.7 million in savings in the short term and up to £45.7 million over the longer term.

The auditors recommended an investigation into the 39.8% rise in outpatient appointments from 2019/20 to 2024/25.

Reducing the number of outpatient appointments could save the board £15 million a year, they said.

The report found increased resources were not linked to increased performance, with outpatient procedures having decreased by 3.8% since 2019/20 while the usage of operating theatres fell by 8%.

The Scottish Government said additional funding of £5.9 million will be made available to drive immediate improvements in A&E performance and unscheduled care.

It said this will support ongoing work to shift the balance of care and reduce hospital occupancy including Hospital at Home, frailty services, and reducing delayed discharge.

Health Secretary Neil Gray said: “This additional funding will support improvements across unscheduled care in NHS Grampian – targeting measures to shift the balance of care towards the community by investing in Hospital at Home, frailty services and the Discharge to Assess programme.

“By improving the flow of patients through hospital, we can deliver real improvements for the people of Grampian.

“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. 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.”