Damning NHS Grampian report ‘appalling’ says John Swinney

A damning report into failures at NHS Grampian made for “appalling reading”, John Swinney has said.

The first minister pledged to leave “no stone unturned” to improve patient safety after Healthcare Improvement Scotland (HIS) said mistakes had caused “repeated and avoidable harm”.

The matter was raised by Scottish Labour leader Michael Marra during First Minister’s Questions, who challenged the Scottish Government for not intervening sooner given ministers knew of concerns about the health board over several years.

The HIS report concluded that there were “very serious shortcomings” with the health board’s leadership and oversight of clinical governance, which led to failures in learning from adverse events.

It focused in particularly on Dr Gray’s Hospital in Elgin, which continued to operate on some children despite being ordered to halt paediatric surgery.

Swinney acknowledged prior problems at the health board which saw it formally escalated to stage 4 status in May 2025, but he added that “most recent issues are of a much greater escalated level of severity”.

He said the recommendations of the assurance board brought in in 2025 had not been taken forward, leading to the instigation of the HIS inspection.

HIS was asked to review the situation by NHS Grampian’s chief executive Laura Skaife-Knight, who started in that role in September 2025.

Swinney said: “The government is taking incredibly seriously the content of the Healthcare Improvement Scotland report. Changes have been made immediately in relation to the leadership of the board, and we will leave no stone unturned to make sure that the services and the safety of the patients particularly in NHS Grampian is at the centre of the steps taken by the government to strengthen the position in the Grampian area.”

Health secretary Angela Constance is to make a statement to parliament on Tuesday to provide further information on action to be taken to handle the matter.

Earlier this month she confirmed the appointment of a new interim chair of the board, John Connaghan.

Marra said the first minister was “right to condemn this in the strongest possible terms”, but also called for the board of NHS Grampian to go.

He said issues at the health board had been “known about for years”. He added: “This is a long-term challenge in the governance and operation of NHS Grampian that the government have failed to get on top of, despite repeated challenges from outside bodies and from parliamentarians over that period of time.”

The Scottish Labour leader also said this was part of a “broader cultural problem at the top of our health service” that goes beyond NHS Grampian, citing issues at the Queen Elizabeth University Hospital in NHS Greater Glasgow and Clyde, and the Eljamel inquiry involving NHS Tayside.

Swinney agreed that those leading public services must be accountable and transparent about any weakness.

“I am being absolutely transparent about the weakness of NHS Grampian today. I am not trying to defend a thing. There is a lot that’s got to change there to address the legitimate issues that are raised here,” the first minister added.

The HIS report points to major deficiencies in the health board’s review of a patient’s death during surgery, and went on to highlight “systemic issues and recurring weaknesses” in leadership, governance, workforce, culture and transparency.

Simon Watson, medical director at HIS, said: “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.

“We were particularly concerned about problems in the way NHS Grampian investigates its most serious adverse events. These concerns were mostly focussed on the senior leadership of the organisation.”

NHS Grampian has accepted the findings of the report.

Rabina Tindale, interim executive director of nursing, midwifery and AHPs, said: “We fully acknowledge the areas where improvement is required and accept the findings of the reports.

“Many of these areas had already been identified by the board with work underway to address them as part of our already agreed priorities for 2026/27, including improving appraisal and mandatory training rates in the organisation.

“We remain committed to delivering safe, high-quality maternity care and will continue to work closely with our staff, women and families, Healthcare Improvement Scotland and our partners to deliver the improvements identified.”