NHS boss issues apology after ‘serious weaknesses’ found in NHS Grampian

Health bosses have apologised to patients for “letting them down” after a report found “serious weaknesses” in NHS Grampian.

A damning report from Healthcare Improvement Scotland (HIS) said it had “identified serious weaknesses in all aspects of leadership and management of the medical workforce across the acute sector of NHS Grampian”.

Citing issues including a lack of workforce plans, poor recruitment controls and “significant concerns” about how doctors are managed, HIS added that these failures are impacting patient care and patient safety.

It comes after NHS Grampian chief executive Laura Skaife-Knight called in HIS in May this year to carry out a “diagnostic review” of services in the wake of “significant concerns”.

After it was published Ms Skaife-Knight acknowledged it had “identified serious failings within NHS Grampian”.

She stated: “As a board we own and accept the findings, we apologise to our patients, families and communities for letting them down and we commit to putting things right. ”

Health Secretary Angela Constance meanwhile made clear that she expected “decisive and urgent action” from NHS Grampian.

Ms Constance said: “The findings of this report are extremely serious and will be deeply concerning for patients, families, local communities and staff across Grampian.

“It identifies significant failings in leadership, governance, accountability and organisational culture.”

The Health Secretary added that “given the seriousness of these findings” she expected the board of NHS Grampian to “immediately make changes in medical leadership and to carry out any further necessary changes at a senior level to restore confidence in services”.

Ms Constance, who is due to visit NHS Grampian on Friday for the health board’s annual review, insisted: “This must be a turning point for NHS Grampian and the board must act with urgency in addressing the serious concerns.”

Her comments came after HIS highlighted “serious concerns” about a significant adverse event review (SAER) that was carried out after a patient died during surgery as a result of complications.

This review, it said, “contained a major omission by not meaningfully examining the actions, clinical decision-making, operative techniques or judgments of the operating surgeons involved”.

And HIS added: “Given the nature of the incident, this omission represented a notable, concerning and unjustifiable failure of governance and a missed opportunity to improve patient safety.”

It also revealed that although NHS Grampian temporarily suspended paediatric surgery in June 2026 following “patient safety concerns”, senior management at the board discovered in August that this had not been “fully enacted”.

Eddie Docherty, the director of quality assurance and regulation at HIS Scotland, said NHS Grampian had notified them that elective paediatric dental and ENT surgery had continued until August 6- with Mr Docherty stating: “This affected our confidence in the reliability and consistency of the information received from NHS Grampian.”

Overall HIS found that scrutiny and oversight from the NHS Grampian board were “inadequate” and that “NHS Grampian’s leadership and management of the medical workforce are weak”.

The report said there were “serious weaknesses in all aspects of leadership and management of the medical workforce across the acute sector of NHS Grampian”.

It stressed these problems were not just present at Dr Gray’s Hospital in Elgin – where it found that key services were “functioning in isolation rather than as part of a cohesive and resilient NHS Grampian model”.

Issues identified across the health board area included “lack of workforce plans, poor recruitment controls, failure of job planning, failure to engage with and deliver changes in clinical practice and interface working, and significant concerns in how doctors are managed”.

HIS added: “These failures are impacting on clinical governance, clinical supervision of resident doctors in training, patient care and patient safety.”

The report also said that “insufficiently effective executive leadership and oversight have allowed some unacceptable arrangements to become normalised, with concerns persisting despite repeated attempts to address them”.

Simon Watson, the medical director at HIS, said: “Our report identifies recurring patterns of harm and points to the need for stronger systems of learning and improvement to ensure that lessons are acted upon and similar incidents are prevented in the future.

“It provides a clear diagnosis of significant problems in key aspects of clinical governance.

“There are findings that will make difficult reading for NHS Grampian’s leadership and will understandably raise concerns among patients, the public and staff.

“We found weaknesses in clinical governance systems, leadership and organisational oversight. These are essential for an organisation to provide assurance to patients, staff and the public about the safety and quality of care they provide.”

Ms Skaife-Knight accepted that “the report makes for very tough reading”.

The NHS Grampian chief executive said: “It describes features of our leadership, governance and culture which are unacceptable and which cannot continue as I take this organisation forward.”

She said that “immediate changes” had been made to medical leadership, with an interim medical director due to start on Monday November 16.

She added: “Most concerning are the unacceptable delays in investigating and implementing learning from incidents involving patient care which can prevent us from making the changes necessary to keep patients safe.

“I know these findings will cause concern to our local community, particularly for patients and families who may have questions about their own care.”

A dedicated phone line has been set up – 08085 202030, which is available from 8am to 6pm on weekdays from today, “for anyone who has specific concerns and wants to speak to us”, she stated.

Ms Skaife-Knight stressed: “Our focus is now about responding at pace to the feedback and making the improvements needed that are now long overdue.”